Endocrine Abstracts

Introduction: 45XO/46XY karyotype has varied phenotypic spectrum ranging from short stature, ambiguous genitalia (60%), clinical signs of Turner’s syndrome in both males and females and normal male phenotype. We report six phenotypically male cases with a varied clinical presentation.Case 1 and 2: Short stature: Two pre-pubertal, phenotypical males, were referred with concerns regarding short stature (height <0.4th centile, height velocity &#150...

Background: 71/270 (26%) of our patients with T1DM, diagnosed for more than 1 year, had an ideal HbA1c of less than or equal to 48 mmol/mol. Are there factors within this group that may be transferred into groups with higher HbA1cs to improve control?Methods: Clinical records were reviewed for the whole year and download data from a randomly selected 2 week period was reviewed. Age, gender, time from diagnosis, ethnicity, postcode, other medical conditio...

Introduction: ‘Transition’ is the period of movement from paediatric to adult healthcare. These patients are in their adolescence when the brain is maturing, causing changes in behaviors including greater risk-taking. The period of transition can be associated with poor adherence to insulin and blood glucose monitoring regimens and an increased risk of diabetic ketoacidosis (DKA). This study looks into how effective our transition programme has been at addressing thi...

Rationale: Although many adolescents meet the NICE criteria for bariatric surgery there is a reluctance to undertake or commission such irreversible procedures in young people. Balloons are temporary, reversible, safer and more acceptable and in adults have been shown to promote a clinically significant change in BMI of 4.0–9.0 kg/m2 But due to subsequent weight regain, bypass surgery is preferred.This is a feasibility study of endocsopic...

Background: Non-attendance in outpatient clinics results in administrative problems, economic loss and poor patient care. Mobile phone intervention has been shown to be effective in improving attendance rates in chronic disease follow up. A pilot study conducted over 9 months in our diabetes clinic showed improved attendance following phone calls and text messages sent to carers/young people prior to their clinic appointment (statistical significance reached when patient spoke...

Background: Adrenal suppression is a well recognised complication of inhaled corticosteroids. Committee for Safety of Medicines (CSM) guidelines (2006) recommend that children taking high dose inhaled corticosteroids (HDICS) are tested for adrenal insufficiency. Patients requiring steroid replacement require a steroid card and written advice on steroid replacement in acute illness.Aims: To determine the impact of CSM guidelines on the use of short synact...

Background: The paediatric diabetes team at our Children’s Hospital were part of a national clinical trial considering whether long term outcomes are better for patients on MDI (multiple daily injection therapy) or insulin pump therapy from diagnosis. Patients and their families had to be approached, consented and treatment for the trial commenced within two weeks of diagnosis. Many centres struggled to recruit, but this was not the case with our centre.<p class="abst...

Background/Introduction: The Best Practice Tariff was introduced in 2012 in England and Wales to provide adequate funding and ensure quality care for all children with Diabetes. The tariff criteria states that units must provide “24 hour access to advice and support” including “24 hour expert advice to other healthcare professionals”. The aims of this audit were to: evaluate the Nottingham Children’s Hospital out of hours paediatric diabetes service, d...

Introduction: The Best Practice Tariff states that units must provide a structured education programme which should be ‘tailored to the child’s needs, both at the time of initial diagnosis and ongoing updates’. Traditionally, there has been poor uptake of our education sessions with attendance rates of 20% (range 0–30). Therefore, an integrated education clinic was introduced which combined education within a multidisciplinary (MDT) clinic session for ongoi...

Background: Children and Young People (C&YP) with poorly controlled diabetes are at increased risk of diabetic ketoacidosis (DKA) and long-term sequelae. There is no clear evidence about how best to manage them. NPDA data highlights that UK numbers are in decline, but still constitutes 21.3% of C&YP with diabetes. The high HbA1c pathway at Nottingham Children’s Hospital (NCH) aims to systematically identify and support C&YP with HbA1c >80 mmol/mol. It prov...