Endocrine Abstracts

Approximately 30% of children aged 2–15 years old in the UK are now either overweight or obese. There is some guidance on appropriate management within the UK for paediatricians, including a consensus statement by the Obesity Services for Children and Adolescents (OSCA) network. Obese patients referred to a tertiary paediatric endocrine clinic between January 2010 and December 2011 were audited retrospectively, with follow-up until the end of December 2012 included. Children with recognised syndromes, diabetes, underlying endocrine and oncology diagnoses were excluded. We looked specifically at investigations performed, medical interventions, follow-up and response to metformin. Twenty-nine new patients (55% females) were identified and followed up, with a median age at first clinic attendance of 13.5 (2.8–17.1) years. Median BMI was 35.0 kg/m². Ninety-seven per cent had BMI SDS ≥2 at presentation; 36% BMI SDS >3.5 (very severely obese). Ninety-three per cent (n=27) of patients had at least one blood investigation. All (n=25) thyroid function tests taken were normal. Seventy-nine per cent (n=23) of patients had either a fasting insulin level (16 patients) or an oral glucose tolerance test (seven patients): 74% had insulin resistance; 4% (one patient) had impaired glucose tolerance. Fourteen per cent were concomitantly diagnosed with polycystic ovarian syndrome. Forty-one per cent (n=12) were commenced on metformin. Six patients (20.7%) were discharged after the first visit. Eight patients (27.6%) were still under follow-up at the end of the study period; all of these were on metformin, with a median BMI change of −0.03 kg/m² (−3.6 to +2.7 kg/m²). Our audit illustrates the significant patient load obesity currently has within a tertiary endocrine clinic and the variations in response to treatment. Management requires standardised guidelines advocating appropriate assessment and intervention in clinical management.