Endocrine Abstracts

Introduction: One third of children in the UK are overweight or obese. The Obesity Services for Children and Adolescents (OSCA) group have agreed upon a guideline for paediatricians on the assessment and management of obese children.

Audit aim: To evaluate and improve the care of obese and overweight children.

Method: Obese patients seen in secondary care were retrospectively audited from 2008 to 2014.

Results: 82 patients were included with a median age of 10.9 years. 52.4% (n=43) were male. Median BMI at presentation was 29.20 kg/m². 53.7% patients (n=44) were morbidly obese (BMI >3.33 S.D. above mean). 76.8% patients (n=63) had ≥1 blood investigation within the first year. 53.7% (n=44) had thyroid function tests, 9.1% (n=4) showed raised TSH. 39.0% (n=32) had fasting glucose performed, 6.3% (n=2) showed raised fasting glucose. 19.5% (n=16) had a fasting insulin level, 43.8% (n=7) showed hyperinsulinaemia. 35.4% (n=29) had lipids investigated, 31.0% (n=9) showed dyslipidaemia. 50.0% (n=41) had an ALT level, 4.8% (n=2) showed ALT >70 U/l. 20.7% patients (n=17) had an OGTT. 94.1% of OGTT (n=16) were normal. 5.9% (n=1) was diagnostic of T2DM. 86.6% patients (n=71) were offered follow-up with a median interval of 4 months. 70.7% patients (n=58) were referred to dieticians, 55.2% of these (n=32) attended. Lifestyle changes were reported by 76.9% patients (n=52) at follow-up. 8.5% patients (n=7) were started on metformin. 3.7% patients (n=3) were trialled on orlistat.

Conclusions: The management of obese children was variable. Data suggests 20–25% obese children in the UK population could have ≥2 cardiovascular risk factors. Co-morbidities may have been missed in this cohort. Local guidelines are to be implemented in order to standardise care with re-audit in 2 years.