Endocrine Abstracts

Introduction: Diabetic Ketoacidosis (DKA) is a medical emergency and major cause of mortality in children with type 1 diabetes (T1D). Careful evaluation is needed to identify expected and more unusual complications of DKA.Case report: A 16 year old male with poorly controlled T1D presented with severe DKA; he reported excessive vomiting and had severe abdominal pain. He informed taking ‘Ecstasy’ (3,4-methylenedioxymethamphetamine; MDMA) twice i...

Background: NICE guidelines (NG18) state that paediatric patients aged <18 years old with suspected diabetes mellitus (DM) should be immediately referred to specialist care to confirm diagnosis and provide immediate treatment. The Nottingham University Hospitals (NUH) Paediatric Endocrine team advise primary care to investigate suspected hyperglycaemia using a POCT (point of care testing) glucose meter at the primary care facility to avoid the delay incurred by sending a s...

Introduction: Flash glucose monitoring is increasingly used in the management of T1DM. Although the FreeStyle Libre reduces the overall burden of conventional self-monitoring of blood glucose, capillary glucose should be checked at times of Libre-predicted extreme hypo/hyperglycaemia.Methods: Consenting FreeStyle Libre users completed a structured questionnaire via phone interview. Users reported incidence of extreme hypo/hyperglycaemia (indicated by LO/...

Introduction: It is essential that children and young people with diabetes are supported to manage their diabetes effectively to prevent the development of early complications. However, the common clinical challenge is difficultly in engaging adolescents and young people to achieve good glycaemic control in their diabetes management. Solution Focus Therapy (SFBT) has been found to be especially beneficial with children, adolescents and teenagers because it is a brief model tra...

Introduction: Diabetic Ketoacidosis (DKA) is a known risk factor for ischaemic and haemorrhagic stroke in children and young people. Cerebral oedema may predispose to ischaemic or haemorrhagic brain injury, however not all cases of stroke are associated with cerebral oedema. This case illustrates severe complications of DKA including ischaemic stroke and cardiac arrest, and raises questions about fluid management in severe DKA.Case report: We describe th...

Background: It has been proved that calculating the accurate amount of carbohydrate intake and good compliance in carb counting play a major role in in diabetes management.Method: All patients who came to diabetes clinic at Hinchingbrooke Hospital in one-month duration were requested to complete the designed questionnaires anonymously and 17 patients/carers returned the results to the diabetes secretary. We asked about the methods they were using for car...

Introduction: Newly diagnosed type 1 diabetes is characterized by a transient partial remission period (‘honeymoon’), starting shortly after initiation of insulin treatment and during which the patient’s requirement for exogenous insulin treatment declines. Improvement of peripheral insulin sensitivity as well as a partial beta-cell recovery with improved insulin secretion was speculating to contribute to the pathogenesis of this phenomenon.<p class="abstext...

Cardiac complications including cardiac arrest in Diabetic Ketoacidosis (DKA) have been reported in adults but is not common in children. We present a case of a 3½ year old child with new onset Type 1 Diabetes who presented in severe DKA and went into cardiac arrest needing prolonged resuscitation after starting insulin infusion due to rapid drop of serum potassium (K+). Serum K+ on presentation was 2.8 mmol/l and dropped to 1.5 mmol/l within 2.5 h of starting insulin lea...