Endocrine Abstracts

Introduction: Diabetic Ketoacidosis (DKA) is a potentially life-threatening complication of type 1 diabetes mellitus (T1DM) in children and young people (CYP). A 5th edition Integrated Care Pathway (ICP) for the management of DKA was published in 2022 in Wales based on updated guidance from BSPED, NICE, and the UK resuscitation council.Objective: To audit the management of DKA in CYP at Noah’s Ark Children’s Hospital for Wales following the int...

Introduction: Heterozygous mutations of PAX6 gene are known to cause congenital eye abnormalities including aniridia. The gene is also required for islet cell development and mutations are associated with glucose intolerance. We report the case of a boy with known PAX6 mutation and aniridia who developed hyperglycaemia.Case: A 15 year old boy presented to the emergency department with hyperglycaemia after reporting intermittent testicular discomfort to h...

HbA1c is a critical marker of long-term glycaemic control and is pivotal in managing diabetes-related complications. Appointment adherence plays a crucial role in diabetes management, enabling healthcare providers to monitor and address patient needs effectively. This audit investigates the correlation between appointment adherence and HbA1c levels in Young Adult Diabetes Clinic patients while also identifying patient characteristics associated with high DNA (Did Not Attend) r...

Introduction: Type 1 diabetes is an Autoimmune disease which usually presents in metabolic decompensation with absolute insulin deficiency. Presentation can vary from mild osmotic symptoms to severe Diabetes ketoacidosis (DKA). We have observed a recent increase of incidence of severe DKA. The aim of this audit was to assess the relationship between severity of presentation and body mass index.Methodology: A descriptive cohort study was undertaken in 55 ...

Introduction: Insulin oedema is an uncommon consequence of insulin therapy and may be overlooked in the differential diagnosis of bilateral limb swelling in paediatric patients. We report two cases of insulin oedema.Case 1: An 11-year-old female with Type 1 Diabetes Mellitus (T1DM) and mild Diabetic Ketoacidosis (DKA) presented with blood glucose of 31.3 mmol/l, H of 51nmol/l, HCO3 of 14 mmol/l, and HbA1c of 130 mmol/mol. She received IV fluids and insul...

Introduction: Glucose monitoring and administration of insulin are critical components of type 1 diabetes management in children. Increasingly, technology such as continuous glucose monitors (CGMs) and insulin pumps are being used in a ‘closed loop’ system to effectively manage diabetes in children.Aim: To evaluate the impact of a closed loop system via the Omnipod 5 pump and Dexcom G6 CGM system on glycaemic control in a cohort of children at ...

For 19 years the National Paediatric Diabetes Audit (NPDA) has worked with hospitals across England and Wales to measure the health outcomes and experiences of children and young people living with diabetes. The data collected and the published reports have become a staple resource for paediatric diabetes units (PDUs) and networks to get an overview of their population. Alongside the NPDA annual reports, PDUs have access to unit level reports, an online extraction tool and the...

Introduction: Wolfram syndrome (WS) is an ultra-rare form of progressive neurodegeneration with diabetes mellitus and optic atrophy as the key clinical manifestations in childhood. Birmingham Children’s Hospital (BCH) is the UK lead centre for management of paediatric WS. In recent years, monitoring of glucose in diabetes management increasingly involves continuous glucose monitoring sensors (rtCGM) rather than capillary blood glucose meters (CBG). Using rtCGM in type 1 d...