ESPE Abstracts

Objective and hypotheses: The aim of the study is comparison of the occurrence of islet autoantibodies in healthy siblings of children with T1DM to healthy children from non-diabetic families.Method: Determination of anti-decarboxylase of the glutamic acid antibodies (anti GAD-Ab), anti-protein tyrosine phosphatase (anti IA2), and antibodies against zinc transporter eight (anti ZnT8) in 75 children with T1DM, their siblings – 105, and 77 healthy chi...

Background: Ambulatory blood pressure monitoring (ABPM) permits the observation of blood pressure (BP) in a nonmedical environment. In adults, ABPM is better related to renal damage and cardiovascular morbidity than office BP readings. In early stages of type 1 diabetes (T1DM), the role of ABPM is still controversial.Objective and hypotheses: To detect blood pressure abnormalities using 24-h ABPM in children and adolescents with T1DM and to determine the...

Background: The pathogenesis of type 1 diabetes (T1D) is multifactorial, caused by interaction of genetic, epigenetic and environmental factors that lead to the production of antibodies early on life and a gradual loss of insulin secretory capacity of the pancreas. The genetics and immunological characteristics of our T1D population have not been precisely identified.Objective and hypotheses: To compare biochemical, genetic and immunological features of ...

Background: There is limited knowledge in children younger than 6 years of age about the safety and efficacy of CSII treatment during long periods of time.Objective and hypotheses: Evaluate the efficacy and safety of CSII treatment in pre-schoolers with T1D, assess if ISPAD/ADA criteria for good metabolic control are achieved and define general and specific characteristics of the treatment in this range of age.Method: Charts of pat...

Background: T1D concordance in MZ twins being ~40%, non-heritable factors play a major causal role in this autoimmune disease. T1D has recently increased in young European children. Collecting prospective environmental data in a cohort of millions children-years starting soon after birth seems unpracticable. Retrospective case–control studies are an alternative, provided biased controls and recall bias can both be avoided.Objectives: To develop a &#...

Background: While non-autoimmune T1D is rare in late childhood, few monogenic causes have yet been identified.Objective: i) to identify the genetic basis of the yet unreported disease phenotype associating late childhood antibody-negative T1D, short stature, optic atrophy (OA), Pelger-Huët anomaly (PHA) of leukocytes and recurrent liver cytolysis: the ‘DISOPHAL’ syndrome; ii) to attract comparable cases for further genetic investigation.</...

Aim: To delineate the diagnosis in a case of antibody negative infantile onset diabetes with deranged liver function.Case Report: A female child, first born of consanguineous couple presented with Diabeteic Keto Acidosis and acute liver failure at 9 months of age. She has been treated as a case of Type I diabetes and was discharged on insulin. Child was further evaluated at our center at 11 months of age. On examination, she had a normal anthropometry an...

Background: CSII has some potential advantages and disadvantages for young children. For many young patients, it is easier and more convenient to take multiple daily doses of insulin with CSII than with a syringe or insulin pen.Objective and hypotheses: The growing popularity of type 1 diabetes (DM1) treatment based on continuous subcutaneous insulin infusion (CSII) raises a question of the group of patients that benefit most from the treatment.<p cl...

Background: There are studies supporting the seasonality of diabetes according to date of diagnosis and date of birth, with most T1D children being diagnosed in fall and winter and most of them been born in the same period. That is in concordance with previously published data from 1978 to 2008 in our country.Objective and hypotheses: To assess whether there is a seasonal variation of diabetes onset according to date of diagnosis and date of birth of inc...

Background: Abnormalities in glucose homeostasis are fairly common complications in thalassemia major (TM) patients. This study aimed at determining the incidence of diabetes mellitus (DM) and studying the potential factors responsible for secondary DM of TM patients.Objective and hypotheses: A total of 54 (33 male) transfusion-dependent TM patients were in the ‘TM group ’; 25 age- and gender-matched healthy children were recruited as the &#145...

Introduction: Wolfram Syndrome (WFS: OMIM 222300), also known as DIDMOAD (diabetes mellitus, optic atrophy and deafness) is an autosomal recessive, progressive, neurologic, and endocrinologic, degenerative disorder caused by mutation in the WFS1 Gene. This report presents a case with a new defined mutation in WFS.Case presentation: Fourteen-year-old male patient was diagnosed with non-autoimmune type I diabetes at the age of 5 and insulin treatment was a...

Introduction: There is no valid evidenced-based recommendation for the optimum basal insulin dose in type-1 diabetes mellitus when supplied either by continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). We studied this previously by evaluating the dose associated with successful fasting. Another way of looking at this is by evaluating the association between basal insulin dose and HbA1c. To this end we performed a retrospective study of 89 childr...

Background: There is a direct relation between C-reactive protein and leukocyte count as indicators of inflammation. The neutrophil lymphocyte ratio (NLR) is the balance between both cells and is considered a marker of low-grade inflammation and an indicator of high risk of cardiovascular events. An elevated NLR is related with type 2 diabetes (T2D), however, even when in type 1 diabetes (T1D) there is an underlying inflammatory process, an elevation of circulating neutrophils...

Objective: To evaluate the pancreatic reserve and metabolic control in our patient diagnosed of type 1 diabetes over the last 20 years.Method: Retrospective cohort study of all patients <15 years, diagnosed in our community between 01/01/1995 and 31/12/2014. Variables: gender, age at diabetes debut, age at study, c-peptide after stimulation with glucagon at debut and 1 month after, HbA1c at debut, 1 month, 1 year, 2 years, 5 and 10 years of debut. Co...

Background: The Best Practice Tariff (BPT) was introduced in England in 2011–2012 to improve paediatric diabetes care. An enhanced amount is paid based on the attainment of 14 standards.Objective and hypotheses: We describe the experience of a District General Hospital working with the new Tariff, including the structural changes and the effect on diabetic control.Method: We observed the changes to the local service since the ...

Background: Cardiovascular risk and obesity are rising problems among individuals with type 1 diabetes (T1D). Interventions targeted at decreasing cardiovascular risk in patients with diabetes may be most effective during adolescence and young adulthood, before atherosclerotic lesions become advanced or cardiac changes become irreversible.Objective and hypotheses: The aim of this study was to evaluate the prevalence of cardiovascular risk factors and obe...

Background: Children with type 1 diabetes (T1D) and their parents need personalized i) information about the disease and glucose homeostasis and ii) knowledge and guidelines about diet and insulin therapy.Objectives: To set a complete educational program that allows children with T1D to improve disease management and daily life.Methods: Education modules were written and trained with children and parents at outpatient visits. Each ...

Background: Mucormycosis which is an invasive fungal disease and commonly seen in immunocompromised patients is very rare in the diabetic children.Case report: We present a case with type 1 diabetes with mucormycosis. A 14-year-old male patient was referred to our department due to polyuria, polydipsia, weight loss, headache, altered consciousness, fever, and rhinorrhea. After the diabetic ketoasidosis treatment, left facial paralysis, anisocoria, and pt...

Background: Insulin pumps have been used for the management of type 1 diabetes for over 15 years in the west. However similar experience is lacking in India where multi dose insulin injections still form the mainstay of management of type 1 diabetes. In a first study of its kind from India, we attempt to highlight the effectiveness, safety and superiority of insulin pump use in type 1 diabetes.Objective and hypotheses: To determine the impact of insulin ...

Background: The GATA family of zinc finger transcription factors including GATA4 and GATA6 are known to play an important role in the development of the pancreas.Aim: The aim of this case-report study is to present a patient with GATA6 mutation treated in Clinic of Pediatric, Diabetology and Endocrinology, Medical University of Gdansk.Case report: Child was born prematurely in 36th week of pregnancy with birth weight of 1520 g, wit...

Background: Diabetic Ketoacidosis (DKA) is a serious and common complication of type 1 diabetes mellitus. Often it occurs due to non-compliance of the patient’s insulin regimen, especially of the basal insulin. In this patient, about 6 months after being diagnosed, she presented to the emergency department in DKA, with a pH of 6.9 with altered mental status, which required intubation for 1 week. She was treated with an IV insulin drip and fluids. As a result of her manage...

Background: Type 1 diabetes mellitus (T1DM) in children carries significant psychological stress for families, as well as considerable long-term complications if good metabolic control is not achieved. Tighter metabolic control carries increased risk of hypoglycaemic episodes, and previous research suggests that families with a high fear of hypoglycaemia will run blood sugars higher in order to avoid this. Continuous glucose monitoring (CGM) provides real time temporal measure...

It is known that more checks of blood glucose, metabolic control of patients with type 1 suffering Dm improvement. Improved technology has made it possible to develop devices interstitial glucose control both blinded (retrospective) and open (in real time). The FREE STYLE free device is the latest appearance on the Spanish/European market. Although initially not seem indicated in <18 th, these are the a priori more could benefit from an improvement of metabolic control.</p...

Background: Permanent neonatal diabetes (PND)with heterozygous mutations of KCNJ11, respond to treatment with sulphonylureas. We report a case of PND in a baby, and mother previously mis-diagnosed with Type 1 DM. Both were switched from insulin to oral sulphonylureas. We evaluate the response and evolution.Case report: A male newborn at 37 weeks’ gestation, with a birthweight 2750 g (40thC) and length 48 cm (40thC), was admitte...

Background: Cystic fibrosis is an autosomal recessive genetic disorder affecting typically the lungs, the pancreas, the gastrointestinal tract and tissues that produce mucus secretion, such as sweat glands. Impaired glucose tolerance and cystic fibrosis-related diabetes are the most common complications of cystic fibrosis. Cystic fibrosis-related diabetes is another type of diabetes mellitus and carries some of the characteristics of type1 and type2 diabetes.<p class="abst...

Background: Diabetic ketoacidosis (DKA) is the most serious acute complication of type 1 Diabetes mellitus (T1DM). It is important to know the factors associated with the development of DKA and elaborate preventive strategies to reduce their prevalence.Objective and hypotheses: To identify DKA predictive risk factors in the initial presentation of T1DM in children and adolescents.Method: We conducted a retrospective study, by analy...

Background: The non-physiological ways and supraphysiological doses of insulin required for good glycemic control in patients with type 1 diabetes right from onset exposes them to effects of hyperinsulinism. In addition insulin resistance may be seen because of glucose toxicity and abnormal fat mass gain during puberty Insulin acts synergistically with luetinizing hormone to facilitate androgen production by theca.Objective and hypotheses: To investigate...

Background: Diabetic Ketoacidosis (DKA) is a serious complication of type 1 diabetes mellitus (T1DM) that require prompt recognition, diagnosis and treatment. There is wide geographic variation in the frequency of DKA at onset of diabetes.Objective: To determine frequency of DKA in children and adolescents with newly diagnosed type 1 diabetes admitted to a tertiary care hospital in Turkey.Methods: A retrospective study was undertak...

Wolcott-Rallison syndrome (WRS) is a rare autosomal recessive disease characterised by neonatal/earlier-onset non-immune insulin –requiring diabetes associated with skeletal dysplasia and growth retardation. WRS is caused by mutations in the gene encoding eukaryoutic translation initiation factor 2 a kinase (EIF2AK3), which plays a key role in translation control during the unfolded protein response. In the endocrinological department of Ternopil Childrens’ Hospital ...

Background: MODY is characterised by an early onset of diabetes and a positive family history of diabetes with an autosomal dominant mode of inheritance. We report a 15 year girl with a HNF1A mutation who presented with MODY without a positive family history.Objective and hypotheses: HNF1A-MODY is often misdiagnosed as type 1 or type 2 diabetes. Genetic confirmation of MODY in insulin-treated patients helps in making changes in the treatment modality as ...

Background: Continuous Glucose Monitoring (CGMS) is a useful method to detect the variability of glucose fluctuations and offers the opportunity for better assessment of glucose homeostasis in TM patients and response to therapy.Objective and hypotheses: Does real-life monitoring of blood glucose add to the therapeutic approach to patients with TM who have glycemic abnormalities?Method: In two thalassemic adolescents with glycemic ...

Background: Diabetic Ketoacidosis (DKA) in newly diagnosed children with Type 1 Diabetes (T1D) has been associated in previous studies with several factors, such as age or season of diagnosis.Objective and hypotheses: The aim of the present study was to assess the impact of age, gender, birth order and seasonality in DKA occurrence in newly diagnosed T1D pediatric patients.Method: Data of children aged 0–14 years newly diagnos...

Background: Several studies have described ethnic differences in HbA1c. Non-Caucasian patients have been found to have an higher HbA1c than the Caucasian ones. These differences have often been attributed to disparities in access to medical care or quality of the care.Objective and hypotheses: Differences in Hba1c among the ethnicities could be related not only to mean glycaemia. The aim of our study was to observe if, at the same level of mean glucose, ...

Background: Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes (T1DM). Although dehydration and electrolyte imbalance can be present in patients with DKA and T1DM, gastrointestinal tract complication remains unusual, especially in children. We report a child case of newly onset T1DM who developed acute ischemic intestinal necrosis with severe DKA combined with hypernatremic hyperosmolarity.Case re...

Case: A South Indian boy diagnosed with ataxic telangectaisa(AT) since aged 5 years (homozygous mutations for ATM gene at C1966A>C and 1968-X.delI), presented with type 2 diabetes (T2DM) aged 15.9 years. There was a 4-week history of polyuria and polydipsia without weight loss. Investigations showed fasting glucose 11.5 mmol/l, insulin 209 pmol/l, HbA1c 103 mmol/mol, negative glutamic acid decarboxylase and islet cell antibodies, and urinary C-peptide 2.84 nmol/mo...

Background: Type 1 Diabetes (T1DM) is one of the most common paediatric endocrine disorders in India, but diagnosis is often delayed. Moreover, systematized data about symptoms, presentation, management and follow-up of T1DM in India is lacking. Absence of such data makes formulation of uniform region and nationwide protocols for diagnosis, management and follow-up of T1DM patients difficult.Objective and hypotheses: To generate data about presentation a...

Background: Obesity epidemic is associated with diabetes and it’s complications at young age. Meanwhile, there is no recommendation concerning stratification as a risky for the overweight without dysglycemia by WHO criteria.Objective and hypotheses: Insulin response during OGTT might be dependent on BMI and can reflect preclinical stage of dysglycemiaMethod: 72 otherwise healthy adolescents aged 13.56±2.47 y.o. were exami...

Background: The classical presentation of type 1 diabetes mellitus is as diabetic ketoacidosis. As health awareness and access to healthcare improves, more subjects with type 1 diabetes are diagnosed early and present with less severe forms of hyperglycaemia. India accounts for most of the children with type 1 diabetes in South East Asia, but studies on the initial presentation is lacking from India.Objective and hypotheses: The aim of the study was to a...

Background: Type 1 diabetes mellitus (T1DM) is one of the most common chronic disease in childhood. Evaluation of the factors that have impact on the glycemic control and developement of complications would help to develop preventive strategies for management of this group of patients.Objective and hypotheses: To evaluate epidemiological, presenting and follow up characteristics and their relationship with glycemic control in pediatric T1DM patients from...

Background: Diabetes mellitus type 1 (T1DM) is the most common chronic diseases in children. Studies show that the prevalence of vitamin D deficiency is higher in this group of patients.Objective and hypotheses: The aim of this study was evaluation HbA1C and IGF-1 levels in children with T1DM that receiving vitamin D supplement.Method: A total of 30 diabetic children 5–15 years with 25(OH) D levels lower than 74 nmol/l (29 ng/...

Introduction: Childhood obesity is an important public health problem with increasing prevalence. Type 2 diabetes (T2DM) is strongly associated with obesity and metabolic syndrome. Adressing obesity and insulin resistance by drug treatment represents a rational strategy for the prevention of T2DM.Aim: The aim of our study was to evaluate the one year metformin treatment’s long-term effectiveness in children and adolescent.Meth...

Background: The two most commonly known types of Diabetes Mellitus (DM) are DM type 1 and DM type 2, characterized by insulin deficiency and insulin insensitivity, respectively. DM can also be associated with rare mutlisystemic syndromes such as Alstrom, Bardet-Biedl, Wolfram and pigmentary hypertrichosis insulin dependent diabetes (PHID) syndromes.Objectives: To understand the genetic and molecular basis of syndromic DM in a large cohort of patients.</p...

Background: Type 2 diabetes (T2DM) increases in parallel with obesity in childhood. T2DM can be associated with cardiovascular risk (CVR) even childhood.Objective: To investigate the presence of CVR criterions in children with T2DM and to detect CVR as the earliest age as possible.Method: This study enrolled 84 (58 Girls) children with T2DM. OGTT was performed in 47 children. Biochemical and hormonal analyses were performed in fast...

Itroduction: Thiamine responsive anemia (TRMA) known as Rogers syndrome; is an early-onset, autosomal recessive disorder characterized by diabetes mellitus, megaloblastic anemia and sensorineural deafness. Diabetes in this condition is well described in infancy but has only very rarely been reported in association with neonatal diabetes.Case: 3-months old male patient with neonatal diabetes was admitted to our outpatient clinic because of uncontrolled hy...

Background: Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes, with an autosomal dominant mode of inheritance and high penetrance. To this date, it is known 13 subtypes of MODY with different genetic etiologies. It is characterized by high incidence in the family, an early onset and primary defect in pancreatic β-cell function.Objective and hypotheses: The primary objective of this study is to identify patients with MODY an...

Background: Type 1 diabetes mellitus (T1DM) is the most common endocrine disease in children and adolescents.Objective and hypotheses: It was aimed to evaluate the frequency of autoimmune thyroiditis (AT) and the possible risk factors for AT at diagnosis and at follow up of T1DM patients.Method: T1DM patients who were admitted to Trakya University Medical Faculty Pediatric Department, Pediatric Endocrinology Outpatient Clinic betwe...

Background: Cataract as a chronic complication of diabetes is well established in the literature and the risk factors are also well known. However, rare cases of acute bilateral cataract have been reported, all of them happening relatively shortly after diagnosis in T1DM. While the pathophysiology of this phenomenon remains unclear – as a lot of different theories proposed so far with the most accepted being the osmotic stress induced oxidative damage – fail to expla...

Background: Diabetes mellitus (DM) in childhood was mostly type 1 DM (T1DM), but sometimes it is not easy to classify, especially in the case having both type 2 clinical phenotype and autoantibody positivity. It is named as latent autoimmune diabetes in youth or type 1.5 DM (T1.5DM).Objective and hypotheses: This study was designed to evaluate the clinical characteristics of T1.5DM who had autoantibody positivity with clinical phenotype of T2DM.<p cl...

Background: Diabetic ketoacidosis (DKA) is an acute complication of type 1 diabetes mellitus (T1DM) that can be fatal if not properly managed. DKA is a leading cause of mortality in these children, early recognition and prompt treatment should substantially reduce childhood mortality in children with T1DM.Objective and hypotheses: We aimed to identify the risk factors and the most common clinical features of newly diagnosed diabetes in children, in addit...

Background: Age and gender are important factors in adjustment and psychological well-being in patients with chronic physical illness.Objective and hypotheses: To determine whether diabetes distress varies by age and/or gender in type 1 diabetic (T1D) patients.Method: Diabetes distress was compared in 255 adolescents and 283 young adults with T1D using Problem Areas in Diabetes Scale.Results: High diabetes di...

Background: Maturity-Onset Diabetes of the Young (MODY) is a rare monogenic form of diabetes that result in β-cell dysfunction. MODY accounts for 2–5% of all diabetes cases. We presented here a family with MODY2 caused by a novel heterozygous p.L164I (c.490 C>A) mutation of the GCK gene.Case: A 15,5-year-old girl was admitted to our department because of fasting hyperglycemia. She had no polyuria, polydipsia and weight loss...

Background: Congenital hyperinsulinism is genetic disorder characterized by dysregulation of insulin secretion and it is the most common cause of persistent hypoglycaemia in infancy. The incidence in individuals of northern European extraction is approximately 1:30,000 live births. Published data on the diagnosis and management of congenital hyperinsulinsim in resource limited setting is scarce.Objective and hypotheses: To describe the clinical presentat...

Background: Vitamin D deficiency (VDD) is common in the general pediatric population of the world. Some studies reported that low vitamin D levels with an increased risk of diabetes.Objective and hypotheses: VDD can be more common in children with type 1A diabetes (DM1A) than those with type 1B diabetes (DM1B). To evaluate 25OHD levels in children with newly diagnosed DM1A and DM1B patients and investigate any relation with clinical and laboratory data a...

The metabolism of several trace elements is altered in diabetes mellitus (DM). The present study investigates serum levels of lipid profile and lipid per-oxidation as well as levels of Mg, Cu, Ni, Co, Mn, Cr, Se, V and Zn, in 72 males with non-insulin-dependent DM (T2DM) and 21 non-diabetic healthy control subjects using inductively coupled plasma optical emission spectrometry (ICP-OES). The results showed highly significant increase in serum concentrations of LDL-C, TG and ch...

Background: Cystic fibrosis-related diabetes (CFRD) is the most common co-morbidity in association with cystic fibrosis. Cystic fibrosis related diabetes is predominantly an insulin deficiency state it shares features of both type 1 and type 2 diabetes, yet there are important differences, which necessitate a unique approach to diagnosis and management. Development of cystic fibrosis related diabetes is associated with a worse lung function, poorer nutritional status, and more...

Background: Type 1 diabetes mellitus (DMI) is a chronic disease that requires frequent visits in outpatient pediatric endocrine clinics in order to rearrange their new lives.Objective and hypotheses: A retrospective study of patients with DMI was performed during 2008–2015, assessing epidemiological and clinical data, treatment and subsequent course.Method: We analyzed the incidence, age and gender of 75 patients at the diseas...

Background: Alström Syndrome (ALMS), occurred due to mutations in ALMS1 gene, is a rare otosomal ressesive disorder. Seven hundred cases have been reported so far. Main clinical findings are rod con dystrofy, neurosensorial deafness, obesity and type 2 diabetes. Hypogonadism, hypothyroidism, growth hormone deficiency, hipertryglyceridemia, cognitive dysfunction, cardiomyopathy, renal, hepatic and pulmoner disorders could also be seen.Objective and h...

Background: Abnormalities in glucose homeostasis are fairly common complications in thalassemia major (TM) patients. Previous studies had shown associations between some endocrinopathies and iron overload of the myocardium, liver as assessed by MRI techniques. This study aimed at determining the relationship among cardiac T2*, liver T2* and abnormal glucose in TM patients.Objective and hypotheses: A total of 34 (27 male) transfusion-dependent TM patients...

Background: Type 1 diabetes (T1D), the most frequent type of diabetes in paediatrics, can be easily misdiagnosed presenting with hyperglycaemia due to monogenic diabetes. Objective and hypotheses: We report a 13-year-old boy with monogenic diabetes, initially diagnosed and treated as T1D.Method: The patient presented at 7.5 years of age with a febrile illness and mild hyperglycaemia. An oral glucose tolerance test (OGTT) then was normal,...

Background: Blood glucose control in children and adolescents with type 1 diabetes (TD1) is the most important goal in order to reduce potential complications. Following up these patients frequently and recording the relative metabolic parameters on a regular basis is necessary.Objective and hypotheses: The aim of the study was to compare the level of metabolic control in the children and adolescents with TD1 that are followed up in our Pediatric Diabete...

Background: Prevelance of type 1 Diabetes Mellitus is increasing world wide and it is associated with multiple factors.Objective and hypotheses: We aimed to evaluate the clinical and laboratory characteristics of patients with type 1 DM.Method: Clinical records of 184 patients with diabetes (0–18 years) admitted between January 2010 and January 2014 were analysed retrospectively. Age and season at admission, type of admission,...

Background: Type 1 diabetes (T1D) is one of the most common chronic diseases in childhood and adolescence. Diabetic ketoacidosis (DKA) and severe hypoglycemia are complications of T1D and are associated with significant morbidity and mortality.Objective and hypotheses: The aim of this study was to determine the prevalence of acute metabolic complications in children with T1D admitted to the children hospital in Qazvin during 2005–2014.<p class="...

Background: The honeymoon period of type 1 diabetes mellitus (DM1) is characterized by reduced insulin requirements to <0.5 Units/kg per day while maintaining good glycaemic control.Case study: Seven years old boy who was diagnosed with type 1 diabetes mellitus presented with history of polyuria, polydipsia and weight loss for 3 weeks duration. His random Blood glucose=408 mg/dl with initial HBA1C 12.7%. Family history was unremarkable for diabetes ...

Background: Multiple organ failure syndrome (MOFS) can occur in diabetic ketoacidosis (DKA).Objective and hypotheses: A 6-year old female child had DKA and MOFS.Method: We presented a case study of a child with DKA and MOFS.Results: A 6-year old female child had 1-week history of excessive thirst, polyuria, polydipsia, and weight loss. One day before coming to Vietnam National Hospital of Pediatrics (NHP), sh...

Background: A neonate, born at 34 weeks gestation by caesarean section for foetal distress, was severely growth retarded at birth. Deranged liver functions were noted at birth with (alanine transaminase (ALT), aspartate transamninase (AST) and gamma-glutamyl transfererase (GGT) recorded as 102, 228 and 1078 U/l respectively. The GGT rose to a peak of 3877 U/l at 6 months of age. The clinical course of the neonate was associated with failure to thrive and intermittent hyperglyc...

Introduction: Intensive insulin therapy with multiple daily injections (MDI) gives better glycaemic control than conventional biphasic insulin regimen in children with type 1 Diabetes mellitus. Though MDI regimen is widely practiced in other countries, this is not so in Sri Lanka.Objective: Effect on glycaemic control and BMI of children with TIDM after the change of insulin regimen to MDI from twice daily insulin regime. Methodology</st...

Background: The main purpose of insulin analogue treatment is mimicking physiologic insulin secretion and accomplishing a good glycemic control without having late hypoglycemia in patients with diabetes mellitus.Objective and hypotheses: In this report, 24 weeks follow-up results of newly diagnosed type 1 DM patients treated with insulin lispro and insulin glulisin is discussed.Method: Twelve patients diagnosed with type 1 DM patie...

Background: Dyslipidemia increases the frequency and severity of micro- and macro-vascular complications of type 1 diabetes.Objective and hypotheses: The present study aims to determine the prevalence of dyslipidemia and its association with clinical and laboratory findings in diabetic children and adolescents.Methods: The study included 202 children and adolescents with type 1 diabetes. Demographic data and laboratory findings wer...

Objective and hypotheses: To study the lipid metabolism in children with diabetes type 1.Method: It was included 44 children (33 girls), the average age – 10.2±3.3 years. Patients were divided: group 1 (less than 5 years) – 23 children (17 girls), mean age 9.8±3.6, the average length of diabetes 2.08±1.5 years. The second (over 5 years) – 21 children (16 girls), mean age of 11.6±2.4, the average length – 7.5±1...

Background: Owing to a common genetic background, patients with type 1 diabetes mellitus (T1DM) are at high risk of developing other autoimmune disorders. Celiac disease (CD) is the next in frequency after hashimoto’s Thyroiditis in these patients.Objective and hypotheses: This study was undertaken to investigate the prevalence of CD in diabetic children and adolescent.Method: 87 patients (44 female, 43 males) aged 2–18 y...

Background: Glycaemic control is adversely affected by family conflict derived from the psychological impact of the disease upon parents.Objective and hypotheses: To identify parental psychological stressors and thus interventions deemed useful to provide parental support.Method: 252 diabetic children were identified and PIP questionnaires were sent to each household to assess parental stress. Two parental focus groups were held to...

Background: Socioeconomic status (SES) is inversely associated with many chronic diseases, with disadvantaged individuals faring worse than the others. In diabetes mellitus, however, studies evaluating the relationship between SES and the glycaemic control have shown variable results.Objective and hypotheses: To understand the effect of SES on the long term glycemic control in children with type 1 diaebtes mellitus (T1DM) at a tertiary centre in India.</...

Case Report: Hyperinsulinemia, diagnosed by laboratory tests, should be diagnosed and treated as soon as possible to prevent fatal complications such as neurological damage. Patients who are resistant to medical therapy should be treated surgically. Minimally invasive surgery, a newly developed approach, is a good choice among surgical procedures to avoid unnecessary extensive pancreatectomy. Here, a 12-year-old boy is presented with diagnosis of hyperinsulinemic hypoglycemia ...