ESPE Abstracts

Background: young children with type 1 diabetes mellitus (DM1) have a tendency to recurrent hypoglycemia. Increased sensitivity to insulin in young diabetes patients may be associated with features of secretion of catecholamine, particularly adrenaline.The aim: to explore the basal levels of catecholamine (epinephrine, norepinephrine, and dopamine) in serum of young children with type 1 diabetes mellitus to identify of p...

Objective: Type 2 Diabetes Mellitus(T2DM)and obesity represent two major health hazards in children and adolescents, with rising prevalence. Several markers have been developed in order to diagnose T2DM and detect potential metabolic abnormalities.The objective of the study was to examine glucose tolerance in Greek children and adolescents and the differences in the glucose, insulin and c-peptide response curves between male and female children and adolescents...

Goal of Research: to assess the significance of the early marker of nephrine diabetic nephropathy of the Uzbek patients with the First Type of diabetes mellitus.Materials and Methods: 100 patients with DM 1 were examined, including 80 patients with normoalbuminuria (NAU) and 20 patients at the microalbuminuria (MAU). The patients were from 1 to 14 years old with the disease duration from 1 to 5 years. They included 48 bo...

Introduction: Development of type 1 diabetes is well known in cases of type 2 autoimmune polyglandular syndrome (APS). We describe a case of APS2 who developed a hybrid form of diabetes that responded to metformin therapy.Case: The patient is a 17.5 year old male patient who has been diagnosed with APS2 at the age of 13 years with primary adrenal insufficiency and autoimmune hypothyroidism .he has been on treatment with ...

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Introduction: Continuous Glucose Monitoring (CGM) is an asset for patients with type 1 DM. The Dexcom G6 is FDA approved for use in patients 24 months and older. This CGM does not require any calibrations or point of care interventions and lasts up to 10 days when inserted into the subcutaneous tissue. We present a case of a 17 month-old patient started on CGM (Dexcom G6), with subsequent improvement in glucose variability and continued excellent glycemic cont...

Introduction: Congenital hyperinsulinism(CHI) is a rare complex disorder of hypoglycaemia attributable to inappropriate and dysregulated insulin secretion from the pancreas with an incidence of 1:50 000(1:2500 in consanguineous populations). Genetics involves defects mainly in the KATP channel genes ABCC8 and KCNJ11.Aim: We describe a male infant, presented with refractory hypoglycaemia the first week of life.<p clas...

Background: In initial treatment of DKA, volume expansion should begin with 0.9% saline to restore the peripheral circulation. The use of large amounts of chloride-rich/bicarbonate-free fluids may cause the rapid development of hyperchloremic metabolic acidosis, which is described in ISPAD Clinical Practice Consensus Guidelines 2018.The severity of DKA, defined by pH, HCO3- Base Excess (BE), is one of the factor...

Background: Insulin pumps are widely used in the treatment of type 1 diabetes mellitus (T1D) in children because of numbers of advantages in compare with multiple daily insulin injections (MDI). However, the long-term efficacy of continuous subcutaneous insulin infusion therapy (CSII) in achieving and maintaining of diabet stability is still not resolved.Purpose: Determine the feffectiveness-related factors of glycemic c...

Introduction: MODY is an autosomal dominant inherited type of diabetes that has been diagnosed before the age of 25 and caused by pancreatic β-cell dysfunction. HNF1B-MODY is more rare than other MODY causes and its frequency is between 1-5%. Mutations in HNF1B (MODY 5) are associated with pancreatic agenesis, kidney anomalies, genital system malformations and liver dysfunction.Case: The patient is 8 years 2 ...

Objective: To estimate the prevalence of Celiac disease (CD) and autoimmune thyroid dysfunction (AITD) in children with Type 1 Diabetes.Study Design: The analysis included 177 (83 girls, 94 boys) children and adolescents with a diagnosis of Type 1 Diabetes who were followed up for a duration of more than 2years at Sir Ganga Ram Hospital, a tertiary care hospital in Northern India.Results</s...

Background: Mauriac's syndrome (MS) may occur in patients with poor controlled type 1 diabetes mellitus (DM1), with often ketoacidosis, episodes of hyperglycemia and hypoglycemia, under the dose insulin. MS characterized growth retardation and puberty delay, Cushingoid obesity, moon facies, protuberant abdomen, hepatomegaly with transaminase elevation, dyslipidemia. Now it is a rare syndrome, firstly described by Mauriac in 1930.<str...

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Background: Thiamine-responsive megaloblastic anemia syndrome(TRMA) is a rare disease characterized by diabetes mellitus, megaloblastic anemia and sensorineural hearing loss. The disease can be accompanied by attack of stroke, which are rarely reported. To analyze the clinical characteristics of a case of thiamine-responsive megaloblastic anemia with attack of stroke in our hospital and review the related literature of this syndrome in order to improve the dia...

Aim: The pathophysiology of developing hypophosphatemia in children with diabetic ketoacidosis (DKA) has not been sufficiently elucidated. Fibroblast Growth Factor 23 (FGF23) is a hormone that causes phosphate excretion from the kidneys. The increase of FGF23 in children with DKA may explain the pathophysiology of hypophosphatemia in these children. The aim of our study was to investigate the effect of serum FGF23 on serum phosphorus level in children with DKA...

Aim: The insulin pump has an important contribution to quality of life and individualized insulin therapy. However, studies that observe clinical criteria can sometimes only reveal marginal benefits or minor differences. The use of insulin pump in our country has become recently widespread. Therefore, we aimed to share our clinical experience and to examine the effect of the pump on individual cases.Method: The records o...

It is noted that patients with heart disease (HD) are likely to develop abnormal glucose metabolism and this metabolic deterioration usually occurs after middle age. However, we recently had two patients with congenital HD, who developed type 2 diabetes mellitus (DM) in their adolescence.The first patient underwent Fontan operation at 2 years of age for single ventricle and pulmonary atresia. His paternal grandfather had type 2 DM. He noticed polydipsia and polyuria at 15 year...

Introduction: Recently the incidence of type 2 diabetes was explosively increased in children and adolescents. The underlying mechanism of childhood-onset type 2 diabetes mellitus may be different to the adult-onset type 2 diabetes. Therefore, it is useful to conduct genetic study in children with type 2 feature to understand underlying cause of glycemic dysregulation as well as for the management of diabetes mellitus.Case</stron...

Oedema is a care complication of insulin therapy. It affects mainly patients with newly diagnosed type 1 diabetes mellitus, poorly controlled diabetes mellitus or patients on large doses of insulin. There are only a few case report showing that it is an uncommon and probably an under-reported complication. Two mecanisms are known: the sodium and water retention and vasoactive mediators release. The oedema tends to develop shortly after initiation of insulin therapy and resolve...

Introduction: Diabetes type 1 (DM1) in children can result in lipid disorders due to insulin deficiency. Familial hypercholesterolaemia (FH) is a very common monogenic disorder with occurrence of 1:250 and it may lead to development of cardiovascular disease (CAD) in a very young age.Case report: Female patient with diabetes diagnosed at the age of 5, was referred to joint diabetes and lipid clinic due to high levels of ...

Objectives: Type 1 diabetes mellitus (DM) is an autoimmune disease caused by the destruction of pancreatic beta cells. The frequency of Type 1 DM is increasing, and the highest incidence rate is in children under 5 years of age. It is estimated that children under the age of five will develop approximately 70% of the cases under the age of 15, with an increased incidence.In our study, we aimed to evaluate the demographic, clinical an...

Introduction: A positive correlation between the onset of T1DM and winter has been suggested by studies conducted in different countries.Objective: To investigate the seasonal variation of T1DM diagnosis and additional epidemiological parameters in children from Western Greece diagnosed with T1DM.Methods: 105 patients, 44 males and 61 females, aged 1 to 16 years (mean: 8.2±4 y...

Case: An 8-year-old boy with Down syndrome. He was born at 36 week of gestation, birth weight was 1668 g (-2.5 SD). He complicated transient hyperinsulinemia (THI) treated with diazoxide for 2 months and hypothyroidism continuing treatment with levothyroxine. He was not detected transient abnormal myelopoiesis at neonatal period. He was diagnosed with precursor B-cell acute lymphoblastic leukemia (ALL) at age 8 years and started chemotherapy with a steroid, an...

Purpose: was to evaluate the interaction of caries risk indicators and metabolic control in children with type 1 diabetes mellitus.Methods: The study included 50 children with type 1 DM and 50 healthy controls. Diabetic children were classified into 3 groups: well, fairly, and poorly controlled based on glycosylated hemoglobin level. Personal, family data, medical and dental history were collected. Children were examined...

Background: The relationship between 25 hydroxy cholecalciferol (25OHD) deficiency and autoimmune diseases including type I diabetes (T1D) is an ongoing area of research interest. Furthermore, vitamin D seems to affect β cells through calcium regulation, as insulin release is a calcium-dependent process. The aim of the study was to screen for (25OHD) deficiency in children with clinical onset of T1D and study the correlation between its serum levels an...

Aim: The aim of this study was to evaluate hematological indices especially PLT indices in children with T1DMMaterials and Methods: in this case-control study which was conducted on 166 participants including 83 children with diabetes type 1 and 83 children hospitalized for thorough assessment of short stature, PLT count, MPV, PDW, WBC count, hemoglobin, blood sugar,PCT, P-LCR, ans PLR were assessed. Patients with type 1...

Background: Type 1 diabetes (T1DM) is a chronic disease with many chronic complications as nephropathy, retinopathy and neuropathy or macrovascular complications as coronary artery disease and peripheral vascular disease due to the effects of hyperglycemia and dyslipidemia on vascular endothelial function. Moreover, in patients with T1DM, hypertension (HTN) is a significant contributor to the development of both micro- and macrovascular complications.<p cl...

Introduction: Hybrid diabetes is a challenging form od diabetes that need to be more studied. We describe a case of hybrid diabetes with a prolonged honeymoon due to the use of metformin.Case: Our patient is a 10 year old female patient who was diagnosed as type 2 DM on September 2017 at the age of 8 years. She was obese with BMI = 29.8 Kg/ m^2 with marked acanthosis nigricans. She had a patch of vitiligo on the face...

Background: Prader-Willi syndrome (PWS) is a complex genetic disorder with implications on the endocrine and neurologic systems, metabolism, and behavior. Early in life, PWS is characterized by hypotonia and failure to thrive, followed by obesity and hyperphagia. Patients with PWS develop hypothalamic dysfunction which may lead growth hormone deficiency, hypogonadism, hypothyroidism, adrenal insufficiency and poor bone mineral density. Traditionally, obesity i...

Introduction: More than 1,106,500 worldwide children were living with type1 diabetes mellitus (T1DM) in 20171. Researchers concluded that better glycaemic control is associating with lesser complications of this chronic condition. Target HbA1c is recommended to be <48mmol/mol(<6.5%) and <53mmol/mol(<7%) as per NICE and ISPAD respectively2. The glycaemic control represented by HbA1c was worse amongst the British gir...

Background: type I diabetes is associated with progressive destruction of pancreatic β-cells with gradual decline of insulin secretion. C-peptide is considered the best indicator of endogenous insulin secretion in patients with diabetes.Aim of the Work: evaluate the effect of different variables associated with preserved pancreatic beta cell function at one year after diagnosis of children with type I DM.<p c...

Background: The non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. It is not uncommon in children with type 1 Diabetes Mellitus. It is often asymptomatic and discovered accidentally.Aim: The aim of this work was to screen the presence of fatty liver among children with type 1 DM attending the diabetes Clinic of Alexandria University Children's Hospital and its relation to the state ...

Donohue syndrome (also known as leprechaunism) is an extremely rare and severe autosomal recessive genetic disorder. Leprechaunism derives its name from the fact that people with the disease often have elfin features and are smaller than usual. Leprechaunism is also characterized by abnormalities of the endocrine system ; such abnormalities include hyperinsulinemia. Due to the mutation in Insulin receptor gene, infants with leprechaunism fail to use insulin effectively (insuli...

Achieving optimal metabolic control can be extremely challenging in some children and adolescents with T1DM. The adherence to multiple injections/day is among the leading causes of suboptimal control. Recently insulin degludec/aspart co-formulation (70%IDeg+30%IAsp: IDegAsp) has become available. Because of the longer-duration of IDeg, and retained individual pharmacokinetics of IDeg and IAsp, we wanted to test insulin IDegAsp's efficacy in our patients with po...

Introduction: Diabetic ketoacidosis (DKA) in children is related with high risk of severe complications in the central nervous system such as cerebral oedema, hematoma and thrombosis.The occurrence of cerebral oedema in children with DKA is around 1: 100 and is higher in young children with severe acidosis and in whom DKA is the first manifestation of the disease.Case Report: 12-month-old patient d...

Introduction: Poorly controlled type 1 diabetes affects the hypothalamic pituitary axis and is likely to have a negative impact on spermatogenesis and result in infertility. Further, a chronic complication of diabetes may also be angiopathy of testicular vessels. Thus, at our center for children with diabetes, testicular ultrasound evaluation is performed on adolescent boys with duration of diabetes> 2 years.Objective</strong...

Introduction: Autosomal recessive mutations in the Wolfram syndrome type 1 gene are responsible for the classical Wolfram syndrome (OMIM_ 222300), also known by the acronym "DIDMOAD" (diabetes insipidus, diabetes mellitus (DM), optic atrophy and deafness). The gene encodes wolframin, a membrane glycoprotein, which helps to regulate the calcium homeostasis in the endoplasmic reticulum of many different tissues, including the pancreatic...

Background and Aims: Despite intensive insulin treatment of type 1 diabetes (T1DM), metabolic control remains suboptimal, especially in children. In an attempt to optimize postprandial glycaemia, some families decrease the amount of carbohydrates contained in a meal. While "low-carbohydrate diets" may improve metabolic control in some selected populations, controversies remain around the risk of hypoglycemia and ketoacidosis and the impact of such diet...

Objective: To Find Prevalence of Type 1 with Autoimmune Thyroid Disorders, Age, Duration,Thyroid Antibodies, Growth and Glycemic variability in Indian Scenario.Methods and Plan: This is retrospective observational Multicentric Study carried out in our four (4) centers of DIA CARE, Ahmedabad during January to December 2018, We divided Diabetes Type 1 Patient with Autoimmune Thyroid disorder According to Age, Diabetes Dura...

Introduction: The growing pandemic of type 1 diabetes is considered as an enormous multifactorial public health challenge in the world. Many targeted interventions should be provided to improve type 1 diabetes management especially during childhood and adolescence.The purpose of this study is to elucidate the epidemiological, clinical and management profile of type 1 diabetes in Moroccan children and adolescents followed up in t...

Keywords: Human Leukocyte Antigen system, DRB1 allelesDiabetes mellitus is one of the diseases, the genetics of which has been most widely studied. In 40-50 % cases it is connected with Human Leukocyte Antigene system. The major genetic deterninants of this disease are DQ and DR genes "DR3" and "DR4" haplotypes create high risk for diabetes.Insulin dependent diabetes mellitus risk is very high a...

Sleep deficit is the well known risk factor for obesity in children and adult. Adenotonsillar hypertrophy is the main cause of obstructive sleep apnea(OSA) in childhood. Adult type (type II ) OSA is increasing in obese children. Eleven year old boy visited our clinic with chief complain of polyuria, polydipsia onset two weeks ago. His grandmother and father are type 2 diabetes mellitus. Adenotonsillectomy was recommended for tonsillar hyperthrophy (Grade 3) and had snoring for...

An increased iron overload led to a disorder in glucose metabolism. However, the mechanism through which iron overload induces beta cell death remains unknown. The present study revealed that ferric ammonium citrate treatment inhibited cell viability in vitro, induced a decline in mitochondrial membrane potential, increased oxidative stress and activated mitophagy. These effects could be alleviated by a reactive oxygen species scavenger. In summary, we demonstrated th...

Background: Diabetic patients frequently develop a constellation of electrolyte disorders. These patients are often potassium-, magnesium- and phosphate-depleted, especially in the context of diabetic ketoacidosis.Patients with type-1 diabetes are predisposed to develop a spectrum of liver diseases, which includes fatty liver, steatohepatitis and cirrhosis. The association of hepatitis A infection with type-1 diabetes is extremely rare.<...

Introduction: The association between type 1 diabetes (T1D) and celiac disease (CD) has been described by many authors in both children and adults. The link between these two pathologies was identified more than 30 years ago, especially by pediatricians. The aim of this work was to study the clinical, biological, and evolutionary features of CD in diabetic children compared to a control group of non-celiac diabetic children.Patie...

Background: The most common cause of permanent neonatal diabetes (PNDM) is heterozygous activating mutations in the KCNJ11 gene encoding the pore-forming Kir6.2 subunit of the pancreatic beta cell KATP channel.Objective and Hypotheses: To determine the dynamic of carbohydrate metabolism in family transferred from insulin to sulphonylureas (SU).Method: We studied a family (...

Introduction: Ketoacidosis is often indicative of diabetes in children in our Tunisian context. It can be severe and life-threatening, with mortality in the order of 1 to 2%.Methods: We report the results of a retrospective study over a period of 2 years (from 1/01/2017 to 31/12/2018) on all cases of inaugural ketoacidosis of type 1 diabetes mellitus in children, collected at the pediatric department of Mohamed Tlatl...

Background: Chronic kidney disease (CKD) was defined by structural or functional renal abnormalities, or an estimated glomerular filtration rate (GFR) of less than 60 mL/min per 1.73 m2. A child with CKD may develop many complications such as: anemia, poor growth and nutrition, bone and mineral disorders, cardiovascular complications, and complications of hemodialysis, and peritoneal dialysis.Aim: Assessment of severity ...

Introduction: Type 1 Diabetes (T1D) is an autoimmune disease where β-cells of the pancreatic islets are destroyed. The vast majority of T1D cases are not due to genetic predisposition, implying that the prevalence is associated with environmental, nongenetic factors. One such factor is the microbiome and its correlation with T1D has been investigated in a multitude of studies.Aims: To investigate whether the curr...