ESPE Abstracts

Background: Secondary forms of diabetes mellitus (DM) are underdiagnosed in children and adolescents with cancer because despite the whole body of evidence that asparaginase, steroids and total body irradiation increase the risk of developing DM, risk factors are missing and – asides from treatments – understudied (e.g., pre-existing obesity, sex, age, ethnicity, family history of DM). The objectives of our study were to assess the incidence and asso...

Introduction: Diabetic ketoacidosis (DKA) is a common medical emergency and is the most common cause of death in children with type 1 diabetes mellitus due its complications. Paediatric residents are usually the first line whom managing paediatric emergencies in Iraqi hospitals. They form the backbone of the provided service. It is important to make sure they are practicing at the highest possible standard to ensure patients’ safety. Therefore, it is cruc...

Introduction: β-thalassemia is a hereditary chronic hemolytic anemia characterized by a defect in the synthesis of beta-globin chains, particularly common in the Mediterranean region, southern Asia, and the Middle East (1) Transfusion programs and chelating therapy have greatly extended the life expectancy of patients (2). This has led to an increase in the prevalence of endocrine complications, linked to iron overload (3) including abnormalities in gluco...

Introduction: Diabetes is a global disease with approximately 425 millions of people affected throughout the world. The treatment cost for diabetes constitutes a significant economic burden and is estimated to increase in areas of Africa, South East Asia and the middle east in parallel to the increase to the disease incidence. These regions contribute differently in the global market revenue for the use of continuous glucose monitoring (CGM) and insulin pump t...

IMNEPD is a mitochondrial disease caused by homozygous mutations in the PTRH2 gene, a nuclear gene coding for a primary mitochondrial protein. IMNEPD was first described in 2014. So far only 3 other case reports have been published, reporting on a total of 15 patients. We report on two affected siblings of whom the girl developed an antibody negative diabetes at 13 years of age with typical symptoms (polyuria, polydipsia, weight loss of 1,5 kg), and without diabetic k...

Introduction: The term hybrid diabetes (HD) describes a form of diabetes in which hyperglycemia occurs in obese children in the presence of positive autoimmunity against the beta cells. Few data are available about the clinical presentation and the course of disease in children with this form of diabetes.Aim: We describe the clinical characteristics and response to treatment in 7 children with hybrid diabetes.<p clas...

Introduction: Spinal muscular atrophy (SMA) is an autosomal recessive neurodegenerative disease. In 2016, nusinersen (Spinraza) was approved by the FDA. The first AAV9-based gene therapy (Zolgensma), was approved by the FDA (2019) for the treatment of infants with SMA. We report an SMA case with recurrent hypoglycemic events after gene therapy.Case Report: A 22 months old boy, with SMA type 1 was born at term by CS for fetal bradycardia....

Introduction: Since diabetes mellitus is one of the major non-communicable diseases, therefore it is important taking this subject in some details during the undergraduate medical course, to prepare the students for recognizing the disease and understanding its management. In Sultan Qaboos University, the medical students go through a pre-internship training period, immediately after their final year of clerkship and just before starting their internship.<...

From time to time pediatric endocrinologists may be confronted with paradoxical constellations. Here, we report on a 13-year-old boy with type-1 diabetes. He had polyuria and polydipsia for the previous 2 weeks. Three days before presentation, he got increasingly exhausted and developed recurrent vomiting. At presentation his weight was 41,4 kg (P 25-50) and his height was 154 cm (P 25-50). Initial labs were HbA1c 10.2%, glucose 530 mg/dl, pH 7.15, base excess - 21.1 mmol/l, b...

Introduction: The COVID19 pandemic had an impact on different health services due to the lockdowns, curfews, or reducing provision of some clinical services in order to minimise the infection spread. Cancellation of clinic appointments was observed. Some patients also did not attend their appointments due to the fear of contracting the infection.Objectives: This study looked at the impact of the pandemic on the paediatri...

Background: STAT1 mutations can cause an extensive spectrum of disease, varying from severe bacterial and viral infections to mild disseminated mycobacterial disease, also chronic mucocutaneous candidiasis. Many patients present with autoimmune manifestations as type 1 diabetes, hypothyroidism and systemic lupus erythematosus. There are risks of cancers and cerebral aneurysms.Aim: To present the clinical manifes...

Introduction: The joint young adult diabetes (YAD) service at a specialist UK centre facilitates transition from paediatric to adult diabetes care for young people (YP) aged 16-25 years. Since 2018, quality improvement interventions have included focus groups with young people, joint paediatric and adult specialist nurse appointments and recruitment of a type 1 diabetes educator. We assess the impact of these interventions and changes imposed by the Covid-19 p...

Introduction: Glucose sensors are medical devices used in glycaemic control of patients with type 1 diabetes (T1D) . Its use prevents multiple capillary measurements, improving disease control and quality of life. However, these systems are not exempt from unforeseen events. The rise in the number of users has resulted in the increasing detection of local skin reactions by these devices, being the most frequent the eczematous ones, which may correspond to irri...

Background: Throughout 2020 telemedicine was rapidly deployed across health services and, during the COVID-19 pandemic, replaced many face-to-face (FTF) medical consultations. Children and young people (CYP) with diabetes present a unique opportunity for this type of consultation, due to the ability to interpret and share glucose data via other platforms. This study describes both CYP and parent experience of a new telemedicine service for CYP with diabetes.</...

Objectives: The SARS-CoV-2 pandemic has resulted in major cutbacks in service provision to patients. This could be detrimental to children with diabetes mellitus (DM), whose condition could deteriorate from poor access to healthcare. The lockdown has also potentially caused changes in diet, sedentary behavior and psychological burden due to the stress associated with the pandemic, which can have negative effects on glycemic control. Thus, this study compares c...

Objective: We aimed to evaluate the relationship between serum myostatin levels and metabolic parameters in children with insulin dependent (Type 1) diabetes mellitus and to show the relationship with sarcopenia in children with insulin dependent diabetes mellitus.Methods: Forty -four patients aged between 8 and 16 years, and 45 control patients were enrolled in the study. Anthropometric measurements and laboratory analy...

Introduction: Continuous Glucose Monitoring (CGM) devices have introduced new metrics to assess metabolic situation of patients with type 1 diabetes mellitus (T1DM). Among them, the glucose management indicator (GMI) provides a proxy to HbA1c, however, these measures do not always match.Purposes: To evaluate the concordance between GMI and HbA1c, and determinate in which scenarios GMI could replace HbA1c.Subjects a...

Background: Therapy in type 1 diabetes has undergone a fundamental change over the last several decades, especially by the use of technical devices. Another change that took place is the growing awareness of sex differences of all kind, e.g. as influencing factors of metabolic control. Our study aimed to evaluate sex differences over two decades with regard to changes in glycaemic control, with regard to trends in insulin pump use and insulin dose. Migration b...

Introduction: Obesity may increase the risk of cardiovascular disease (CVD) in patients with type 1 diabetes (T1DM). Risk of CVD in girls with T1DM is suggested to be higher than boys, however data pertaining to risk of CVD in boys are limited. The aim of this study is to determine the prevalence of obesity and risk factors of CVD in adolescents with T1DM as well as the impact of gender on these parameters.Methods: This ...

Thiamine-Responsive Megaloblastic Anaemia (TRMA) is a rare autosomal recessive disorder emerging due to mutation in the thiamine transporter 1 gene. It presents with sensorineural hearing loss, non-immune diabetes mellitus and megaloblastic anaemia. Ocular manifestations of TRMA described so far include optic atrophy and cone-rod retinal dystrophy. This paper presents a case report of a British-Pakistani adolescent boy unexpectedly diagnosed with bilateral severe proliferative...

Background: Diabetes mellitus is the second most common chronic disease of childhood. It requires appropriate management and follow up to reduce the complications. Type 1 diabetes mellitus (T1DM) is the most common type of diabetes that affects children. Most of the developed countries launched registries. In Iraq, there is no access to statistics or national report about the provided service. Rather, there is no standardization of the practice.<p class="a...

Background: Type 2 diabetes (T2D) is an emerging disease in the pediatric population. The association between T2D and non-alcoholic fatty liver disease (NAFLD) has been described; the mechanisms responsible for the development and progression of NAFLD are incompletely understood. Evidence of high Haemoglobin A1c (HbA1c) levels and the risk of diabetes complications has been demostrated. Recent evidence suggests that metabolic control may have a role in the dev...

Increased glycemic variability is an important risk factor in terms of complications independent of HbA1c. The aim of this study was; to investigate the relationship between continuous glucose monitoring system (CGMS) indices and clinical data, to investigate DNA damage in patients with diabetes and to evaluate the effect of glycemic variability on DNA damage. Fifty patients with T1DM, aged under 18 years old, who were followed up at least one year in Pediatric Endocrinology D...

Introduction and aim: Parental health is associated with children’s health and lifestyles. Thus, the aim of the present study was to assess lifestyle behaviours of children from parents with insulin resistance (IR) and at risk of type 2 diabetes.Methods: 2117 European parents from six countries included in the Feel4Diabetes-study measured in 2015 and identified as being at risk for diabetes with the FINDRISC questio...

Background: Recent studies showed that Rotavirus vaccination may affect the prevalence of type 1 diabetes (T1D). Our aim is to determine the prevalence of early childhood (<5 years) T1D before and during the introduction of Rotavirus vaccination in Israel by syndromic surveillance.Methods: Data on insulin purchases reported by Israel’s four health care organizations (HMOs) was retrieved from the National Program...

Background: The course of type one diabetic disease (T1DM) varies according to the period of life and in response to various external or internal factors. Adolescence is an evolutionary phase that involves important developmental changes and identity construction. Diabetes disease and its management, especially in this life period, can lead to psychological distress and impact on Self-redefinition.Method: We conducted a ...

Congenital Hyperinsulinism (CHI) is primarily associated with defects in the regulated release of insulin from ß-cells but little information is available about the role of other islet cell types. Pancreatic polypeptide (PP) cells represent a minor component of the islet endocrine cell population. PP causes satiety, decreases gastrointestinal tract motility and suppresses glucagon release. Since CHI is associated with feeding problems and loss of glucagon-mediated counter...

CRN04777 is an orally administered nonpeptide that is a potent and selective agonist of somatostatin 5 (SST5) receptors and is currently under development for the treatment of congenital hyperinsulinism (HI), the most common cause of persistent hypoglycemia in newborns and infants. Congenital HI arises from mutations within the insulin secretion pathway and is characterized by excessive and/or inappropriate insulin secretion by pancreatic islet beta cells. This excess insulin ...

Background: Thiamine-responsive megaloblastic anemia syndrome (TRMA) is characterized by a triad of megaloblastic anemia, progressive sensorineural hearing loss, and diabetes mellitus (DM). It is due to an inherited mutation in SLC19A2 gene, encoding a high-affinity thiamine transporter 1 in charge of facilitating the uptake of thiamine by the cells. Other manifestations including optic atrophy and stroke are rarely reported. We herein report an extremely rare...

The aim of this study was to assess the impact of meal size on glycemic control for T1D adolescent patients equipped with Diabeloop’s Closed Loop, DBLG1 System[1], based on data from the clinical trial NCT04190277. Among this dataset we isolated 37 adolescents. Only days with ≥70% available CGM data and >50% of time in closed-loop were included in the analysis, resulting in an average duration of 18 days per patient for a total of 668 days of treatment. To asses...

Introduction: Continuous-glucose monitoring (CGM) is becoming a useful tool to evaluate glucose profiles in real-life conditions and to detect glucose abnormalities undetected by OGTT in CF patients.Objectives: • Evaluation of OGTT and CGM results longitudinally • Evaluation of BMI z-score and %FEV1 changes in relation to OGTT and CGM results. • Analysis of 6 proposed criteria to classify glucose abnormali...

It is noted that with gestational diabetes mellitus, lipids cross the placenta in a limited amount. It is assumed that their concentration in maternal blood correlates with the concentration of lipids in the fetus. The purpose of this study was to compare the levels of the main indicators of the lipid profile, such as cholesterol, triglycerides and high and low density lipoproteins, in newborns and similar indicators in their mothers with gestational diabetes.<p class="abs...

The “Hybrid Diabetes (HD)” is a new term that emerged in the last few years to describe diabetes with combined features of type 1 and type 2 diabetes. The etiology behind hybrid diabetes is not well understood, and clinical characteristics for these unique patients were not described before. Differentiating HD from other forms of diabetes will lead to a better understanding of the disease process and course, as well as knowing the most appropriate management plan to ...

Type 1 diabetes is one of the common chronic diseases of children’s age. In recent years there is an increase in the rate of primary morbidity of 1 type diabetes in children with a displacement of peak manifestation for age 5-9 years. Medical History of 110 patients aged from 0.5 to 18 years diagnosed with 1 type diabetes have been analyzed in the Republican Center for Pediatric Endocrinology with a division into comparison group (2018- 2019) and control group (2020). Com...

Background and Aims: The incidence and prevalence of childhood type 1 diabetes (T1D) increases all over the world. The disease is often combined with other autoimmune lesions. The most common is autoimmune thyroid diseases. The combination of several autoimmune diseases significantly worsens diabetes control in children with T1D. The aim of the study: to identify risk factors of autoimmune thyroid diseases in children with T1D based on the study of the feature...

Introduction: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of type 1 diabetes mellitus (T1DM) and infection is the most common precipitating factor for DKA and is responsible for more than 50% of cases.Aim: We evaluated the frequency and severity of DKA in children with T1DM, before and during the coronavirus disease 2019 (COVID-19) outbreak, in order to identify its indirect effects on DKA incide...

Maturity onset diabetes of the young (MODY) is a clinically heterogeneous disorder characterized by noninsulin-dependent diabetes diagnosed at a young age (<25 years) with autosomal dominant transmission and absence of pancreatic autoantibodies. Due to the relatively low prevalence in the general population and atypical clinical manifestations, MODY is often misdiagnosed with type 1 diabetes and type 2 diabetes. Currently, distinguishing MODY from type 1 and type 2 diabete...

Aim: Type 1 Diabetes Mellitus (T1DM) is a chronic disease and requires lifelong care and management. Carbohydrate (CHO) counting is one of the meal planning methods that can be preferred in the treatment of diabetes. We aimed to investigate the effect of carbohydrate counting on the nutritional habits and metabolic control of adolescents with Type 1 DM.Subjects and Method: Patients with Type 1DM diagnosis who applied to our Pediatric End...

Introduction: Nutritional education is a cornerstone in the management of the type 1 diabetic patient in combination with insulin and physical activity. The objective of our study was to explore the nutritional profiles of type 1 diabetic children during their first hospitalization.Materials and methods: This is a retrospective descriptive study carried out 100 type 1 diabetic patients less than 15 years old hospitalized in the Endocrino...

Introduction: The pathogenetic process in type 1 diabetes mellitus includes a complex mechanism between genetic and immunological factors. Chronic autoimmune reaction relies upon the detection on autoantibodies in the patient’s serum long before initiation of the disease. Autoimmune markers include mainly 4 types of antibodies - GAD65, IAA, ICA and IA-2, some present in children less than 10 years (IAA, ZnT8), and some later in life (GAD, IA-2).The presen...

Background: Due to the Ukrainian Pediatric Diabetes Register (UPDR) the number of children with DM1 0-17 y.o. in 2019 was 9860 (1 in 769), with Dm2 36 (1 in 210,547) with neonatal DM (NDM) 66 (1 in 115,000), with MODY 40 cases (1 in 114,844). The diabetes prevalence rates increased from 9.3 (per 1000) in 2007 up to 12,57 (per 1000) in 2018. CSII is well established in pediatric patients with DM1. Most studies focus on such parameters as HbA1c levels...

Introduction: More than 1.1 million children and adolescents are living with Type 1 diabetes mellitus (T1DM) in 2019 worldwide1. Transition period is considered a crucial phase in management of T1DM, where movement of adolescents to adult health care is initiated. During this period, physical, psychological and behavioral changes may make this interval becoming more challenging by which diabetes management can be affected. HbA1c worsening was report...

Introduction-Objective: Nephropathy, retinopathy, neuropathy are long-term microvascular complications of diabetes. Glycated hemoglobin (HbA1c), used as a glycemic control indicator, have proven to be indicative in the development of microvascular complications. In this study, the contribution of HbA1c variability to complication development was evaluated.Method: Twenty one cases with type 1 diabetes mellitus (T1DM) who ...

Background & objectives: An important aspect of managing type 1 diabetes is to identify and address the apprehensions of patients and parents of newly diagnosed type 1 diabetes. Understanding parental difficulties in managing type1 diabetes and promptly dealing them will surely affect the short and long-term outcome in children. The aim of this study was to determine the affective response of parents after the diagnosis of type 1 diabetes in a developing c...

Objectives: The study aimed to observe and compare the short-term glycaemic outcome among Muslim type 1 diabetes mellitus (T1DM) children and adolescents using retrospective continuous glucose monitoring (CGM) before and during Ramadan month. The selection of retrospective CGM over real-time CGM conferred the benefit of representing the actual glycaemic impact of Ramadan fasting, especially relevant to developing Muslim nations that have less access to persona...

Background/Aim: Type 1 diabetes Mellitus (T1DM) often presents with clear clinical signs after a long-term asymptomatic autoimmune process. This long and silent period has been leading to an increase in awareness day by day in order to prevent and predict the development of the disease. Among the well-known genetic and environmental risk factors, close relatives of the index cases constitute a population that is quite suitable for predicting and preventing the...

Introduction: During management of Diabetic ketoacidosis (DKA), and after starting the insulin infusion, it is crucial to monitor the blood glucose level frequently. If the glucose level drops quickly or below certain limit when there is still an evidence of ketonemia, it is recommended to add dextrose to the maintenance fluids and continuing the insulin infusion to switch off the ketosis process. However certain measures are required when the glucose continue...

Introduction: Type 1 diabetes mellitus (T1D) is the most common form of carbohydrate metabolism disorder in childhood. There are also monogenic forms of diabetes. In the world literature, there are isolated mentions of the combination of monogenic and autoimmune forms of diabetes mellitus.Clinical case: A 10-year-old obese patient presented with hyperglycemia. At hospitalization: height 168 cm, weight 87 kg, SDS BMI +3.0. Glycemia 14.4 m...

Introduction: Diazoxide is the first-line drug for Hyperinsulinemia-Hyperammonemia (HI/HA) syndrome, a disease due to a mutation in the glutamate dehydrogenase-1 (GLUD1) gene.Diazoxide, an opener of the pancreatic β-cells KATP-channels reducing insulin release, is uncommonly associated with thrombocytopaenia.Aim: We describe a toddler with HI/HA syndrome who developed thrombocytopaenia on diazoxide treatment.<p ...

Background: Paediatric nephrotic syndrome has an estimated incidence of 2 per 100,000 children per year and type 1 diabetes had a reported incidence of 9.5 per 100,000 habitants in Portugal (2018 data). To the best of our knowledge, the simultaneous occurrence of nephrotic syndrome and type 1 diabetes is rare – we found 13 published cases in paediatric age worldwide. Clinical case: A 5-year-old boy with personal history of nephrotic syndrome was admitted ...

Introduction: After contact with the antigen, lymphocytes require activation for proliferation and differentiation into effector cells. Activation of lymphocytes results in the expression of activation markers. The CD69 antigen appears first on the surface of lymphocytes. This occurs one hour after receiving the activation signal. The CD69 molecule acts as a cellular stimulating signal, causing further activation and proliferation of cells, stimulating the syn...

Introduction: PIMS-TS [Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2] is a unique clinical complication of COVID -19 infection in paediatric patients. We report a case of a child presenting with PIMS-TS and new onset type 2 diabetes.Presentation: A previously healthy 15 year old boy of Bengali-Indian origin presented to the hospital with polyuria, polydipsia, dry cough, abdominal pain and 1 episode of...

Methods: A retrospective analysis of children with T1DM attending the Paediatric-diabetes service in an inner-city hospital. We included CYPD with paired values of hospital-measured BMI and HbA1C during 2 periods covering pre and post-lockdown (January-June 2020 versus November2020-April 2021). Children without paired values were excluded. HbA1C is expressed in DCCT% units. BMI calculated in absolute values, given the short study period....

Introduction: Diabetic ketoacidosis (DKA) is a known complication of diabetes mellitus, mainly type1. It is a medical emergency condition. The recent British paediatric DKA guideline clearly recommends involving a senior clinician at time of diagnosis, usually either an emergency medicine or general paediatric doctor. There is no clear recommendation of when to consult the on-call paediatric endocrinologist or diabetologist who covers the admission of diabetic...

Background: An increased urinary albumin excretion rate of 30 to 300 mg/24h (microalbuminuria) constitutes an early stage of nephropathy, especially when it becomes persistent. The main modifiable initiation and progression factors of diabetic nephropathy are hyperglycemia and hypertension. There is limited information on the burden of diabetic nephropathy in developing countries. To date there are no studies that show the magnitude of microalbuminuria in the ...

Background: Pancreatic agenesis has been reported as a cause of neonatal diabetes. Most commonly it was associated with severe neurodevelopmental problems caused by homozygous mutations in the transcription factor PTF1A. Isolated pancreatic agenesis was related to biallelic mutations in an enhancer located near PTF1A gene, which suggests that the enhancer is tissue specific to the pancreas. PDX1 is another transcription factor gene in which biallelic mutation ...

Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus. The characteristic features of diabetic dyslipidemia in adults are a high plasma triglyceride concentration, low HDL cholesterol concentration and increased LDL cholesterol. Dyslipidaemia in children with type 1 diabetes mellitus (T1D) have been little studied (P. Lozano et al., 2016; J. D. Schofield et al.,2016; M. Kinoshita et al., 2018; C.Elkins et al., 2019). DECODE studies (Diab...

Objective: Vitamin D plays an important role in hyperlipidemia, cardiovascular disease risk, and glucose/insulin metabolism. The aim of this study is; to investigate the relationship between serum vitamin D levels and metabolic profiles of children with T1DM, atherogenic index, and cardiovascular disease risk.Materials and Methods: T1DM patients were included in the study retrospectively. Anthropometric and clinical measurements, biochem...

Introduction: Extreme hypertriglyceridaemia is uncommon in the paediatric population but can have devastating consequences. It can lead to acute pancreatitis, cutaneous eruptive xanthomas and lipaemia retinalis. Severe hypertriglyceridemia likely accounts for 1-10% of acute pancreatitis cases in adults but there is limited data in children. We report a case of new-onset type 1 diabetes mellitus (T1DM) presenting in diabetic ketoacidosis (DKA) with acute pancre...

Introduction: HNF1A-MODY (MODY3) is a common subtype of the Maturity Onset Diabetes of the Young (MODY), a monogenic autosomal dominant disease presenting as a nonketotic diabetes with onset usually during adolescence, or early adulthood. HNF1A-MODY is less common among children as the hyperglycaemia usually manifests after 10th year of life.Aim: We describe a young girl presented with hyperglycaemia and glysosuria.<...

Background: Glucose 6 phosphate dehydrogenase (G6PD) is expressed in all tissues and is necessary for the oxidant stress capacity of cells. G6PD deficiency is the most common enzymopathy in humans; it is among the important causes of hemolytic anemia. It has been reported that severe hemolytic anemia due to G6PD deficiency may develop in newly diagnosed diabetes, especially during the correction of hyperglycemia. To date, 9 cases have been described in the lit...

For the safe delivery of Paediatric Diabetes services at DBTH during the COVID pandemic a postal HbA1c service with patients collecting capillary blood samples to send to the laboratory for analysis was proposed. The aim of this pilot study was to assess stability of HbA1c at ambient temperature in capillary whole blood samples collected into Sarstedt Microvette EDTA tubes. Samples were analysed on the day of collection on the TOSOH G11 analyser and then re-assayed daily for u...

Background: Maturity onset Diabetes of the young (MODY) is a rare form of diabetes with specific features that distinguish it from diabetes mellitus type 1 (DM1) or type 2 (Dm2). Research studies suggest that 5% of subjects diagnosed with diabetes before the age of 45 years have MODY, with 80% of them having been incorrectly diagnosed as having DM1 or Dm2. Genetic testing my enable correct diagnosis and treatment, optimize glycemic contro...

Introduction: Since its introduction in the 1970s, insulin pump therapy became more and more recommended in patients with type 1 diabetes, in order to achieve and maintain an optimal glycemic control, by mimicking the physiological release of insulin through continuous infusion. The aim of our study was to determine the effectiveness of insulin pump therapy in improving the metabolic control in children with type 1 diabetes.Patients and ...

Background: Mauriac Syndrome (MS) is currently an extremely rare complication in type 1 diabetes mellitus (DM1). It is characterized by the triad: poor metabolic control, dwarfism and hepatomegaly. Other findings are elevated transaminases, dyslipidemia, cushingoid features and delayed puberty.Case: Male patient with DM1 since 5 years age. Coinciding with a family breakdown, from the age of 7 his metabolic control deteriorated significan...

Background and Objectives: Managing type 1 diabetes (TIDM) in covid pandemic is a real challenge in resource limited countries like Pakistan. This study was aimed to determine the effects of covid 19 in managing type 1 diabetes in resource limited countries.Methods: Cross-sectional observational study, included all type 1 diabetes patients who were already enrolled in endocrine and diabetes clinic and were on regular fol...

Introduction: Insulin regulates the activity of lipoprotein lipase, the enzyme responsible for triglyceride metabolism. Although mild hypertriglyceridemia is seen in diabetic patients, severe hypertriglyceridemia (>1000 mg/dl) is extremely rare in the pediatric population. We present a case of co-existence of new onset diabetic ketoacidosis (DKA) with severe hypertriglyceridemia, together with therapeutic outcome.Case: A 9-year-old, ...

Introduction: Continuous Glucose Monitoring System (CGMS) takes place increasingly in the daily routines of diabetic patients. It has been shown that metabolic control improves when CGMS is used consistently. We aimed to show the effect of CGMS in patients using MDI therapyMaterials - Methods: All patients using multiple-dose insulin therapy at our center and continued their regular follow-up and using CGMS for at least three months were...

Background: There are some studies about vitamin D level and type 1 or type 2 diabetes mellitus (DM). Its effect on metabolic control of patients with type 1 DM is the subject of this study.Patients and Method: In 339 patients with type 1 DM, 192 cases (99 males, 93 females) randomly enrolled in the study. The age of males was 9 ± 4.4 yr and age of females was 8.3±4.3 yr. Their HbA1C and 25(OH) D3 were measured by HPLC method. ...

Introduction: During this year, scientific research revolves around COVID-19, with so many unanswered queries in term of pathogenesis; complications, and mortality rate; in light of limited pediatric evidence. The close relation between COVID 19 and new-onset diabetes especially in children is still an unresolved issue. Our paper, exhibits an unique presentation of DKA misleading COVID 19 diagnosis at this ageCase presentation: A three-y...

Background: MODY HNF1B variants are most frequently associated with extra-pancreatic manifestations like renal cysts [leading to renal cysts and diabetes (RCAD) syndrome], abnormalities of the uro-genital tract and hypomagnesemia, but may also cause MODY or renal structural disease in isolation, therefore cases of HNF1B MODY still remained largely undiagnosed. In Ukraine, there are currently three patients with MODY HNF1B de novo who...

Objective: To describe the differences in metabolic parameters and in time to recovery from Diabetes ketoacidosis (DKA), between children and adolescents with newly diagnosed compared with established Type 1 Diabetes (T1DM).Methods: A single center, retrospective study. The cohort comprised 356 children and adolescents with T1DM who had DKA during 2008-2018. Data were obtained from the patients’ medical files. Recov...