ESPE Abstracts

Aim: In numerous studies, a decrease in sleep quality and regulation has been reported in patients with type 1 diabetes (T1D). However, research on sleep disturbances in T1D patients is limited. Diagnosis of sleep disorders is crucial as this condition adversely affects cognitive functions in children, which in turn affects the essential skills required for diabetes management. We aim to assess sleep disorders in patients diagnosed with T1D and investigate the...

Background: Few studies have investigated the association between the development and progression of diabetic retinopathy and autoimmune processes resulting from HLA genotype and the relationship of these genes with islet autoantibody status.Objective: This study explored how serum diabetes autoantibodies are related to the development of early diabetic retinopathy (EDR) in children with type 1 diabetes mellitus (T1DM).<...

Background: Telehealth programmes can provide purposeful and relevant solutions to facilitate management and interactions between patients with diabetes and healthcare professionals.Patients & Methods: A case control study was conducted from June 2021 till August 2022 on 140 children and adolescents with Type 1 diabetes following at outpatient clinic of DEMPU (Diabetes Endocrine and Metabolism Pediatric Unit) at Cair...

Background: The annual incidence rate (IR) of childhood-onset type 1 diabetes mellitus (T1D) among Estonian children under the age of 15 between 1983 and 2006 was 12.6 per 100 000 per year, with the highest incidence rate in the age-group 10-14.9 years. During this time period the most rapid increase in incidence was seen in age-group 0-4.9 years, with a 9.3% increase annually.Objective: To calculate the incidence of T1D...

Background: Maturity-onset diabetes of the young (MODY) represents 1-5% of all patients with diabetes mellitus (DM) and numerous genes have been found to be associated with it. While mutations of the insulin gene (INS) are better known to cause permanent neonatal diabetes mellitus, several rare disease-causing variants have also been identified in patients with MODY. Patients with INS-MODY demonstrate variable clinical phenotypes – ranging from milder fo...

Context: Wolfram syndrome (WS) is an autosomal recessive neurodegenerative disorder caused by mutations in the WFS1 gene characterized by central diabetes insipidus, juvenile-onset diabetes mellitus (DM), optic atrophy (OA), and deafness. The natural history of WS is variable, even within the same family and with the same mutation.Objective: The aimof this study is to report the phenotypes of five patients of Dr...

Objective: Studies contain evidence that anemia in diabetic patients may lead to the development of microvascular and macrovascular complications by causing hypoxia and oxidative stress in peripheral tissues. In this study, we aimed to determine the frequency and risk factors of anemia in children with type 1 DM.Material and Methods: The study group included 82 children with Type 1 DM aged between 1 and 18 years with dis...

Introduction: Many HCL-algorithms are available in pediatrics but real-life comparison studies are limited.Objective: Analyze and compare metabolic control indicators achieved with the two HCLS used in our hospital in Children-with-T1D (CwD).Methods: Retrospective descriptive study of CwD on HCLS treatment (Tandem with Control-IQ, Medtronic MiniMed780G). Data collection through cli...

Introduction: Single, large scale mitochondrial DNA (mtDNA) deletions (SLSMDs) comprise clinically heterogeneous group of rare and progressive multisystem disorders. Diverse initial symptoms, evolving and overlapping phenotype together with genetic heterogeneity pose a major challenge in diagnosis and treatment. We report on a young girl with SLSMD who presented with unique constellation of initial symptoms including diabetes mellitus (DM), macrocytosis, and s...

Backgrounds: Congenital hyperinsulinism (CHI) is a rare condition linked to several genetic, metabolic, and growth disorders in which there is dysregulated insulin secretion. Biochemical evidence of insulin-induced hypoglycemia is a prerequisite for genetic testing; however, there are no established criteria for the age at diagnosis of CHI. This study aims to investigate the genetic and clinical features of patients with CHI in a single center.<p class="ab...

Objectives: Advanced hybrid closed-loop (AHCL) therapy with the Medtronic MiniMed™ 780G system improves glycemia; however, the clinical outcomes in younger children remain less established. The evaluation of the use of the Medtronic MinimedTM 780G in children under 7 years old was aim ed.Methods: Children under 7 years old with type 1 diabetes mellitus (T1D) using MiniMed™ 780G AHCL and a control g...

Objective: Hyperglycemia is the primary metabolic problem of Diabetes Mellitus (DM). DM is characterized by chronic high glucose levels. Chronic hyperglycemia or poor metabolic control of diabetes is associated with increased systemic inflammation and oxidative stress. The rate at which hyperglycemia induces oxidative stress is important in determining strategies for reversing the process and preventing comorbidities. In our study, we aimto evaluate the relati...

Introduction: This retrospective study aim ed to assess the correlation between whole blood electrolytes measured by an arterial blood gas analyzer and serum electrolytes measured at a central laboratory, of patients with diabetic ketoacidosis (DKA).Materials and Methods: Children (1-18 years old) with DKA, followed up at Ayd&imath;n Adnan Menderes University Faculty of Medicine Hospital between January 2017 and August 2...

Background: MiniMed™ 780G was launched in Japan in November 2023 and is expected to further improve glycemic control.Objectives and Methods: 】Subjects of this study were 29 patients with T1DM, aged 2-18 years (average 8.8 years old), who have been treated by SAP using MiniMed™ 770G for at least 3 months prior to switching to 780G smart guard system. We divided subjects into 2 groups by HbA1c levels ove...

Introduction: Acute kidney injury (AKI) is a common complication in diabetic ketoacidosis (DKA). AKI in children with DKA is often mild and transient. Severe AKI is rare.Case: A 14-year-old female presented with symptoms consistent with recent-onset diabetes mellitus, accompanied by abdominal pain, vomiting, and respiratory distress over the preceding two days. Physical examination revealed confusion with a Glasgow Coma ...

Introduction: IPEX Syndrome (Immune dysregulation, Polyendocrinopathy, Enteropathy, X-linked) is characterized by mutations in the Forkhead BoxP3 (FOXP3) transcription factor, leading to autoimmunity in various organs starting in the perinatal period. This syndrome manifests with proliferative lesions in the thyroid gland, gastrointestinal system, skin, and other organs. We report a case of a 4-month-old male with neonatal diabetes, resistant thrombocytopenia,...

Introduction: Neonatal diabetes mellitus (NDM) is a rare monogenic disease associated with genetic defects in pancreatic beta cell number and/or function. It can be divided into two forms: transient neonatal diabetes mellitus (TNDM) and permanent neonatal diabetes mellitus (PNDM). TNDM is usually diagnosed within the first month after birth and usually regresses before the age of one year, but may reappear during adolescence. In contrast, PNDM is a lifelong di...

Aim: To assess the incidence and mode of presentation of type 1 diabetes mellitus (T1DM) in children and adolescents younger than 16 years of age between January 2012 and December 2023 in Malta. This was done as a follow up study to a previously published paper describing the incidence of T1DM in Malta between 2006-2010.Methods: A nationwide retrospective study which collected data from newly diagnosed T1DM children who ...

Background: Rabson-Mendenhall Syndrome (RMS) is a rare, autosomal recessive disorder characterized by hormonal and clinical features of insulin resistance (acanthosis nigricans, hirsutism, etc.) Other clinical features may include lipodystrophy and metabolic syndrome (hypertension, non-alcoholic fatty liver disease (NAFLD), hypertriglyceridemia and polycystic ovary syndrome). Biallelic loss of function mutations in the insulin receptor gene (INSR) affect insul...

Introduction: Ketoacidosis is an acute metabolic complication often indicative of diabetes in children. It can be severe and life-threatening, especially when complicated by major hypertriglyceridemia (HTg). This association is rare in pediatrics but should not be overlooked.Observation: A 8-year-old girl admitted for treatment of severe diabetic ketoacidosis (DKA). The biological assessment, apart from the diagnostic cr...

Introduction: Lipodystrophy syndromes are rare heterogeneous disorders characterized by deficiency of adipose tissue, usually a decrease in leptin levels and, frequently, severe metabolic abnormalities including diabetes and dyslipidemia. Congenital Generalized Lipodystrophy is a rare autosomal recessive genetic desease that presents early, at birth or just after. The estimated prevalence ranges from 1 in a millon to 1 in 10 millon individual...

Backgorund: Neonatal diabetes is a rare genetic condition with multiple mechanisms, some of them diagnosed in molecular levels.Objectives: To present the incidence, genetics, clinical phenotype and treatment in permanent neonatal diabetes in Kosova.Methods: Patients with PNDM that were identified between 2007 and 2022 were clinically phenotyped and gene sequencing of ABCC8, KCNJ11 ...

Introduction: GATA6 is a gene that encodes a zinc transcription factor with a key role in the development of several organ systems, as evidenced by the many congenital malformations that have been associated with its mutation. GATA6 plays a role in gut, lung, pituitary, and heart development, with broad expression in developing heart tissue and close link with pancreatic agenesis/hypoplasia. Most cases present with neonatal Diabetes, but a small proportion dev...

Objectives: Latvia has experienced significant rise in new-onset type 1 diabetes (T1D) cases in children during COVID-19 pandemic from 2020 to 2022, similarly to other countries. In addition, it was recognized that children during pandemic tended to have more severe initial manifestation than it was before pandemic. There have been several theories and studies so far mostly based on patient division in pre-pandemic and pandemic cases. Our aimwas to analyse, wh...

Background/Purpose: Case report of two siblings (nine-year-old boy and four-year-old girl) with rarely described factitious diabetes by proxy, aim ing to enhance physician’s awareness.Methods: Initially the boy was referred by a physician to the outpatient clinic to apply (successfully) for an insulin pump. The mother convincingly claim ed her son has had T1DM for 3 years. Reported history started during hospitaliz...

Confidence of Emergency Department (ED) Clinicians in the management of Paediatric Type 1 Diabetic (T1DM) Emergencies was investigated at Wythenshawe Hospital to gain an understanding of future training needs. A questionnaire assessing the overall confidence of ED clinicians in the recognition and management of Diabetic Ketoacidosis (DKA), management of children with insulin pump therapy and use of the BSPED sick day rules was circulated. Previous training on this topic in the...

Background: Emerging evidence suggests the presence of distinct endotypes of type 1 diabetes mellitus (T1DM): T1DE1 in individuals diagnosed at age <7 years in contrast to T1DE2 in those diagnosed at ≥13 years of age. We aimed to comprehensively explore the phenotypic heterogeneity of T1DM with respect to the age-related endotypes.Methods: This cross-sectional study was conducted in China involving 1,204 children n...

Objectives: The incidence and importance of endocrine comorbidities related to cystic fibrosis-related diabetes (CFRD) and bone diseases (CFRBD) increase with age. Recent studies have indicated that insulin deficiency in type 1 diabetes mellitus(T1D) may be associated with an increased risk of osteoporosis. Our study aims to evaluate the relationship between glucose metabolism and bone health in pediatric cystic fibrosis patients.<strong...

Aim: This study aims to investigate the presentation characteristics, follow-up, and treatment modalities in children and adolescents diagnosed with Type 2 Diabetes (T2D).Materials and Methods: This retrospective chart review includes 50 patients aged 4-20 years diagnosed with T2D between February 2013 and October 2023 according to American Diabetes Association (ADA) criteria in pediatric endocrinology clinic of a univer...

Introduction: Type 1 diabetes (T1D) is due to decreased insulin production due to autoimmune destruction of β cells. There is an increase in the diagnosis of T1D in young patients with poor pancreatic reserve due to greater destruction of β cells and more complex evolution.Objectives: To classify patients into different Endotypes based on age, characteristics at onset, and progression one year later.<p clas...

Background: Type 1 Diabetes (T1D) is a chronic condition characterized by the autoimmune destruction of pancreatic beta cells, leading to insulin deficiency. The honeymoon phase (HP), a period of partial clinical remission shortly after the diagnosis, presents a significant opportunity for intervention. Understanding the factors influencing the duration and onset of HP could inform treatment strategies and potentially prolong the remission period.<p class=...

Background: Managing glucose control in young children with Type 1 Diabetes (T1D) is challenging due to variable insulin needs, sensitivity, and unpredictable eating and activity behaviours. Despite their effectiveness, the majority of the Advanced Hybrid Closed Loop (AHCL) systems is not approved for children under six in many countries of Europe.Aim: To assess and compare the effectiveness of Multiple Daily Injection (...

Background: An increased incidence of Type 1 diabetes has been observed worldwide over the past 30 years. Obesity is a well-documented risk factor for Type 2 diabetes (T2D), but poor studies have postulated an association between the obesity and overweight and the rate of T1D in these age groups. This is known as Accelerator Hypothesis. In addition, a further effect seems to be exerted COVID-19 pandemic which is related to raised rate of T1D onset and obesity....

Aim: The Irish Childhood Diabetes National Register (ICDNR), established in 2008, prospectively collects robust data to monitor the epidemiology of Type 1 diabetes mellitus (T1DM) in children up to the age of 15 years. It is well recognised that the incidence of T1DM in children differs over time and between populations. The recent IDF atlas noted Ireland to have the 10th highest reported T1DM incidence globally. In the Irish population, similar to ...

Introduction: Type I diabetes (T1D) is an autoimmune disease that might be associated with a family history of T1D (1). In Kuwait, pediatric diabetes is a growing healthcare concern with limited knowledge about familial T1D. We aim ed to identify the prevalence, clinical, and biochemical characteristics of familial T1D in Kuwait.Methods: All children (aged ≤12 years old) diagnosed with T1D between 2011-2022 and were r...