ESPE Abstracts

Patient satisfaction is of increasing importance and is widely recognized as an indicator of quality of medical care. The aim was to assess children with type 1 diabetes and their families Satisfaction with Healthcare Services.Methods: The study was conducted at Pediatric outpatient clinic, Suez Canal University Hospital, Ismailia Egypt. Eighty children diagnosed with type 1 diabetes for at least 1 year. They were interviewed to obtain t...

Type 1 diabetes mellitus is a chronic disease of autoimmune etiology that is highly prevalent in childhood. In the last decade, the possibility of using the Bacillus Calmette-Guérin vaccine for the treatment of this disease has been studied thanks to its immunomodulatory action. These authors published a few years ago an inconclusive work on the influence of the use of BCG on the number of cases observed in the CCAA in a smaller cohort (Bol S Vasco- Nav Pediatrician 202...

Type I diabetes mellitus (DM) is one of the most common childhood chronic diseases. Early signs of diabetogenic cardiomyopathy, which appears as a complication of autonomic diabetic neuropathy in children, have not been sufficiently studied. The purpose of the work: the study of the electrical stability of the myocardium based on the analysis of the QT interval in the ECG in children with DM type 1.Material and Methods: 82 children with ...

Objective: The aimis to evaluate the effect of continuous glucose monitoring device (CGMD) assistance provided to the children with type 1 diabetes following the 2023 Türkiye earthquake compared with those that did not benefit from this assistance, as well as to investigate the changes in sensor parameters during 9-month usage of CGMD.Methods: This retrospective study included 11 centres from 7 provinces in the disa...

Background: Mauriac syndrome, a rare complication of type I diabetes mellitus (T1DM) results from inadequate glycemic control and excessive insulin therapy. Fluctuating plasma glucose, excessive insulin and glucose administration stimulate glycogen synthase, causing glycogen accumulation in the liver. Furthermore, elevated serum cortisol secretion in Mauriac syndrome inhibits hepatic glycogenolysis while enhancing fatty acid synthesis, worsening liver enlargem...

Diabetic nephropathy is the leading cause of chronic renal failure. Poor metabolic control exposes the patient to multiple chronic complications, the most serious of which is diabetic nephropathy. This complication is the leading cause of chronic renal failure.Aims: the main aimof our work is to assess the frequency of nephropathy in diabetic children and to study the impact of clinical parameters and metabolic control on microalbuminuri...

Background: Diabetic neuropathic cachexia is a rare syndrome of acute neuropathic pain and profound weight loss. Mauriac syndrome has rarely been reported in children and adolescents with a poorly controlled diabetes mellitus type 1. Common presenting features include short stature, growth retardation, moon facies, protuberant abdomen, and proximal muscle wasting. We report the first case of the association of Mauriac Syndrome and Diabetic neuropathic cachexia...

Background: Neonatal Diabetes Mellitus (NDM) is a rare monogenic disease with an incidence of 1/21000-300 000 live births, increasing with consanguinity. NDM presents with hyperglycemia from the 1st few days till 6 months of life. Few cases start between 6 to 12 months or later. NDM is divided into transient (TNDM) and permanent (PNDM). TNDM type 1 is caused by mutation at 6q24 whereas TNDM type 2 is mainly caused by mutation in K-ATP channel genes ...

Background: Acute Lymphoblastic Leukemia (ALL) is the most common pediatric oncologic disease. Nowadays, ALL has become a treatable disease due to a well designed chemotherapy protocol. L-Asparaginase is an essential drug which has improved the long term outcome of ALL. However, hyperglycemia due to L-Asparaginase (4-20%) and PEG- Asparaginase (4-17%) is one side effect and can lead to diabetes mellitus or even to diabetic ketoacidosis DKA (0.8%) in combinatio...

Background: Type 1 diabetes mellitus (T1DM) is a disorder characterized by insulin insufficiency caused by the autoimmune destruction of pancreatic beta cells. Optimum control of TIDM needs insulin administration along with intensive education. Lipohypertrophy is one of the complications and risk factors of uncontrolled diabetes.Objective: To determine the frequency and associated factors of lipohypertrophy in children a...

Introduction: Disease-modifying agents, such as anti-CD3 monoclonal antibodies, have shown promising outcomes in improving the management of Type 1 Diabetes (T1D). Immunotherapy with teplizumab has delayed the onset of T1D for three years. It is been administered intravenously for 14 days in children and young people (CYP) aged > eight years already in stage 2 (multiple islet autoantibodies, abnormal glucose tolerance, usually pre-symptomatic). This treatme...

Objective: In this study, we aim ed to investigate the effect of body mass index on metabolic control and the relationship between daily insulin requirement and body mass index in children with newly diagnosed type 1 diabetes.Materials and Methods: Between 17.11.2020 and 31.12.2021, 23 patients with newly diagnosed type 1 diabetes mellitus in the Pediatric Endocrinology Clinic and followed prospectively for the first yea...

Background: The development of diabetes mellitus type 2 (T2DM) involves a disbalance between pancreatic β-cell function and insulin sensitivity. The impact and sequence of pathological mechanisms involved in the development of T2DM in adolescents haven’t been established.Aims: To compare the role of pancreatic β-cell dysfunction and insulin resistance in the development of prediabetes and T2DM in obese ad...

Instruction: Type 1 diabetes mellitus is closely associated with several autoantibodies such as GAD autoantibody, insulin autoantibody, islet cell cytoplasmic antibody (ICA), IA-2 Autoantibody, ZnT8 autoantibody., ICA test is being replaced by IA-2, ZnT8 is still not available in Korea. The implement of IA-2 autoantibody testing in Korea marks a significant diagnostic advancement. The aimof this study is evaluating clinical significance and diagnostic utility ...

• Kamelia, 10 months, known case of neonatal diabetes diagnosed at 5 months of age.• Presented to our pediatric ICU in Mansoura Health Insurance Hospital by hyperglycemia associated with high grade fever.• She was diagnosed diabetic at age of 5 months associated with hypothyroidism at initial diagnosis in Mansoura university children hospital.• Discharged on NPH 3 times daily on 0.7 units/...

Presentation: A 15-year-old girl presented to Paediatric A&E with lethargy, polyuria, polydipsia and blurred vision. Initial blood gas showed a pH of 7.28, blood glucose unrecordable and ketones of 4mmol/L. The patient was started on IV fluids and insulin, according to the diabetic ketoacidosis (DKA) protocol, and a new diagnosis of type 1 diabetes mellitus was made.Investigations: Finger-prick capillary sampling pro...

We report three cases of patients with pancreatitis that developed diabetes mellitus (DM). Case 1: 8,9 years old female, treated with valproic acid (VPA) for epilepsy. Who is admitted with 5 days of abdominal pain, vomiting and altered state of consciousness, in the ER the patient was dehydrated and initial labs showed glycemia of 423 mg/dl. She was admitted to the ICU, further studiesResults: amylase 502 U/L, lipase 1491 U/L, HbA1c 5.4%...

Objective Insulin autoimmune syndrome (IAS) is a rare cause of hyperinsulinemic hypoglycemia in children. Methods We retrospectively analyzed the youngest diagnosed case of IAS in China, which presented as frequent spontaneous hypoglycemia. Results A 4-year-old boy with a height of 102.5 cm (-0.16 SD), weight of 18 kg (0.84 SD), and BMI of 17.13 kg/m2 (1.35 SD) was examined. He had no distinctive facial features or acanthosis nigricans. After a fasting test for 14 hours, his v...

Background: In this study we anaysed the epidemiology, clinical characteristics, immunological and metabolic factors in children with type 1 diabetes (T1DM).Methods: From January 2009 to January 2023, children with T1DM. were enrolled in this study. 79 healthy children were recruited as the control group.Results: A total of 357 children with T1DM were included, including 177 males ...

56 patients under the care of the paediatric diabetes team at Wythenshawe Hospital were identified as current Omnipod® 5 insulin pump users for Type 1 Diabetes Mellitus management in April 2024. Time in range (TIR) i.e. the time spent with blood glucose in the normal range, total daily dose (TDD) of insulin, BMI Z-score along with total daily carbohydrate intake (CHO) and insulin boluses (TDB) during the first six months of pump therapy were compared against those of their...

We conducted a quality improvement project in our centre to assess the screening process for hypertension in annual review clinics. All children with diabetes should have their BP checked at least once a year and it should be plotted against their age, gender and height centile to calculate BP centile to determine if their BP is within normal range or high. Hypertension is defined BP >95th centile for age and height centile. These children should be monitored and subsequent...

Introduction: Thiamine-responsive megaloblastic anemia syndrome (TRMA) a rare autosomal recessive condition described by megaloblastic anemia, diabetes mellitus and progressive sensorineural hearing loss. The onset occurs between infancy and adolescence. Thiamine treatment correct the anemia, but the red blood cells remain macrocytic; the anemia can recur when thiamine treatment seized. Progressive sensorineural hearing loss can be started early in kids; it is...

Introduction: Diabetic nephropathy is the main cause of end-stage renal disease worldwide and can remain asymptomatic for a long time. Urine Albumin-creatinine ratio (uACR) and Glomerular filtration rate (GFR) help to assess the kidney disease in patients with type 1 (T1D) diabetes. Dyslipidemia represents biomarkers of the risk of occurrence of macrovascular complications. The objective was to evaluate the relationship between classic biomarkers of diabetic n...

Introduction: Neurofibromatosis type 1 (NF1) is an autosomal dominant condition, caused by genetic mutation of NF1 gene in chromosome 17q11.2, with a worldwide incidence of approximately 1 in 3000 people. It is caused by de novo mutation, in about 50%. This is a multisystemic disease, presenting with café-au-lait spots, axillary freckling, skeletal dysplasia and neural crest tumors (benign neurofibromas usually). Autoimmune disease associated with NF1 c...

Introduction and Objective: In patients with Type 1 Diabetes Mellitus (DM), a reduction in insulin requirement often occurs 2-4 weeks after diagnosis. Although the underlying mechanisms of this reduction in insulin requirement are not fully understood, the benefits it provides to the patient are significant. It is suggested that several factors may influence this period, known as the remission (honeymoon) phase. Our study aims to contribute to the literature b...

Case presentation: We report two cases of patients with Cystic fibrosis-related diabetes (CFRD) Patient 1. At 5 years of age, a genetic diagnosis of cystic fibrosis with homozygous delta F508 variant was made in relation to a brother diagnosed in the newborn period. At 12 years old FEV1 91%. Initial screening at age 14 with impaired fasting glucosa and HbA1c of 5.9%; She was overweight and had acanthosis. Hospitalizations for recurrent pneumonia. At 17 years o...

Background: Bone health impairment in patients with diabetes mellitus type 1 (DMT1) is already evident in pediatric age. Crucial moment is the time of attainment of peak bone mass which is also a window of opportunity for bone health interventions. Currently there are no detailed guidelines for screening/specific treatment of bone complications in DMT1.Aim: To develop recommendations for screening and prevention of bone ...

Introduction: The Saudi National Diabetes Registry focuses mainly on adult patients. In 2020, the National Guard Health Authority (NGHA) launched the Saudi Pediatric and Youth Diabetes Registry (SPYDR), for children and adolescents with diabetes. We report on the first data and the challenges we faced during SPYDR initiation.Methods: Patients were identified from the electronic medical records of the Saudi NGHA hospitals...

Congenital hypothyroidism (CH) and hyperinsulinemic hypoglycemia represent two distinct yet interrelated metabolic disorders in pediatric endocrinology. We report a comprehensive case study of a 14-day-old female neonate presenting with persistent hypoglycemia since birth, despite initial management with thyroxine for suspected CH. The neonate exhibited classical clinical features of CH, including lethargy, puffy face, and umbilical hernia, alongside a pertinent family history...

Introdaction: The prevalence of Diabetes type 1 constantly increases worldwide from birth to 12 years with a peak in school age. The appearance of students with diabetes in class may be a challenge for their teachers. Diabetic children spend routinely most of their daytime at school and may need adult support in insulin injections or at episodes of hypo and hyperglycemia during school activities and meals. Therefore, our study aims to evaluate the knowledge an...

Aim: The ideal intravenous (iv) fluid administration rate in the treatment of diabetic ketoacidosis (DKA) and its effect on metabolic normalization, changes in electrolyte levels and the development of complications such as cerebral oedema are controversial in the paediatric age group. We aimto present the results of a practical and modified DKA treatment protocol, which was prepared with reference to the International Society for Paediatric and Adolescent Dia...

Background: There has been in recent years a significant increase of incidence of obesity and Type 2 diabetes (T2D) in children and young people (CYP). Most therapeutics research for T2D has been done in adults. There is increasing concern of high risk patients that are very slow to respond to our standard approach, especially as youth with T2D have greater degree of insulin resistance, more rapid beta cell failure and prevalence of complications compared with...

Introduction: Automated insulin delivery (AID) systems provide an improvement in metabolic control of patients with type 1 diabetes mellitus (DM1). Our center works with 2 systems: (Control-IQ T-slim (A) and Medtronic780G (B)), each one have their own characteristics that could determine the selection of the users. The aimof the study is to evaluate the metabolic control of patients with DM1 after starting AID and evaluate differences between the two treatment...

Background: Thiamine-responsive megaloblastic anemia (TRMA) syndrome, is an autosomal recessive disorder marked by sensorineural hearing loss, diabetes mellitus, and megaloblastic anemia caused by mutations in the SLC19A2 gene.Objective: We are reporting five patients with TRMA syndrome in the Pakistani population.Case Summary: We report five male patients, from two differ...

Introduction: Non-diabetic ketoacidosis occurring with hyperglycaemia causes diagnostic dilemma in the emergency department. Biochemistry mimics diabetic ketoacidosis [DKA], the proposed mechanism is ketosis from reduced carbohydrate intake, with stress hyperglycaemia from acute illness.Case Description: A 1 year old boy presented to the emergency department with a short history of fever and reduced oral intake. Initial ...

The COVID-19 pandemic has an impact on the incidence of type 1 diabetes. It is important to synthesize estimates of changes in incidence rates.Aim: To compare the incidence rates of type 1 diabetes mellitus (T1DM) in children of Saratov region during and before the COVID-19 pandemic.Patients and Methods: This is a retrospective multicenter study involving new onset T1DM paediatric patients (0-17 y....