ESPE Abstracts

Background: Congenital hyperinsulinism (HI) results in hyperinsulinemic hypoglycaemia in infants; a significant risk factor for brain injury due to neuroglycopenia and the suppression of alternative neuroprotective mechanisms such as ketogenesis. Neuronal damage can occur in both transient and persistent HI, with worse neurodevelopmental outcomes reported in those who receive a delayed diagnosis. There is currently no method for screening for HI and neuronal d...

Background and Aims: Hypoglycaemia is a life-threatening risk for many patients and prevention is individualised and complex. Continuous Glucose Monitoring (CGM) shows promise but current accuracy is insufficient for acute hypoglycaemia detection and data review services are complex and generic. Machine Learning is increasingly used but ignores weekly hypoglycaemia patterns and behaviour change and thus has demonstrated no real-world reduction in hypoglycaemia...

Introduction: The neonatal threshold for hypoglycaemia is debatable and makes its treatment challenging. Neonatal hypoglycaemia can be transient and yet pose a significant risk of neuroglycopaenia, especially with severe and recurrent hypoglycaemia in Congenital Hyperinsulinism. Untreated hypoglycaemia induced cerebral injury can be identified by magnetic resonance (MR) brain scan changes affecting cerebral white matter, occipital lobes and posterior parietote...

Background and Aims: In patients with congenital hyperinsulinism (CHI), recurrent hypoglycaemia can lead to longstanding neurological impairments. At present, glycaemic monitoring is with infrequent fingerprick tests; a practice which can miss hypoglycaemic episodes between tests. Continuous glucose monitoring (CGM) is a promising alternative method which has the utility to identify risk and patterns of hypoglycaemia. Although CGM is well established in type 1...

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...

Introduction: Easypod-connect™ for childhood growth disorders is a unique connected system that enables the transmission of injection adherence information for recombinant human growth hormone (r-hGH). Although this system has the potential to facilitate greater adherence, observational studies have shown declining adherence over prolonged periods when used without additional support. Supplemental nurse practitioner support has been envisaged but not inv...

Introduction: Patients with hyperinsulinism suffer recurrent and severe hypoglycaemia. Inpatient glucose monitoring is currently via intermittent, infrequent fingerprick self-monitoring blood glucose (SMBG), and risks missing hypoglycaemia between tests. Continuous glucose monitoring (CGM) offers a supplementary therapy which may identify unexpected hypoglycaemia and ultimately reduce total exposure. However, CGM has never been evaluated for its efficacy in th...

Background: The incidence of Type 2 Diabetes Mellitus (T2DM) among children is escalating at an alarming rate, presenting a significant public health concern. This increase is intrinsically linked to the obesity epidemic, with most children diagnosed with T2DM being overweight or obese. While the oral glucose tolerance test (OGTT) remains the gold standard for diagnosing T2DM (and the preceding dysglycaemia), its accessibility and practicality in community set...

Background and Objective: Continuous Glucose Monitoring (CGM) is gaining in popularity for patients with paediatric hypoglycaemia disorders such as Congenital Hyperinsulinism (CHI), but no standard measures of accuracy or associated clinical risk are available. A small number of studies have shown suboptimal accuracy of CGM in CHI but assessments have been inconsistent, incomplete and offer no measure of clinical application. Error grids that categorise clinic...

Background & Aims: Hypoglycaemia is a constant threat for all patients with congenital hyperinsulinism (CHI) and, left untreated, can lead to neurological damage and impaired development. To improve glycaemic monitoring, self-monitoring-blood-glucose (SMBG) is increasingly being replaced by Continuous Glucose Monitoring (CGM) with potential to identify illness patterns and treatment responses although with unproven benefit for patients and families. Explor...