ESPE Abstracts

Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive condition which leads to glucocorticoid deficiency. During childhood, the main aims of treatment are to prevent adrenal crisis and to achieve normal stature, optimal adult height and to undergo normal puberty. In adults, the aims of treatment are to prevent adrenal crisis, ensure normal fertility and to avoid long-term consequences of glucocorticoid use. Current treatment regimens for CAH with glucocort...

Background: Socioeconomic deprivation is an important determinant of health.Objectives: This study examined the relationship between incidence of hospital admissions for patients with Type 1 diabetes mellitus (T1DM) and their socioeconomic deprivation.Methods: All hospital admissions of patients with T1DM from 0 to16 years were identified during a 5-year period between 2007 and 2012 using the hospital episodes statistics database (...

Background: Socioeconomic deprivation, obesity and emotional well-being are important determinants of health inequalities and poor glycaemic control in adults with type 1 diabetes mellitus (T1DM).Objectives: This study aims to look at the effect of social deprivation, BMI and patient reported emotional well-being on glycaemic control in children and young adults with T1DM.Methods: Socioeconomic status was measured by cross-referenc...

An 11-year-old female presents with a 6-week history of double and blurred vision associated with headaches and neck swelling. Thyroid function tests demonstrated antibody negative hypothyroidism and connective tissue disorder screening was negative. The patient was commenced on thyroid hormone replacement (levothyroxine). 5 days later, she re-presented with strabismus and progressive diplopia. Intracranial imaging was performed to rule out space occupying masses. A diagnosis ...

Background: Type 1 diabetes mellitus (T1DM) in children carries significant psychological stress for families, as well as considerable long-term complications if good metabolic control is not achieved. Tighter metabolic control carries increased risk of hypoglycaemic episodes, and previous research suggests that families with a high fear of hypoglycaemia will run blood sugars higher in order to avoid this. Continuous glucose monitoring (CGM) provides real time temporal measure...

Background: Children with severe hypothyroidism are known to present with significant growth restriction. Institution of treatment with thyroxine (T4) results in catch-up growth. However, treatment commenced in pubertal period may result in loss of adult height in cases with longstanding severe hypothyroidism.Objective and hypotheses: The objective of our study is to evaluate the presentation, investigations and catch-up growth after initiatio...

Background: The UK has the highest number of children and young people with type 1 diabetes mellitus in Europe, but the lowest number of children and young people attaining good diabetes control.Methods: In December 2012, our diabetes service established the use of an electronic diabetes information management system that was web-based (Twinkle.Net) and routine uploading of glucose meters and pumps (Diasend). The electronic management system Twinkle.Net ...

Background: Self monitoring of blood glucose (SMBG) is an important part of diabetes management. Continuous glucose monitoring system (CGMS) provides the real time measurements of users’ glucose levels. The NICE guideline recommends use of CGMS if there is persistent hypoglycaemia unawareness or repeated hypoglycaemia or hyperglycaemia. In our paediatric diabetes clinic within a large DGH, we have a cohort of 12 children who were funded for the CGM use for a minimum of 1 ...

Background: Neonatal hyperthyrotropinaemia (HT) is defined by elevated thyroid stimulating hormone (TSH) and normal free-thyroxine (FT4) level. Persistent HT in the neonatal period is often a diagnostic dilemma for clinicians to either treat to prevent subclinical hypothyroidism or to wait and monitor thyroid function tests (TFTs).Methods: As part of an audit, 1,449 term infants who had TFTs undertaken as part of a prolo...

Background: In type 1 diabetes (T1D), optimal glycaemic control requires intensive self-management to reduce the risk of complications. While routine downloading and review of blood glucose data is part of clinical practice of healthcare providers in an outpatient setting, patients and families are also educated, advised and encouraged to regularly download and review blood glucose data at home in order to make adjustments to insulin dosing for carbohydrate in...