ESPE Abstracts

Background: Pseudohypoparathyroidism (PHP) is a group of disorders characterized by end-organ resistance to the parathyroid hormone (PTH). PHP type 1A is caused by mutations in GNAS exon 1 through 13 with multihormone resistance (PTH, TSH and gonadotropins), Albright’s hereditary osteodystrophy, and obesity. However, patients often do not present with elevated levels of PTH until after the first years of life.O...

Background: Insulin therapy by creating a subcutaneous depot remains an integral part of the treatment of diabetes in children. Places of insulin administration are restricted to certain parts of the body and the condition of subcutaneous fat affects the variability of glycaemia no less than quality of insulin. Formation of lipodystrophies (LD) causes glycaemia variability, difficulties in selection of insulin doses and achieving disease compensation.Obj...

Background: The liver is one of the most important organs in glucose metabolism and closely related to diabetes pathophysiology. Non-alcoholic fatty liver disease (NAFLD) is well known in type 2 diabetes mellitus (DM), but also adult patients with type 1 DM are at increased risk for NAFLD.Objective and hypotheses: Here, we studied the prevalence of liver disease in a representative number of children and adolescents with type 1 DM in Germany.<p class...

Background: CSII has some potential advantages and disadvantages for young children. For many young patients, it is easier and more convenient to take multiple daily doses of insulin with CSII than with a syringe or insulin pen.Objective and hypotheses: The growing popularity of type 1 diabetes (DM1) treatment based on continuous subcutaneous insulin infusion (CSII) raises a question of the group of patients that benefit most from the treatment.<p cl...

Background: Cataract as a chronic complication of diabetes is well established in the literature and the risk factors are also well known. However, rare cases of acute bilateral cataract have been reported, all of them happening relatively shortly after diagnosis in T1DM. While the pathophysiology of this phenomenon remains unclear – as a lot of different theories proposed so far with the most accepted being the osmotic stress induced oxidative damage – fail to expla...

Background: With the use of insulin resistance (IR) as a cause of metabolic syndrome (MetS), it is possible to screen the risk group of childhood MetS. Indirect index of IR can be estimated thru homeostasis model assessment (HOMA) of IR. Another index of triglyceride and glucose (TyG) were evaluated and equally effective in some adult studies. However, we do not have consistent prevalence rate and percentile distribution of MOMA-IR and TyG index in children and adolescent popu...

Background: Several previous publications have documented the usefulness of Nifedipine for treating hyperinsulinaemic hypoglycaemia (HI). These reports include transient and persistent forms of HI, with and without known genetics, used in monotherapy or in combination with other drugs, and demonstrate various outcomes.Objective and hypotheses: To systematically trial Nifedipine in children with known HI mutations and diazoxide unresponsive, assessing gly...

Background: The exact mechanisms on growth are not fully eluciated, but they involve insulin resistance, fetal hyperleptinemia, hypothalamic changes. The adipose tissue-derived signaling molecules include adipokines such as leptin, adiponectin and resistin. On the other hand, ghrelin is the hunger hormone and an endogenous growth hormone secretagogue.Objective and hypotheses: This study aimed to investigate the relation between growth and serum insulin, ...

Background: Accurate prediction of responsiveness to growth hormone (GH) therapy is an important issue. The 1st year response to treatment is regarded as significant predictor of the attained final height. Neural networks are techniques of machine learning which do not require any assumptions and preprocessing of data, contrary to linear regression models.Objective and hypotheses: The aim of the study was to predict height velocity (HV) during 1st year o...

Background: The definitive diagnosis of childhood GH deficiency (GHD) depends on the demonstration of failure to respond to two stimuli. In our center children are allocated to either glucagon-first or clonidine-first according to the preference of the pediatric endocrinologist following the patient. The nursing staff prefer glucagon-first due to patient safety (less pronounced adverse events and faster recovery time). Few studies have addressed which GH stimulation test shoul...