ESPE Abstracts

Obesity—defined as excess fat mass which impacts on physical health—is a complex and multifactorial disease where numerous environmental factors (overeating and/or reduced physical activity) act in concert with genetic factors. Understanding molecular mechanisms of obesity has rapidly improved in recent years due to the development of faster, more specific genetic screening tools (1). Rare genetic obesities are distinguished from more-common polygenic obesities where...

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The medical treatment of osteoporosis in children at present mainly relies on anti-resorptive drugs, in particular bisphosphonates. However, not all forms of pediatric osteoporosis are characterized by increased bone resorption. In disorders with low bone turnover and decreased bone formation activity, such as osteoporosis due to neuromuscular disorders and glucocorticoid exposure, use of bone anabolic approaches appears to be a more logical option than antiresorptive drugs, w...

Despite significant advances in the medical management of childhood diseases, glucocorticoids (GCs) continue to be the mainstay of therapy for numerous serious conditions, including hematological malignancies, Duchenne muscular dystrophy (DMD) and inflammatory disorders. In order to understand the natural history of bone development in GC-treated children, a pan-Canadian longitudinal observational research study called "STOPP" (STeroid...

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There is no single conception of sex that covers the multitude of biological process that are commonly encompassed by the term and its cognates. Gonadal sex determination is sometimes known as 'primary' sex determination due to its centrality in our understanding of 'maleness' and 'femaleness'. In mammals, this is characterised by the sexually dimorphic development of an initially bipotential gonadal primordium in the fetus into either a testis or an ov...

Among the many complications of type 1 diabetes (T1D), hypoglycemia is an acute concern for children with T1D and their families. Moreover, fear of hypoglycemia is a common barrier to achieving glucose targets. Numerous advances in care have been made since the Diabetes Control and Complications Trial was published in 1993 in which lower HbA1c was associated with increasing risk of severe hypoglycemia. More recent data indicate that lower HbA1c (7% ISPAD target) can be ach...

Screening for diabetic retinopathy has been expanded from ophthalmology-based assessments. Retinal photography can be used in primary care by trained photographers, and then graded by trained staff using Telemedicine. Ultrawide retinal cameras can now capture over 80% of the retina from a single image. It may be more predictive of progression to proliferative retinopathy than the traditional views, but cost of equipment for benefit is unclear. There have been advances in D...

Vascular complications continue to be a major concern for young people with type 1 diabetes (T1D), who have a decreased life expectancy, by 8-16 years, compared to the background population. Diabetic nephropathy and cardiovascular disease are main contributors to morbidity and mortality in people with T1D. Thus, early detection and prevention of complications are of paramount importance to improve their long-term prognosis.Although HbA1c is a major risk ...