Frequent Monitoring of C-Peptide Levels in Newly Diagnosed Type 1 Subjects Using Dried Blood Spots Collected at Home.

Objective: To evaluate an approach to measure β-cell function by frequent testing of C-peptide concentrations in dried blood spots (DBSs).

Patients: Thirty-two children, aged 7 to 17 years, with a recent diagnosis of type 1 diabetes.

Design: Mixed-meal tolerance test (MMTT) within 6 and again at 12 months after diagnosis, with paired venous and DBS C-peptide sampling at 0 and 90 minutes.

Care of children with diabetes as inpatients: frequency of admissions, clinical care and patient experience.

Aim: Hospital inpatient care for children with diabetes is frequently mentioned by parents as unsatisfactory. The aim of this study was to examine the reasons for inpatient admission of children with diabetes and to understand patient and carer experience in order to improve services.

Methods: Questionnaires were given to medical teams, parents and children during admissions of children with diabetes under 16 years of age in three regions of England.

Inpatient care for children with diabetes: are standards being met?

Background: Hospital inpatient care is frequently mentioned by parents as unsatisfactory for children with diabetes. Ward staff are now less familiar with diabetes, as admissions are less common and diabetes management is more intensive.

Objective: To compare current practice with Department of Health Children's Diabetes Working Group care standards.

Current methods of transfer of young people with Type 1 diabetes to adult services.

Aims: To determine the efficacy and patient perception of various transfer procedures from paediatric to adult diabetes services.

Methods: Comparison between four districts in the Oxford Region employing different transfer methods, by retrospective study of case records and interviews of patients recently transferred from paediatric diabetes clinics. The main outcome measures were age at transfer, clinic attendance rates, HbA1c measurements and questionnaire responses.

Growth hormone treatment in non-growth hormone-deficient children: effects of stopping treatment.

Overnight physiological growth hormone (GH) secretion was evaluated in 95 short, prepubertal children (73 boys, 22 girls). All the children were below the 3rd centile for height and achieved GH levels greater than 15 mU/l following pharmacological stimulation. The mean average GH level was 7.

Intracranial volume in children with craniosynostosis.

The intracranial volume of 104 children with craniosynostosis was measured. Premature fusion of skull sutures is thought to deny the growing brain room to expand, but contrary to traditional teaching the intracranial volume of such children is often within normal limits.

Physiological growth hormone secretion and response to growth hormone treatment in children with short stature and intrauterine growth retardation.

Physiological growth hormone (GH) secretion was examined in 31 children (8 girls, 23 boys) with short stature secondary to intrauterine growth retardation (IUGR). Seventeen (4 girls, 13 boys) had dysmorphic features of Russell-Silver syndrome. Four of the 31 children had GH insufficiency with peak GH levels of less than 20 mU/l during the night.

Physiological growth hormone secretion in children with short stature and intra-uterine growth retardation.

31 prepubertal children with short stature [mean height standard deviation score (SDS) -2.84] and low birth weight (mean -2.82 SDS) were studied.

Cushing's disease and craniopharyngioma.

A 14-year old girl presented with growth failure and Cushing's disease. Histological examination confirmed a craniopharyngioma but failed to show that the tumour secreted adrenocorticotrophic hormone. We suggest that her Cushing's disease was caused by hypothalamic dysfunction associated with increased corticotrophin-releasing hormone secretion, secondary to the craniopharyngioma.

Catch-up growth.

We describe the phenomena of catch-up and catch-down growth. These are normal physiological responses in both endocrine and non-endocrine diseases of childhood. Evidence suggests that catch-up growth is controlled by a centre in the central nervous system and that it is not dependent on increased growth hormone secretion.