AimsTo estimate the incidence of Type 2 diabetes in children aged <17 years, compare this with similar data 10 years ago, and characterize clinical features at diagnosis in the UK and Republic of Ireland.MethodsUsing the British Paediatric Surveillance Unit reporting framework, cases of Type 2 diabetes diagnosed in children aged <17 years between 1 April 2015 and 30 April 2016 were reported each month.ResultsA total of 106 cases were reported, giving a UK incidence of 0.72/100 000 (95% CI 0.58–0.88). Children from ethnic minorities had significantly higher incidence compared with white children (0.44/100 000) with rates of 2.92/100 000 and 1.67/100 000, in Asian and BACBB (black/African/Caribbean/black British) children respectively. Sixty‐seven percent were girls and 81% had a family history of Type 2 diabetes. The mean BMI sd score at diagnosis was 2.89 (2.88, girls; 2.92, boys); 81% were obese. Children of Asian ethnicity had a significantly lower BMI sd score compared with white children (P<0.001). There was a trend in increased incidence from 2005 to 2015, with a rate ratio of 1.35 (95% CI 0.99–1.84), although this was not statistically significant (P=0.062). There was statistical evidence of increased incidence among girls (P=0.03) and children of South‐Asian ethnicity (P=0.01) when comparing the 2005 and 2015 surveys.ConclusionsType 2 diabetes remains far less common than Type 1 diabetes in childhood in the UK, but the number of cases continues to rise, with significantly increased incidence among girls and South‐Asian children over a decade. Female gender, family history, non‐white ethnicity and obesity were found to be strongly associated with the condition.

ObjectiveTo establish short-term and medium-term complications 1-year postdiagnosis, of acute pancreatitis (AP) in children aged 0–14 years.DesignOne-year follow-up of a prospective monthly surveillance of new cases of AP in children under 15 years through the British Paediatric Surveillance Unit (BPSU) from April 2013 to April 2014.SettingA monthly surveillance of >3700 consultant paediatricians and paediatric surgeons in the UK and Ireland using the BPSU.PatientsChildren aged 0–14 years with a new diagnosis of AP.Main outcome measuresThe outcomes following AP, including the incidence of complications and comorbidity at diagnosis and at 1 year.ResultsOf the 94 new confirmed cases of AP identified in the UK during the study period, 90 cases (96%) were included in the 1-year follow-up. 30 patients (32%) developed further episode(s) of AP. Over one-fifth of patients developed one or more major complication. At initial admission, the most common of these was pancreatic necrosis (n=8, 9%), followed by respiratory failure (n=7, 7%). Reported complications by 1 year were pseudocyst formation (n=9, 10%), diabetes requiring insulin therapy (n=4, 4%) and maldigestion (n=1, 1%). At 1-year postdiagnosis, only 59% of children made a full recovery with no acute or chronic complications or recurrent episodes of AP. Two patients died, indicating a case fatality of ~2.0%.ConclusionsAP in childhood is associated with significant short-term and medium-term complications and comorbidities including risk of recurrence in approximately a third of cases.

Aims To establish the incidence and clinical associations of acute pancreatitis (AP) in children aged 0-14 years in the UK. Methods Monthly surveillance of new cases of AP in children under 15 years of age through the British Paediatric Surveillance Unit. Results A total of 94 cases (48 boys and 46 girls) of AP, clini-cian-diagnosed from April 2013 to April 2014, fulfilled the diagnostic criteria. The median age of diagnosis was 11.2 years (range 1.30-14.89 years). White children accounted for 60% of cases compared to 40% from ethnic minorities (71% Asian and 13% Black). Pakistani children alone made up 19% of the cohort. The reported incidence of AP in children under age 15 in the UK was 0.78 per 100,000 (95% CI 0.62-0.96). Of the 94 cases: 36 (38%) were idiopathic, drugs 18 (19%), gallstones 12 (13%), hereditary 7 (7.5%), organic acidaemia 7 (7.5%), anatomical anomalies 4 (4%), viral infections 3 (3%), vasculitis 3 (3%), trauma 1 (1%) and others 3 (3%). The most common drug associations were asparaginase (28%), azathioprine (17%) and sodium valproate (17%). Of the 12 gallstone-associated cases, 5 were boys; body weight of 5 cases were above the 91st centile (4 were above the 98th centile). Overall, 6 of 7 organic acidaemia cases (86%) and 3 of 5 asparaginase-associated cases (60%) were of Pakistani ethnicity. Conclusion This is the first estimate of incidence of AP in children in the UK. In children, AP is associated with a wide variety of potential aetiologies and more than one third of cases have no cause identified. The associations of AP have changed significantly since the 1970/80s. Drug therapy and gallstones are now the commonest associations, whilst trauma and mumps have become uncommon. Children from some ethnic minorities are greatly over-represented, which possibly reflect the greater frequency of inborn errors of metabolism in some ethnicities. However the over-representation of asparaginase associated AP in Pakistani children merits further investigation. Aim To use prospectively collected data to investigate the outcomes up to 16 years of TBI in childhood. Methods Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. Background demo-graphics and developmental and behavioural profile of the children were derived from questionnaires completed by the mother in pregnancy, at 6 weeks and at 18 and 42 months. Injury data were derived from questionnaires completed by the child's carer at 4½ 5½ 6½ 8 ½ and 11½ years of age. Outcomes were collected when the child was 11-16 years old, from ALSPAC questionnaires and research clinics, and from linked educational data. TBI cases (n = 410), defined as any head injury resulting in loss of consciousness and/or a skull fracture before the age of 11, were compared with children of the same age (n = 1819) who suffered traumatic orthopaedic injuries (fractures-excluding skull fractures). Controls (n = 8770) were all children with available injury data who did not have a TBI or orthopaedic injury. Results 410 ALSPAC participants (59% ma...

ObjectiveTo report outcomes from a national cohort of children and young people with type 2 diabetes (T2DM), 1 year post diagnosisResearch design and methods1 year follow up of a cohort of children (<17 years) with T2DM reported through the British Paediatric Surveillance Unit between April 2015 to April 2016. This established an overall UK incidence of 0.72 per 1 00 000 per year (2.92/100,000 in Asians, 1.67/100,000 Black/African/Caribbean/Black British)ResultsNinety-nine (93%) of the 106 notified cases had data available for one-year review. Of these, seven had been lost to follow up and one had the diagnosis revised. The mean age at follow up was 15.3 years. Of those with data, average BMI SDS was 2.72 with a mean increase of 0.14 SDS over a year (92% remained overweight or obese). Only ~15% of cases achieved a reduction in body weight of 5% or more from baseline. Median HbA1c was 53 mmol/mol (range 31–130 mmol/mol) and ~40% attained the UK national target of <48 mmol/mol. HbA1c was associated with BMI SDS change at 1 year (p=0.007) and clinician reported compliance and attendance concerns (p≤0.0001). In over half of cases, clinicians reported issues with compliance and attendance. Mean clinic attendance was 77%. Metformin was the most frequently used agent in management at baseline (77%) and follow up (87%). Microalbuminuria at 1 year was seen in 16.4% of cases compared to 4.2% at baseline.ConclusionsGood compliance and BMI reduction is associated with better outcomes, one year after diagnosis in early onset T2DM. It is concerning that the prevalence of microalbuminuria increases four-fold in this short time frame.