G431(P) Gender dysphoria – a description of the changes in prevalence, demographics and the clinical care provided by a paediatric endocrinology department

Abstract

0-16yo), place of diagnosis (local hospital), and new diagnosis. Results 21 patients were identified within the database; four were excluded due to diagnosis in other country or lack of notes. 9 females and 8 males were included, with a mean age of 8 years and a median duration of presenting symptoms of 21 days. 82% were referred to the paediatric emergency department by their general practitioner (GP). 82% reported polyuria, 76% reported polydipsia, 29% reported fatigue and weight loss, with other presenting symptoms including nocturia and high capillary blood glucose measured at home. 76% had a family history of diabetes or autoimmune disease. 82% presented with hyperglycaemia, and 18% in diabetic ketoacidosis. Mean presenting capillary blood glucose was 24 mmol/L with a mean HbA1c of 106 mmol/mol. Only 2 patients (12%) had urine dipstick results documented on their hospital discharge summary. 16 subjects had a new diagnosis of type 1 diabetes and 1 had a new diagnosis of type 2 diabetes. Compared to previous data from 2013, in which 50% of patients had a delay in diagnosis, 3 patients (18%) had delayed diagnosis of diabetes. All of this group were seen prior to diagnosis by their GP, with a median duration of delay of 3 days. Conclusion Delay in diagnosis of diabetes in children appears to have reduced in the past 5 years in the local area. However, practice must continue to improve to prevent unacceptable delay. This requires education to improve symptom recognition, of both local healthcare professionals, and also of adult patients with autoimmune disease, in view of the high incidence of diabetes in children with a family history.