Page 203 - Abstract Book KONIKA 18

Endocrinology

P-ENDO-053
Correlation Control Metabolic and Thyroid Stimulating Hormone Levels
in Children with Type 1 Diabetes Mellitus in Dr. M. Djamil Hospital

Ivanny Khosasih, Eka Agustia Rini
Department of Pediatrics, Endocrinology Division, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil Hospital,
Padang, West Sumatera, Indonesia

Abstract
Background Thyroid disease (TD) and type 1 diabetes mellitus (T1DM) are both prevalent endocrinopathies.
Asymptomatic TD is prevalent among diabetic patients, particularly T1DM patients. Association between
control metabolic and thyroid stimulating hormone (TSH) levels remains inconclusive. Objective To
describe thyroid stimulating hormone levels in T1DM and the correlation with control metabolic. Methods
We conducted a cross sectional study from 44 patient T1DM since Januari - Desember 2020 in the Pediatric
Endocrine Outpatient at M. Djamil Hospital. The correlation of thyroid stimulating hormone levels (TSH)
with metabolic controlled was analyzed by Pearson correlation analysis. Results The prevalence of T1DM
was twenty six (54.2%) in females and eightteen (45,8%) in males. The overall mean age was 14,15 years
and mean duration of diabetic was 2.5 years. Eight (18,18%) were undernourished, two (4,54%) were obese
and thiry four (77.28%) were well nourished. Their mean TSH concentration was 2,3552 mIU/L, no patient
with hypothyroid, thirty four (77.3%) had poor metabolic control. No patient with hypothyroidism (mean
FT4 15.1 pmol/L, with range 11.9-17 4 pmol/L). Pearson’s correlation test revealed no significant association
between metabolic control and TSH. (P= 0,109). Conclusion There is no significant association between
metabolic control and TSH levels in children with T1DM.
Keywords: type 1 diabetes mellitus; children; thyroid

P-ENDO-054
Congenital Hyperinsulinism and Global Developmental Delay
in A 10-month-old Boy: A Case Report
Chintami Putri Rejekiya, Irfan Agus Salim, Harjoedi Adji Tjahyono
Departement of Child Health, Faculty of Medicine Universitas Brawijaya/Saiful Anwar General Hospital,
Malang, East Java, Indonesia
Abstract
Background Hyperinsulinaemic hypoglycemia (HH) is an important cause of recurrent and severe
hypoglycemia during infancy and childhood. In children, congenital hyperinsulinism (CHI) is the most
common cause of HH and it typically presents in early infancy. Case We presented a case of congenital
hyperinsulinism and global developmental delay in A 10 months old boy The diagnosis was established
by a history of lethargy and seizure 3 days before admission. The random blood glucose result on the day
of admission was low. Laboratory results confirm hyperinsulinaemic hypoglycemia, because the pH
results are normal, ketones are normal, lactate are normal,and growth hormone normal. From radiological
work-ups in MRI of the pancreas showed normal size, there is no visible pathological signal. He was
treated with Intravenous glucose infusion, intravenous hydrocortisone therapy, subcutan Octreotide, and
Oral nifedipine. The patient also received physiotherapy for treatment of global developmental delay.
Discussion The American Academy of Pediatrics (AAP) and the Pediatric Endocrine Society (PES) have
both accepted that plasma glucose values drop down to 30 mg/dL (1.67 mmol/L) in the first 2 hours of life
and subsequently rise to a value of at least 45 mg/dL (2.5 mmol/L) before stabilizing around 12-24 hours.
Hyperinsulinaemic hypoglycemia (HH), refers to a clinically, genetically and morphologically heterogeneous
group of disorders associated with dysregulated insulin secretion. It is the most common cause of persistent
hypoketotic hypoglycemia in neonates and infants and is associated with a significant risk of permanent
brain damage. The goal of emergency treatment is to achieve normoglycemia immediately, keep plasma
glucose levels at a safe range (>3.5 mmol/L/65 mg/dL) while the etiological investigations for differential
diagnosis and long-term treatment planning are in progress. Conclussion A prompt diagnosis and immediate
management of HH is essential to avoid complications. A thorough clinical examination and utility of
laboratory examination from the critical sample can be used to diagnosed the etiology of HH.
Keywords: hypoglycemia; hyperinsulinaemic; global developmental delay

KONIKA XVIII Abstract Book 155