ACTA ENDOCRINOLOGICA (BUC)

Context. Continuous glucose monitoring (CGM) and insulin pump technologies have improved the management of type 1 diabetes mellitus, particularly in childhood. Physicians’ knowledge and awareness of these devices are essential for their effective use. Objective. To assess physicians’ knowledge and awareness regarding CGM and insulin pump systems. Design. This study was designed as a descriptive cross-sectional study. Subjects and Methods. A total of 203 nonendocrinologist physicians from different regions and healthcare levels in Turkey participated. A 33-item questionnaire based on the ISPAD guidelines was used to evaluate knowledge. Results. Although 95.6% of participants had heard of CGM devices, only 14.8% correctly identified interstitial fluid as the medium of glucose measurement. While 34.5% knew that 6–10 daily fingerstick measurements are recommended, only half were aware that CGMs record 288 readings per day. Some mistakenly believed CGMs deliver insulin or require insertion in an operating room. Knowledge regarding insulin pump indications and age suitability was also insufficient. Knowledge levels did not significantly differ by specialty, academic title, or institution type. Conclusions. Non-endocrinologist physicians show limited knowledge of diabetes technologies, which may hinder patient education and management. Structured continuing medical education programs are needed to strengthen physicians’ competencies in this rapidly advancing field.

Introduction. Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder that typically presents in childhood and involves multiple organ systems. Turner syndrome (TS) is a chromosomal condition resulting from complete or partial loss of one X chromosome. Both disorders can independently cause short stature and pubertal delay. Case Report. We present a 9-year-old girl diagnosed with NF1 at age 6, based on widespread café-aulait macules and a positive family history. She was referred to our pediatric endocrinology clinic for evaluation of severe short stature. Physical examination revealed TS stigmata, including height SDS: -4.07, cubitus valgus, webbed neck, low posterior hairline, and widely spaced nipples. Karyotype analysis confirmed mosaic TS: 45,X[12]/46,X,del(X) (p11.2)[18]. Cranial magnetic resonance imaging revealed hamartomatous lesions, an empty sella, and an optic pathway glioma, for which she had received chemotherapy. Laboratory findings were consistent with hypergonadotropic hypogonadism. Estrogen replacement therapy was initiated; however, recombinant human growth hormone treatment was declined by the family after counseling. Conclusions. This co-occurrence is exceedingly rare, with only a few pediatric cases having been reported in the literature. This dual diagnosis poses diagnostic and therapeutic challenges and necessitates a personalized approach to growth assessment, pubertal induction, and long-term tumor surveillance in pediatric endocrine care.

Objective. We aimed to examine the auxological findings of girls diagnosed with idiopathic central precocious puberty (CPP) at the end of the GnRHa treatment and to investigate the effect of related factors on the height gain of those patients. Design. Single-center, descriptive, cross-sectional retrospective study. Method. A total of 43 patients who were diagnosed with idiopathic CPP and treated with GnRHa between 2012 - 2021 were included in to the study. Results. A decline in height standard deviation score (SDS) from 1.20 ± 0.14 to 1.02 ± 0.06 during the therapy was observed (P<0.001). The bone age/chronological age ratio was decreased and predictive adult height was increased at the end of the therapy (P<0.001; P=0.001). Both the rates of being overweight and obesity were increased (38.6% to 50% and 9% to 15.9%) when the treatment onset compared to the end of therapy. At the end of the treatment, the mean body mass index (BMI) SDS of the overweight patients was still higher compared to the normal-weight group (P<0.001). Conclusion. We observed a positive effect of GnRHa therapy on height potential. An increase in BMI during the therapy has been also demonstrated especially in subjects who were overweight before treatment.