Introduction: Incidence of type 2 diabetes (T2DM) among young adults (age <= 40) has been increasing rapidly. We hypothesize that this could be due to increasing levels of stress seen in this age group due to demographic, economic and environmental shifts that have occurred in the past 30 years. Method: Modifiable vs. non-modifiable risk factors were evaluated at a specialist diabetes and endocrinology clinic. Consecutive patients meeting the inclusions criteria (T2DM between the ages of 18 to 40), were provided with study questionnaire at their appointment over a 3 month period. The questionnaire assessed socio-economic factors, self-reported levels of stress, dietary habits, sleep duration and physical activity. Results: 52 patients (Males = 38 (73%)) completed the study questionnaire. Mean age (± SD) at diagnosis of T2DM was 31 (± 5.8). Thirty five (79%) were immigrants to Canada, of which 47% had immigrated to Canada within the last 10 years (2010-2019). Of the study participants, mean stress level (on a scale of 1-10) was 5.9 (± 2.7). Work stress was reported by 79.1%, financial stress by 43.7%, family related stress by 39.5%, and unemployment related stress by 10.4% of the patients. Other stressors reported were weight management and medication coverage. Twenty (38%) participants reported sleeping an avg of ≤ 6 hrs/day. Moderate intensity physical activity (≥ 150 mins per week) prior to diagnosis was reported by 36% patients. Discussion: High prevalence of modifiable risk factors such as stress, decreased physical activity, inadequate sleep was found in young adults with T2DM. Immigrants are at high risk of T2DM at a young age likely due to stressors as well as diet and lifestyle changes involved in relocating to a new country. Education regarding higher risk of T2DM at an early age, and interventions to reduce modifiable risk factors is paramount at an individual and societal level, in order to stem the epidemic of young onset T2DM. Disclosure S. Dave: None. K. Suntharamoorthy: None. S. Mohyiddin: None. U. Muhammad: None. S. Malik: None. N. Gupta: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim (Canada) Ltd., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Sanofi.

Data was collected from National Inpatient Sample (NIS). NIS is part of Healthcare Cost and Utilization Project (HCUP) databases and is made possible by a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ). The NIS is derived from all States for national estimates of healthcare utilization, cost and outcomes (9) . Since NIS is compiled annually, the data can be used for analysis of disease trends over time. The study was deemed exempted from Institutional Review Board approval given the de-identified nature of the NIS database and public availability.

Recurrent respiratory papillomatosis is a respiratory disease caused by human papillomavirus and can infect any part of the aerodigestive tract, but the larynx is most involved (Derkay et al. 2010). This report is a discussion about a 7-month-old male that presented to our institution for respiratory distress. He was admitted to the Pediatric Intensive Care Unit (PICU) for stabilization, observation, and further treatment and management due to an acute RSV infection. Initial efforts failed to improve his respiratory failure. A bronchoscopy was performed and showed various flesh-colored lesions throughout the larynx, vocal cords, and tracheal tree just above the carina. Pediatric otolaryngology performed an emergent debulking surgery to alleviate his respiratory failure. He has had multiple exacerbations of his condition since then and has required frequent debulking procedures with a few trials of intralesional bevacizumab therapies.

Introduction: Incidence of type 2 diabetes (T2DM) among young adults has been increasing rapidly. We have noticed a significant increase in consultations received for patients with T2DM diagnosed at age <40 and much younger ages. Patients diagnosed at younger age are at higher risk of microvascular and macrovascular complications over their lifetime. We aim to characterize the clinical characteristics of this patient population. Methods: All patients (new and follow-up) with T2DM and age≤ 50 years, at our Diabetes and Endocrinology Centre were included. 95 patients (21% of all patients in our diabetes registry) met the eligibility criteria. Demographic variables. comorbidities, diabetes complications, vitals, lab parameters and medications were reviewed. Results: n=38 (40%) were females. Sixty-eight (71%) were South Asians. Mean age at diagnosis was 34 years(± 7.2). Normal, overweight and obese BMI was seen in 25%, 42% and 33% of South Asians and 12%, 25% and 62% of Caucasians, respectively. South Asians were diagnosed at a younger age with 9%, 16% and 57% diagnosed at age <20, 21-30 and 31-40, respectively, compared to Caucasians 0%, 12.5% and 50% for the same age distribution above. Prevalence of dyslipidemia (86%), Hypertension (62%), retinopathy (4%), neuropathy (21%), nephropathy (29%), CAD (4%), stroke 2% and PVD was 0%, reflecting the younger population in this study. Conclusion: A large proportion of patients in our diabetes registry are young or middle aged. South Asian ethnicity increases risk of diabetes at a younger age and lower BMI. The epidemic of diabetes at a young age is likely related to increased sedentary lifestyle, inadequate sleep, stress and increasing use of technology and screens. Disclosure K. Suntharamoorthy: None. S. Dave: None. U. Muhammad: None. E. Javaid: None. N. Gupta: Consultant; Self; AstraZeneca, Eli Lilly and Company, Novo Nordisk Inc., Sanofi. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk Inc., Sanofi.