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Announcing New Faculty: Ben Palmer, MD

Dr. Palmer

We are pleased to announce that Dr. Benjamin Palmer is starting as a new pediatric endocrinologist in our division. He received his Medical Doctorate from the University of Iowa Carver College of Medicine, completed pediatric residency at the University of Iowa Stead Family Children’s Hospital, where he also just completed fellowship in pediatric endocrinology. He has published expertise in several aspects of diabetes care in youth. His ongoing clinical interests revolve around diabetes, including diabetes and sports/exercise, and the rapidly advancing field of diabetes technology. In clinic, his initial practice will include general pediatric endocrinology and diabetes, as well as outreach services in Cedar Rapids and Dubuque. Welcome Dr. Palmer!

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Vitamin D Repletion in People with Cystic Fibrosis

Dr. Larson Ode

Cystic fibrosis often disrupts gastrointestinal function, impairing the absorption of fat-soluble vitamins such as vitamin D. As a result, individuals with cystic fibrosis are at increased risk for vitamin D deficiency. While daily supplementation is a common corrective strategy, it adds to the already significant treatment burden faced by these patients.

An alternative approach known as stoss dosing involves administering a single, very high dose of vitamin D. This method is effective because vitamin D remains active in the body for several weeks, potentially reducing the need for daily supplementation.

To evaluate the effectiveness of stoss dosing, researchers analyzed the medical records of 58 individuals with cystic fibrosis who received this treatment. Their findings showed that vitamin D levels were increased by the therapy, as measured three months after the dose administration. However, only about half of the patients reached the target vitamin D levels, suggesting that while stoss dosing is likely beneficial, further research and optimization are necessary.

Dr. Larson Ode from our division contributed to the research, which has been peer-reviewed, published in Health Science Report and is publicly available in the PubMed Central repository (link).

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Supporting Medical Student Education

Dr. Eirene Alexandrou

We are excited to announce that Dr. Alexandrou has been selected to serve as Co-Director of the Flocks Learning Community at the University of Iowa’s Carver College of Medicine. Each medical student at the Carver College of Medicine is matched into one of four Learning Communities. These Learning Communities enhance the activities and learning environment of students, in part by providing a physical study space. In her role as Co-Director, Dr. Alexandrou will provide leadership for the students in the Flocks community. She will support their support educational, philanthropic, and social endeavors in a way that extends beyond the formal medical school curriculum. Furthermore, she will provide guidance to ease transition to the rigors of medical school and give career mentorship. This is a part-time activity and Dr. Alexandrou will continue her important role as a clinical doctor providing care to children and youth with hormonal and endocrine disorders. We envision that she will provide astute and caring guidance to the Flocks Learning Community.

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Sugar Surge: Rates of Pediatric Type 2 Diabetes More than Doubled During the Pandemic

Dr. Catherina Pinnaro

Early in the pandemic, pediatric endocrinologists began noticing a rise in new cases of diabetes among youth. To investigate this trend, a group of specialists formed a national consortium representing 23 pediatric centers across the country. Their findings revealed a significant increase in new diagnoses of type 2 diabetes during the pandemic, with cases more than doubling. This increase was observed across all sampled regions of the United States. In contrast, the rise in new-onset type 1 diabetes was less pronounced and did not reach statistical significance.

Encouragingly, the number of new type 2 diabetes cases appeared to return to baseline by the end of the pandemic’s second year.

While the study was not designed to determine the exact causes of the type 2 diabetes surge, the results suggest that the major contributing factors were transient in nature. These temporary factors may have included reduced physical activity, disrupted daily routines and eating habits, and increased psychosocial stress. Perhaps less likely to play a major role would be the physiological effects of the SARS-CoV2 virus itself.

The consortium has now published these findings in the Journal of Clinical Endocrinology and Metabolism. Dr. Pinnaro, from our division, was involved with the consortium’s creation, this research and the writing of the published manuscript. The abstract can be found on PubMed at this link.

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Announcing New Pediatric Endocrine Fellow: Dr. Radig

Dr. Radig

Today we are thrilled to announce that Dr. Ashley Radig has joined our division as a new pediatric endocrine fellow. She will serve three years in this role, after which she will be a full-fledged, board-eligible pediatric endocrinologist. Dr. Radig received her Medical Doctorate degree from the University of Iowa having completed undergraduate studies at Central College where she was an athlete scholar. She just completed a three-year pediatric residency at the University of Iowa. She has a long standing interest in diabetes care and has volunteered multiple times at Diabetes Camp. In 2024, she was selected to join the PedsENDO Discovery Program administered by the Pediatric Endocrine Society. She has worked in various diabetes research programs for the past decade and has been working recently on methods to better deliver diabetes care to underserved populations. A warm welcome from all of us to Dr. Radig!!

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Dr. Palmer Completes Pediatric Endocrine Fellowship

Dr. Palmer

We are extremely proud of Dr. Ben Palmer. For the past 3 years, Dr. Palmer has been a pediatric endocrinology fellow in our program. Today he finishes this training and will officially become a “board eligible” pediatric endocrinologist. During these past three years, Dr. Palmer has been an exemplary fellow, delivering excellent clinical care and demonstrating exceptional clinical interpersonal skills and judgement. His contributions include being an enthusiastic volunteer at Diabetes Camp Hertko Hollow. While a fellow, he has been an energetic scholar, publishing two articles on how review of continuous glucose monitoring data at home impacts outcomes of type 1 diabetes in children and adolescents. His most recent work in not yet published, but involves how exercise and athletic participation is impacted by type 1 diabetes in youth. Dr. Palmer will be taking a position as a Pediatric Endocrinology attending — stay tuned for more details! Congratulations Dr. Palmer on completing fellowship!!!

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Adrenal Insufficiency after Pediatric ICU

Dr. Radig

Children admitted to the Pediatric Intensive Care Unit (PICU) often receive glucocorticoid steroids as part of their treatment. While these medications can be highly effective in managing critical illness, prolonged use may lead to adrenal insufficiency—a dangerous but treatable condition in which the body cannot produce adequate levels of cortisol. To better understand the risks, researchers reviewed the medical records of 530 pediatric patients who received steroids during their PICU stay. Among these patients, 2.3% were diagnosed with adrenal insufficiency. The study identified several key risk factors including the following: younger age, higher cumulative dose of steroids and the use of steroids specifically for treating excess inflammation. These findings aim to improve the identification of pediatric patients at risk for adrenal insufficiency following critical illness. The study has been published in the Journal of Intensive Care Medicine. The lead author, Dr. Radig, will soon join our Division as a pediatric endocrinology fellow. Also contributing to the the research was Dr. Curtis, also from our Division. The abstract is available on PubMed at the following link.

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Dr. Castano Leads Webinar for Medical Students

Dr. Castaño

On June 10th, Dr. Castano from our division lead a live, national, free Webinar for medical students across the country. The title of his webinar was “Growth and Puberty”. His purpose was to elevate the clinical knowledge of medical students on this important topic. The session was sponsored by the Pediatric Endocrine Society. Dr. Castano covered a range of important topics ranging from normal growth patterns in children and adolescent, to various medical disorders that disrupt puberty and growth. Thank you Dr. Castano for lending your expertise to help teach tomorrow’s physicians about these important topics.

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Long-Term Study Links Elevated Glucose Levels to Persistent Brain Changes in Children with Type 1 Diabetes

Dr. Tsalikian
Dr. Tansey

In 2018, faculty from our division participated in a multicenter, observational study that added to growing evidence linking elevated glucose levels in children with type 1 diabetes to changes in brain structure. While the initial findings highlighted these associations, they could not determine how such changes might evolve over time. Now, the research team—including Drs. Tsalikian and Tansey from our division—has completed a long-term follow-up of the original study participants. The results, recently published in the journal Diabetes, are available via PubMed (link here) in abstract form. The follow-up spanned 6 to 8 years and revealed that the previously observed brain differences largely persisted. Although the magnitude of some differences diminished slightly, higher average blood glucose levels continued to correlate with more pronounced structural changes. These findings reinforce the importance of maintaining tight glycemic control to potentially mitigate long-term neurological impacts. As the cohort transitions into adulthood, continued monitoring will be essential to fully understand the long-term implications of these early brain changes.

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The Mouth Tells the Story: Metabolic Syndrome Impacts the Oral Milieu Even Before Dental Disease Occurs

Dr. Curtis
Dr. Kanner

Obesity and metabolic syndrome are known to negatively affect oral health, but the underlying mechanisms and early indicators remain unclear. To help bridge this knowledge gap, Dr. Curtis and Dr. Kanner from our division collaborated with scientists from the School of Dentistry led by Dr. Sukirth Ganesan. Together they conducted a study involving children and adolescents with healthy teeth and gums. Participants were grouped into three categories: normal-weight healthy, healthy obese, and obese with metabolic syndrome.

Saliva samples were collected from each participant and analyzed their bacterial, metabolic, and hormonal content. All three components showed distinct differences between the obese and normal-weight healthy groups. Notably, by integrating data from all three saliva components, researchers were able to identify individuals with metabolic syndrome.

These findings suggest the potential for developing non-invasive saliva-based tests to assess metabolic health—potentially even eliminating the need for some blood draws. Additionally, the results offer new insights into how obesity and metabolic syndrome may contribute to oral health issues. The study was published in the Journal of Dental Research, and the abstract is available on PubMed at this link.