from the division director
Dr. Sandberg is an ardent educator regarding training medical professionals at all levels on how to provide compassionate and informed care for highly vulnerable youth with endocrine needs. To this end, Dr. Sandberg serves as the co-leader of the education subcommittee of one of the related special interest groups at the national Pediatric Endocrine Society. We thank her for her important service in this area and for helping educate health care providers how to provide the best care possible.
The American Pediatric Society (APS) was founded in 1888 and remains the most prestigious pediatric academic organization in North America. Election to the APS is highly selective, recognizing those pediatricians who have exhibited leading excellence in their pediatric-focused scholarship, advocacy, education, and leadership. We are thus quite proud to announce that our own Dr. Mike Tansey has been elected to the APS, effective January 1st, 2020. Dr. Tansey received his medical training at Loyola School of Medicine. He then completed a pediatric residency followed by a pediatric endocrinology fellowship at the University of Iowa. While a pediatric endocrinology fellow he became interested in diabetes-focused clinical research. He quickly showed great aptitude for the design of important and practical research studies to help address key knowledge gaps in how we manage diabetes in pediatric patients. He has developed nationally recognized expertise in continuous glucose monitoring and the impact of exercise on glucose levels in children with type 1 diabetes. He has given invited lectures at the annual American Diabetes Association scientific sessions. Dr. Tansey is an important contributor at the University of Iowa, where is an active clinical member of our pediatric endocrinology and diabetes program, but also serves as the Associate Vice Chair for Faculty Development in Pediatrics, and as the Interim-Chair Health Information Management Subcommittee. He also is the director of the Pediatric Endocrinology fellowship program. Finally, he provides important service to the state and region by being the (volunteer) Medical Director for Hertko Hollow Diabetes Camp for children, located in central Iowa. Congratulations Dr. Tansey for this well earned honor of being elected to the APS.
Dr. Pesce is now a member of the American Thyroid Association Patient Affairs & Education Committee . She plans to serve on this committee through fall 2022. We thank her for her service in this area, helping make sure that pediatric thyroid considerations are well represented at the national level. Back here in Iowa, Dr. Pesce is the Director of the Pediatric Thyroid Clinic at the UI Stead Family Children’s Hospital, where she provides expert care for children and adolescents with thyroid conditions including hypothyroidism, hyperthyroidism including Graves Disease, thyroid nodules and thyroid cancer.
Dr. Pinnaro, pediatric endocrine fellow, with supervision from pediatric endocrine faculty Dr. Curtis, have devised a simulator that models how pediatric patients develop ketones and how insulin dosing can be applied to prevent ketoacidosis. They have just published an overview of their work in the Journal of Diabetes Science and Technology.
Polycystic ovarian syndrome, often abbreviated as PCOS, affects 4-12% of American women. What is less commonly appreciated is that PCOS can start as early as puberty. Symptoms can include irregular periods, excess body/facial hair growth , and acne. Diagnosis of PCOS is less straightforward in adolescents compared to adults. Pediatric endocrinologist Dr. Lauren Kanner has assembled a multidisciplinary clinical team to help tackle PCOS in adolescents. The clinic offers a full PCOS diagnostic work-up and provides ongoing screening and treatment regarding any metabolic, weight, and hyperandrogen concerns. The clinic includes dietary and psychology services. Referral to other specialists needed for care, such as dermatology and gynecology, is also provided. Currently the clinic meets monthly. Browse to the “Clinical Website” on the Links page to find appointment contacts.
We have entered a new era whereby wearable continuous glucose monitors (CGMs) can provide a reasonable representation of a person’s blood glucose for days on end. These devices have been very useful for persons with diabetes. However, one difficulty has been understanding what glucose levels reported by these devices represent normal. To better addressed this knowledge gap, our own Dr. Tansey helped direct a study assessing CGM data collected from healthy persons without diabetes. The results are now published in the prestigious Journal of Clinical Endocrinology and Metabolism. The results from this study will be very useful, especially when assessing persons who might be in the process of developing diabetes to determine when their blood glucose levels deviate from normal patterns.
To help better distribute pediatric endocrine care across the state, Dr. Sandberg has started a new outreach pediatric endocrine clinic in Cedar Falls. She will be seeing pediatric endocrine patients there on Wednesdays. To find how to schedule an appointment, go to the links page and click on the “Clinical Website” link. (Note that at this time, the Cedar Falls clinic does not have the personnel or resources to see pediatric diabetes patients at that location.)
Dr. Larson Ode is the principal investigator and leader of an ongoing multicenter research study aimed at better understanding cystic fibrosis related diabetes. The study is funded by the Cystic Fibrosis Foundation (https://www.cff.org/). The name of the study is the “EnVision CF Multicenter Study of Glucose Tolerance in Cystic Fibrosis”, and will be funded at least through August 2021. As the leader of the study, Dr. Larson Ode coordinates studies at the University of Iowa, the University of Minnesota, University of Colorado, and Washington University in St Louis.
A recent study published Aug 2019 in the New England Journal of Medicine (abstract link here) has shown that a drug called teplizumab can delay the onset of type 1 diabetes by 2 years on average in persons at risk. Teplizumab is a monoclonal anti-CD3 antibody, and as such interferes with the activation of T cells involved in attacking beta-cells of the pancreas. This is a significant step towards meaningful strategies to prevent type 1 diabetes. Not only are we thrilled at this development, but we are also proud that one of the senior faculty in our Division, Dr. Eva Tsalikian, helped conduct the research and write the article. Other staff in Iowa involved with the study included division faculty Dr. Michael Tansey, and research coordinators Joanne Cabbage & Julie Coffey.
Metformin is a first-line medication used to treat type 2 diabetes, where its main action is to improve insulin sensitivity and ultimately to decrease complication rates. In persons with type 1 diabetes, metformin alone is not effective treatment, because it can not replace the profound lack of insulin that occurs in this disease. However, some patients with type 1 diabetes, especially those who are obese, develop insulin resistance. Dr. Tansey and Dr. Tsalikian helped direct a recent study which found that 3 months of metformin treatment (in addition to insulin treatment) in these patients led to improvements in insulin sensitivity. Differing from type 2 diabetes however, hepatic insulin sensitivity was not improved. The results from this study are now published in the prestigious Journal of Clinical Endocrinology and Metabolism.