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Treatment-Induced Neuropathy of Diabetes in Pediatric Aged Patients

Dr. Eirene Alexandrou

Treatment-Induced Neuropathy of Diabetes (TIND) is a insufficiently recognized complication, usually temporary, that can occur after rapid correction of severe hyperglycemia. Its occurrence in the pediatric-aged population has not been well studied. Dr. Eirene Alexandrou has just published a paper describing 7 cases of TIND among children and young adults. She published the work in the Journal of the Endocrine Society (link to paper). The cases occurred in both type 1 and type 2 diabetes, and in each case followed a rapid improvement from severe hyperglycemia. All but 1 of the cases were transient. Symptoms included pain, often burning in nature, numbness, and autonomic disturbance. Management included stabilization of glycemia and medical therapy.

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Glucose Control and COVID Hospitalization Risk in Persons with Type 1 Diabetes

  • Dr. Pinnaro
  • Dr. Tansey

Yesterday, data were published indicating that among persons with type 1 diabetes, higher average glucose levels are associated with increased risk of requiring hospitalization for COVID infection. The peer reviewed data was published in the Journal of Clinical Endocrinology and Metabolism ( doi permanent link ; pubmed link ). The data were collected via the national T1D Exchange study consortium. Drs. Pinnaro and Tansey from our division are part of this consortium and helped author the article. The data indicate that if you have type 1 diabetes, you should keep your blood sugars in range as much as possible to help prevent severe COVID. We remain happy to help you achieve this goal; our contact information can be found by clicking on the “clinical website” at the top of our links page.

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Electromagnetic Fields Can Treat Type 2 Diabetes

Graphical summary of findings showing that electromagnetic fields can treat type 2 diabetes.

Our division director has contributed to new scientific work that has been published in Cell Metabolism showing that exposure to generated electromagnetic fields lowers blood sugar in rodents with type 2 diabetes. Dr. Norris helped design and interpret the glycemic clamp studies that were used to better understand the physiological mechanisms involved in the phenomenon. (Pubmed link; DOI link).

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A Tale of Two Pancreases

A graphical summary of exocrine-endocrine interactions in the pancreas

Fascinatingly, the pancreas is really two organs mixed together. The exocrine part of the pancreas produces digestive enzymes that are secreted into the small intestine. The endocrine part of the pancreas makes insulin and glucose, which are secreted into the blood stream. The endocrine parts of the pancreas are scattered like islands within the exocrine part. Although the function of endocrine part of the pancreas has long been considered to be fairly independent of the exocrine, it is increasingly being recognized that the health of the exocrine pancreas influences the endocrine portion. Our division director, Dr. Norris, just helped author a review article on this topic. The work was just published in the journal Diabetologia, which is the leading diabetes research journal published in Europe. The article reviews how diseases of the exocrine pancreas can lead to defects in insulin production and diabetes. (Pubmed link, DOI link)

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Announcing New Faculty: Eirene Alexandrou, MD

Dr. Alexandrou

We are pleased to announce that Dr. Eirene Alexandrou is starting as a new pediatric endocrinologist in our division. She received her Medical Degree from Indiana University School of Medicine, completed a residency in pediatrics at the Medical College of Georgia, and just completed a fellowship in pediatric endocrinology at the prestigious Cincinnati Children’s Hospital. She has published expertise in the areas of growth research (link) and Turner Syndrome. In clinic, her initial practice will include general pediatric endocrinology and diabetes, as well as outreach services in Cedar Rapids and Dubuque.

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Announcing New Faculty: Akhila Ramakrishna, MD

Dr. Ramakrishna

We are pleased to announce that Dr. Akhila Ramakrishna is starting as a new pediatric endocrinologist in our division. She received her Medical Degree from the Armed Forces Medical College, then completed a residency in pediatrics at Case Western Reserve, and just completed a fellowship in pediatric endocrinology at the prestigious Mayo Clinic. She has published expertise in the area of thyroid dysfunction (link) and has studied rodent models of obesity as a fellow as well. In clinic, her practice will include general pediatric endocrinology and diabetes, as well as gender-related endocrine care, obesity-related endocrine care especially regarding bariatric surgery in adolescents, and outreach pediatric endocrine services in Cedar Falls.

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Announcing New Faculty: Catherina Pinnaro, MD

Dr. Pinnaro

We are pleased to announce that Dr. Catherina “Cat” Pinnaro is starting as a new pediatric endocrinologist in our division. Her position will be on the tenure-track, meaning that she will be expected to be productive as a research physician. Dr. Pinnaro received her Medical Degree from New York Medical College where she successfully competed for a Doris Duke research year, which she spent at the University of Iowa. She then completed a residency in pediatrics at the University of Iowa, just completed a fellowship in pediatric endocrinology here as well, and is on track to earn a Master’s in Translational Biomedicine in late 2020. While a fellow, she has created several productive research projects, having already published on the genetics of 22q syndrome (link) and diabetes care simulation (link). Her research will focus on the etiology of diabetes in specific disease contexts, applying her genetics expertise. In clinic, her practice will include general pediatric endocrinology and diabetes.

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Announcing New Pediatric Endocrine Fellow: Dr. Tuttle

Dr. Tuttle

Today we are thrilled to announce that Dr. Alex Tuttle has joined our division as a pediatric endocrine fellow. He will serve three years in this role, after which he will be a full fledged board eligible pediatric endocrinologist. Dr. Tuttle received his Medical Degree from Indiana University. He then completed a pediatric residency at the University of Iowa Children’s Hospital. While a resident he demonstrated an aptitude for and interest in pediatric endocrinology, and was highly involved in diabetes camp (see picture below) at Camp Herkto Hollow and helped report an unusual pediatric endocrine case related to thyroid eye disease (link). Welcome Dr. Tuttle!!

Diabetes Camp Hertko Hollow: some of the volunteer staff from teen week 2019. Division members include Diabetes Nurse Sue Huff on the far left and (now) endocrine fellow Dr. Alex Tuttle on the far right.
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Dr. Pinnaro Completes Pediatric Endocrine Fellowship

Dr. Pinnaro

We are extremely proud of Dr. Catherina “Cat” Pinnaro. For the past 3 years, Dr. Pinnaro has been a pediatric endocrinology fellow. Today she finishes this training, and will officially become a “board eligible” pediatric endocrinologist. During these three years, Dr. Pinnaro has been an exemplary fellow, providing outstanding clinical care, highly commended clinical teaching, and published research. She won several national awards as a fellow, including the Rising Star award from the Pediatric Endocrine Society, and the Leona Cuttler Quality Assurance Award from the American Academy of Pediatrics. We will miss her energetic approach to everything a fellow does. Following fellowship, Dr. Pinnaro has accepted a tenure-track position at a major research university where she continue her pediatric endocrine research related to diabetes, and will also continue her clinical work in pediatric endocrinology — stay tuned…. Congratulations Dr. Pinnaro!