from the division director
News and updates about our Division of Pediatric Endocrinology & Diabetes.
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.
Dr. Pesce has authored a powerful opinion piece entitled “Everything but Everydayness” about the joy of being a pediatric endocrinologist. In an almost poetic way, she describes the many scenarios in which a pediatric endocrinologist can make a significant difference in the health and well-being of a child. Find the piece here (link note this is not a permanent link) , on page 10 (12th page of PDF) of the Feb 2018 issue of Endocrine News .
We are pleased to announce that Dr. Beth Sandberg is starting as a new pediatric endocrinologist in our division. She received her MD from Northwestern University, completed a residency in pediatrics at Univ North Carolina, and then completed a fellowship in pediatric endocrinology there as well. She has published expertise in the areas of quality improvement for diabetes care and in the genetics of short stature. In clinic, her practice will include general pediatric endocrinology and diabetes, as well as gender-related endocrine care.
Dr. Curtis has authored an editorial weighing recent evidence suggesting that male puberty is occurring earlier than in the past. The editorial appears in JAMA Pediatrics, and has received national press. Many thanks to her for sharing her expertise.
The Pediatric Endocrine Society is dedicated to advancing the treatment of children and adolescents with endocrine disorders. Part of its mission is to identify and support talented young physicians who show acumen for biomedical research. For this purpose, the Pediatric Endocrine Society has created a competitive “Rising Star Award”, which provides funds to support research being conducted by pediatric endocrine fellows. We are pleased to announce that our own pediatric endocrine fellow, Dr. Cat Pinnaro, has been announced as the recipient of one of these competitive awards. Congratulations Dr. Pinnaro on this recognition and support.
It has long been wondered what effects diabetes in kids may have on the developing brain. Recent studies suggest that higher glucose levels found in poorly controlled diabetes alter brain development. Dr. Tsalikian is an author on a recent manuscript (link) published in the prestigious journal Diabetologia furthering these observations. The multicenter observational trial found that among children with diabetes, those with higher average glucose levels had greater degrees of persistent disruption of their brain white matter, and that the changes in white matter were associated with worsened cognitive performance. These results suggest that good glucose control is important for future brain function in children with diabetes. However, since the study was observational and correlative, these conclusions are not truly definitive and further study is needed. It remains crucial that children with diabetes be followed by an expert pediatric endocrinology team, such as at the University of Iowa. Several other of our division members contributed to this work, including Dr. Tansey, along with study coordinators Julie Coffey MSN, Joanne Cabbage, and Sara Salamati.
Heading off to college is challenging enough, but especially for teens and young adults with diabetes. Issues range from storing insulin in dorms, navigating roommates, knowing about the effects of alcohol, and complete independence of diabetes care. To assist with this transition, Dr. Kanner helped organize and host our inaugural “Diabetes Off To College” class which was held today. The event included dinner and 2 hours of diabetes education for teens and young adults about to head/return to college. The event was held in the beautiful and scenic Press Box on Level 12 of Stead Family Children’s Hospital.