For reasons that are not well understood, persons with cystic fibrosis are at very high risk to develop diabetes. A major factor in this risk is poor secretion of insulin from beta-cells. A research team at the University of Iowa has now published findings that may have identified one of the root causes. The team found exceptionally high levels of reactive oxygen species in pancreas with cystic fibrosis. Furthermore, the islets isolated from cystic fibrosis pancreases exhibited increased production of reactive oxygen species and impaired secretion of insulin. However, two different approaches aimed at reducing or neutralizing excess reactive oxygen species production failed to improve insulin secretion. Nonetheless, the findings highlight what might be an important contributor to poor insulin secretion in persons with cystic fibrosis. From our division, Dr. Andrew Norris contributed to the research and publication. The paper can be found at this DOI link and a full text version can be found at this PubMed Central link.
Our Program Ranked Among the Best Children’s Diabetes & Endocrinology Programs Nationally
Our Division has been rated among the Best Children’s Hospitals for Diabetes & Endocrinology Care by the US News & World Report 16th annual national report, where we were ranked #23 nationwide. Other top ranked specialties at the University of Iowa Stead Family Children’s Hospital included neonatology, pediatric cancer, pediatric orthopedics, pediatric nephrology, pediatric neurology and neurosurgery, and pediatric pulmonology & lung surgery.
“Our national ranking is a testament to the dedication and expertise of our pediatric endocrine physicians, nurse practitioners, specialty nurses, diabetes educators, psychologists, researchers, medical assistants, dieticians, pharmacists, social workers, and all teams members. We remain devoted to provide the best care for the children and adolescents in the region and beyond.”
Andrew Norris, M.D. Ph.D.
Director, Division of Endocrinology and Diabetes
UI Stead Family Children’s Hospital
Creating Resources to Teach Diabetes Inpatient Management
Proper blood sugar management of hospitalized children with type 1 diabetes is complex and notoriously difficult to teach. For this reason, Dr. Alex Tuttle has begun work aimed at creating teaching materials for training doctors best practices for managing diabetes in the hospital setting. He has created a draft set of teaching materials. To support further development of these materials for broader use, he applied to the OpenHawks program. The program has just announced that they will help fund his project (announcement can be found at this link). This funding will enable him to convert his work into a proper Open Educational Resource that would be freely available to anyone. Congratulations to Dr. Tuttle for this milestone, and we look forward to further progress. Dr. Vanessa Curtis from our division has also been involved in advising Dr. Tuttle’s project.
University of Iowa F.O.E. Diabetes Research Center Featured in New Video
Each June, the American Diabetes Association hosts its annual scientific meeting. This meeting is the world’s largest and most important gathering focused on diabetes research, attracting over 10,000 attendees who come from across the world to hear the latest cutting edge research. This year, the University of Iowa was featured in a short video film shown at the meeting. The video focused on how the Fraternal Order of Eagles Diabetes Research Center (FOE-DRC) is advancing diabetes research . The FOE-DRC was created in 2008 when the Fraternal Order of Eagles pledged $25 million to establish a diabetes research center at the University of Iowa. With this gift, the FOE-DRC has grown to include over 100 faculty researchers from across the University. Collectively, these faculty conduct over $30 million of NIH-funded research annually. Several members of our Division are faculty in the FOE-DRC: Drs. Curtis, Larson Ode, Norris, Pinnaro, Tansey, and Tsalikian. Earlier this year, the American Diabetes Association requested that investigators at the University of Iowa help create a short video highlighting the work of the FOE-DRC. The video is now available on youtube (link to video here). The video highlights work by two members of our Division: Dr. Larson Ode and Dr. Norris, as well as several colleagues in the Division of (Adult) Metabolism and Diabetes and in the FOE-DRC.
Anxiety and Turner Syndrome
Turner syndrome affects over 70,000 women in the United States. Turner syndrome is caused by loss genetic material from one X chromosome in a process that happens long before birth. Turner syndrome increases the risk of a variety of physical and medical changes such as shorter stature, subtle changes in facial structure, delayed puberty, congenital heart disease, and frequent ear infections. It has more recently been recognized that Turner syndrome also increases the risk of anxiety and depression. To better address the situation, Dr. Eirene Alexandrou recently developed an approach by which medical providers can screen persons with Turner syndrome using a simple questionnaire. She found that a high proportion, over half, of women with Turner syndrome had elevated anxiety levels. The results of Dr. Alexandrou’s study have been published this month in the journal “Hormone Research in Paediatrics” after peer review. The abstract of the work can be found on Pubmed (link). The results highlight the importance of multidisciplinary specialty clinics for persons with Turner syndrome, such as the clinic here led by Dr. Alexandrou and Dr. Pinnaro.
Patient Choice Award Recipients
We are pleased to report that 6 of the pediatric endocrinology physicians in our division have received Patient Choice Awards. These awards are given out by UI Health Care to recognize physicians for consistently providing patients with an excellent healthcare experience. The recipient physicians were:
- Lauren Kanner
- Katie Larson Ode
- Liuska Pesce
- Catherina Pinnaro
- Mike Tansey
- Eva Tsalikian
The Award was given to only 156 providers across the entire institution. The Award recognizes those who scored in the top 10% nationally in response to patient surveys asking whether the physician showed concern for patient questions or worries, gave explanations about problem or condition, made efforts to include the patient in care decisions, discussed proposed treatments (options, risks, benefits, etc), and whether they would be likely to recommend the care provider to others. Our division is fortunate to have these Award winning physicians on our team. We thank each of them for their wonderful work. Find more about the awards at this link.
Dr. Pesce and the University of Iowa Pediatric Thyroid Clinic join the Child and Adolescent Thyroid Consortium (CATC)
Infants, children and adolescents sometimes suffer from a wide range of thyroid disorders. Examples of thyroid conditions experienced by children include hypothyroidism (low thyroid hormone levels), hyperthyroidism (elevated thyroid hormone levels), goiter (enlarged thyroid), thyroid nodules (growths on the thyroid) and thyroid cancer. Pediatric endocrinologist Dr. Liuska Pesce has devoted her career to the treatment of children with these conditions. She has developed a national reputation as a caring and adept physician for pediatric thyroid care. To help develop even better treatments for thyroid conditions, she has now joined a collaborative effort of the leading pediatric thyroid groups across the country. The collaboration is called the Child and Adolescent Thyroid Consortium (CATC). The consortium has the goal of improving knowledge of thyroid disease and identifying ways to improve thyroid disease care for children and adolescents. The consortium member centers include the Children’s Hospital of Philadelphia, Boston Children’s Hospital, Yale University, MD Anderson, and the Hospital for Sick Children in Toronto, all leading institutions. Congratulations to Dr. Pesce for joining this rarefied group and we wish them success in their quest for better treatments.
A Novel Target to Treat Type 2 Diabetes
Type 2 diabetes affects over 35 million Americans and is a leading cause of disability, expense, and mortality. Type 2 diabetes occurs worldwide and some countries have rates up to roughly three times higher than in the US. Type 2 diabetes rates are climbing, in part because there are not optimal therapies and preventative strategies. Dr. Norris has contributed to a team that has identified a novel molecular target to treat type 2 diabetes. The new findings have now been published in the scientific journal Nature Communications (link). The new target is a protein named SWELL1. It is a chloride transport protein and is involved in beta-cell and adipose tissue functions. Interestingly, certain small molecules that inhibit SWELL1 both improve insulin sensitivity and increase beta-cell function. This combination of effects potently improved blood sugar levels in mice, indicating that these types of SWELL1 inhibitors may be a very effective means to treat and/or prevent type 2 diabetes.
Growth Failure and Arthritis Caused by Aggrecan Deficiency
There are a number of reasons for growth failure in a child. There are a variety of genetic conditions that cause inherited forms of growth failure. One of these that is being increasingly recognized is aggrecan deficiency. This is a genetic condition that is passed from parent to child in a dominant pattern. To better understand aggrecan deficiency and its impact on growth and bone health, Dr. Eirene Alexandrou studied multliple families. She has now published her findings in the American Journal of Medical Genetics (PubMed link here). This work indicates that aggrecan deficiency is associated with moderate but progressive growth failure. Arthritis was very common among adults with aggrecan deficiency. With increased knowledge and awareness about this condition, the hope is to improve outcomes from earlier detection and treatment.
Dr. Norris Named Interim Co-Director of the Fraternal Order of Eagles Diabetes Research Center
The Fraternal Order of Eagles Diabetes Research Center (FOE-DRC) is located at the University of Iowa. The FOE-DRC was created in 2008 when the Fraternal Order of Eagles pledged a $25 million gift toward diabetes research. Since then, the FOE-DRC (link to FOE-DRC homepage) has grown to include over 100 faculty researchers from across the University. Collectively, these faculty conduct over $30 million of NIH-funded research annually. Major innovations have included studies of mitochondrial function, muscle wasting in diabetes, heart dysfunction in diabetes, diabetes in cystic fibrosis, and use of electromagnetic fields to lower blood sugar. From 2013-2021, the Center was under the stellar leadership of Dr. Dale Abel, who now has been recruited to lead the Department of Internal Medicine at UCLA. While a new permanent FOE-DRC head is being recruited, Dr. Andrew Norris from our Division will serve as interim Co-Director of the FOE-DRC, alongside Dr. Kamal Rahmouni. From 2014-2021, Dr. Norris served as Associate Director of the FOE-DRC. Dr. Norris has been a diabetes researcher for over 2 decades, leading translational studies related to the integrated physiology of diabetes across the lifespan, with recent focus on cystic fibrosis related diabetes and early life determinants of diabetes risk.