Type 1 Diabetes, Hyperglycemia, and Structural Brain Changes in Children.

It has previously been observed that young children with type 1 diabetes have changes in brain structure, when compared to children without diabetes. However, it has not been known how these differences in brain structure might change over time. To help address this knowledge gap, Drs. Tsalikian and Tansey have helped conduct a multicenter longitudinal trial following over 100 children with type 1 diabetes. The children underwent repeated brain imaging with MRI over an average span of 6 years time. The results from this study have now been published in the prestigious journal Diabetes Care (link). The study found that the brains of children with type 1 diabetes exhibited smaller volume, and that this difference became greater over time. Importantly, higher blood sugar levels were correlated with greater loss of brain volume. These results lend further credence to the notion that loss of brain tissue is a complication of childhood diabetic hyperglycemia. Furthermore, the results suggest that meticulous glycemic control might prevent these structural brain changes. Since the study was correlative, these conclusions are not fully 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 study coordinators Julie Coffey MSN and Rachel Bisbee. We also thank the families and children who volunteered as participants in this study.

Diabetes Research Center Highlighted

The University of Iowa Fraternal Order of Eagle Diabetes Research Center

The University of Iowa Fraternal Order of Eagles Diabetes Research Center (FOEDRC) is being highlight this month in Iowa Magazine (link). You can read about work from the FOEDRC aimed at better treating and preventing diabetes. Our faculty members Drs. Norris, Tansey, and Tsalikian are mentioned.

Youtube Interview on Subject of Diabetes

Cardiothoracic Surgeon Dr. Shriram Nene

Diabetes is a very common condition worldwide. To discuss diabetes and raise awareness, our division’s Dr. Norris was interviewed by celebrity physician and philanthropist Dr. Shriram Nene. The interview was highlighted on his Youtube channel (link here) and other social media channels. The interview touched on aspects of pediatric onset diabetes, both type 1 and type 2 diabetes. The discussion also touched some on aspects of diabetes in adults, noting that most adults with diabetes worldwide have type 2. To learn more about diabetes worldwide, you can visit the International Diabetes Federation website. We are indebted to Dr. Nene for his interest in diabetes and promoting health and wellness worldwide. You can read about his healthcare initiatives here (website). We are humbled that the interview has been highly viewed, over 40,000 times.

Dr. Larson Ode Interviewed by WeAreIowa-TV

Dr. Larson Ode

We are proud of Dr. Larson Ode for sharing her experience and expertise on short notice with TV station WeAreIowa. In particular, she reflects succinctly on how the physician’s guiding principle of “do no harm” impacts medical decision making regarding transgender care in youth. Her statements also reflect current medical consensus guidelines on the topic. You can find the interview clip at the WeAreIowa website, here.

A Novel Approach that Might Prevent “Belly Fat”

Dr. Akhila Ramakrishna

Perhaps the worst place to gain fat is inside your abdomen. This type of fat is called visceral fat, and contribute to risk of cardiovascular disease, type 2 diabetes, and a host of related complications. Unfortunately, it is also a common place to gain fat. Dr. Ramakrishna has just published new research that has identified a potential new strategy to prevent visceral fat. She used two approaches in mice to reduce the amounts of a protein called PAPP-A. This was accomplished using a genetic and a neutralizing antibody approach respectively. These treatments reduced the amounts of visceral fat that the mice developed while on a high fa diet. Not only was the amount of visceral fat reduced, but the treatments helped prevent fatty liver. She published the work in the journal Endocrinology (link to paper). We look forward to further development of this approach.

Dr. Pinnaro Earns Masters of Science in Translational Biomedicine

Dr. Catherina Pinnaro

Congratulations to Dr. Catherina Pinnaro, who has just fulfilled the requirements of the Masters in Translational Biomedicine at the University of Iowa. This was no easy accomplishment, as she worked on the degree while simultaneous initially being a Pediatric Endocrine Fellow and most recently while being a full time faculty member. Additionally, the degree required original research of publishable quality. Dr. Pinnaro will be using her newly acquired skills and knowledge to advance a research program aimed at better understanding the genetic modifiers of endocrine diseases.

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.

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

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.

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).