Research – News & Views

November 25, 2025

Advancing Expert Diagnosis and Care for Pancreatogenic Diabetes

Pancreatogenic diabetes is an underrecognized form of diabetes that develops as a consequence of diseases affecting the exocrine pancreas. Though often overshadowed by type 1 and type 2 diabetes, pancreatogenic diabetes is estimated to account for 1–9% of all diabetes cases, making it a significant contributor to global health burden. This condition can arise from a range of pancreatic disorders, including pancreatitis, pancreatic cancer, cystic fibrosis, surgical removal of the pancreas, and fibrocalculous pancreatic disease. Each of these conditions presents unique diagnostic and therapeutic challenges, underscoring the need for heightened clinical awareness. Two faculty members from our Division, Dr. Larson Ode and Dr. Norris, have authored a comprehensive clinical review on this topic, recently accepted for publication in the Journal of Clinical Endocrinology and Metabolism (JCEM), one of the leading journals in the field.

Their article, titled “Approach to the Patient with Pancreatogenic Diabetes,” synthesizes current evidence and offers practical guidance for clinicians managing these complex cases. The work was co-authored by adult endocrinologist Dr. Yumi Imai. The review emphasizes the importance of timely diagnosis and tailored treatment. For instance, diabetes can be an early warning sign of pancreatic cancer—a disease with poor prognosis and no reliable biomarkers—making clinical suspicion critical. In cystic fibrosis, even mild diabetes can worsen lung function and increase mortality risk, highlighting the need for proactive screening. The authors also discuss the frequent coexistence of exocrine pancreatic insufficiency in these patients, noting that in these cases pancreatic enzyme replacement therapy may improve glycemic control.

We are glad that these authors have been able to bring their recognized expertise in pancreatogenic diabetes to this work, providing clinicians with actionable insights into evolving screening and treatment strategies. The article’s abstract can be found on PubMed (https://pubmed.ncbi.nlm.nih.gov/41252284/), where there are links to the open access full manuscript.

November 19, 2025

What Mechanisms Drive Diabetes-Risk in Youth with Pancreatitis?

Why does diabetes happen in some children who have experienced pancreatitis? A new study from Dr. Larson Ode and Dr. Pinnaro, along with a former research fellow Dr. Parra Villasmil, delves into this very question, uncovering unexpected patterns. Their work has been just published in the Journal of Pediatric Gastroenterology and Nutrition. The manuscript, titled “Early mechanisms of diabetes development in pediatric pancreatitis – a pilot study”, explores the complex interplay between pancreatitis and diabetes risk in children. Diabetes is a serious complication for children with pancreatitis, affecting nearly 9% during childhood and up to half over a lifetime. Despite this high risk, little is known about the underlying mechanisms or biomarkers that predict which children are most vulnerable. This study takes an important step toward filling that gap. Their findings revealed that 35% of participants exhibited dysglycemia, often linked to insulin resistance. Could insulin resistance be the key mechanism that drives diabetes risk? Another surprise finding was that dysglycemia was associated with higher pancreatic polypeptide levels. These results will help inform future studies that could pave the way for earlier detection and/or targeted interventions to prevent diabetes in this high-risk population. The manuscript is indexed on PubMed at this URL.

November 17, 2025November 17, 2025

Inhaled Insulin Shows Some Benefits for Children with Type 1 Diabetes in Landmark Clinical Trial

We are proud to announce our division’s contribution to a major clinical study recently published in Diabetes Care: “INHALE-1, A Multicenter Randomized Trial of Inhaled Technosphere Insulin in Children With Type 1 Diabetes.” One of our Division physicians, Dr. Tansey, served as a co-author on this important research. The INHALE-1 trial examined the safety and effectiveness of an inhaled form of insulin compared to standard rapid-acting insulin injections in 230 children and adolescents aged 4 to 17 living with diabetes. Over a 26-week period, participants continued their long-acting basal insulin and used continuous glucose monitoring while receiving either inhaled or injected rapid acting insulin. Compared to the injected insulin group, the inhaled insulin group experienced a similar hemoglobin A1c, similar continuous glucose monitor readings, and lung function. Children using TI reported greater treatment satisfaction and experienced less weight gain compared to those on injected insulin. These findings suggest that inhaled insulin could become a valuable option for some pediatric patients. It is important to note that the study did not compare inhaled insulin to insulin pump-based therapy. The manuscript abstract is available on Pubmed. We especially wish to thank the research coordinators, research participants and their families who made this study possible.

August 11, 2025

Vitamin D Repletion in People with Cystic Fibrosis

Cystic fibrosis often disrupts gastrointestinal function, impairing the absorption of fat-soluble vitamins such as vitamin D. As a result, individuals with cystic fibrosis are at increased risk for vitamin D deficiency. While daily supplementation is a common corrective strategy, it adds to the already significant treatment burden faced by these patients.

An alternative approach known as stoss dosing involves administering a single, very high dose of vitamin D. This method is effective because vitamin D remains active in the body for several weeks, potentially reducing the need for daily supplementation.

To evaluate the effectiveness of stoss dosing, researchers analyzed the medical records of 58 individuals with cystic fibrosis who received this treatment. Their findings showed that vitamin D levels were increased by the therapy, as measured three months after the dose administration. However, only about half of the patients reached the target vitamin D levels, suggesting that while stoss dosing is likely beneficial, further research and optimization are necessary.

Dr. Larson Ode from our division contributed to the research, which has been peer-reviewed, published in Health Science Report and is publicly available in the PubMed Central repository (link).

July 21, 2025July 30, 2025

Sugar Surge: Rates of Pediatric Type 2 Diabetes More than Doubled During the Pandemic

Early in the pandemic, pediatric endocrinologists began noticing a rise in new cases of diabetes among youth. To investigate this trend, a group of specialists formed a national consortium representing 23 pediatric centers across the country. Their findings revealed a significant increase in new diagnoses of type 2 diabetes during the pandemic, with cases more than doubling. This increase was observed across all sampled regions of the United States. In contrast, the rise in new-onset type 1 diabetes was less pronounced and did not reach statistical significance.

Encouragingly, the number of new type 2 diabetes cases appeared to return to baseline by the end of the pandemic’s second year.

While the study was not designed to determine the exact causes of the type 2 diabetes surge, the results suggest that the major contributing factors were transient in nature. These temporary factors may have included reduced physical activity, disrupted daily routines and eating habits, and increased psychosocial stress. Perhaps less likely to play a major role would be the physiological effects of the SARS-CoV2 virus itself.

The consortium has now published these findings in the Journal of Clinical Endocrinology and Metabolism. Dr. Pinnaro, from our division, was involved with the consortium’s creation, this research and the writing of the published manuscript. The abstract can be found on PubMed at this link.

June 30, 2025October 7, 2025

Adrenal Insufficiency after Pediatric ICU

Children admitted to the Pediatric Intensive Care Unit (PICU) often receive glucocorticoid steroids as part of their treatment. While these medications can be highly effective in managing critical illness, prolonged use may lead to adrenal insufficiency—a dangerous but treatable condition in which the body cannot produce adequate levels of cortisol. To better understand the risks, researchers reviewed the medical records of 530 pediatric patients who received steroids during their PICU stay. Among these patients, 2.3% were diagnosed with adrenal insufficiency. The study identified several key risk factors including the following: younger age, higher cumulative dose of steroids and the use of steroids specifically for treating excess inflammation. These findings aim to improve the identification of pediatric patients at risk for adrenal insufficiency following critical illness. The study has been published in the Journal of Intensive Care Medicine. The lead author, Dr. Radig, will soon join our Division as a pediatric endocrinology fellow. Also contributing to the the research was Dr. Curtis, also from our Division. The abstract is available on PubMed at the following link.

June 9, 2025June 9, 2025

Long-Term Study Links Elevated Glucose Levels to Persistent Brain Changes in Children with Type 1 Diabetes

In 2018, faculty from our division participated in a multicenter, observational study that added to growing evidence linking elevated glucose levels in children with type 1 diabetes to changes in brain structure. While the initial findings highlighted these associations, they could not determine how such changes might evolve over time. Now, the research team—including Drs. Tsalikian and Tansey from our division—has completed a long-term follow-up of the original study participants. The results, recently published in the journal Diabetes, are available via PubMed (link here) in abstract form. The follow-up spanned 6 to 8 years and revealed that the previously observed brain differences largely persisted. Although the magnitude of some differences diminished slightly, higher average blood glucose levels continued to correlate with more pronounced structural changes. These findings reinforce the importance of maintaining tight glycemic control to potentially mitigate long-term neurological impacts. As the cohort transitions into adulthood, continued monitoring will be essential to fully understand the long-term implications of these early brain changes.

June 3, 2025June 3, 2025

The Mouth Tells the Story: Metabolic Syndrome Impacts the Oral Milieu Even Before Dental Disease Occurs

Obesity and metabolic syndrome are known to negatively affect oral health, but the underlying mechanisms and early indicators remain unclear. To help bridge this knowledge gap, Dr. Curtis and Dr. Kanner from our division collaborated with scientists from the School of Dentistry led by Dr. Sukirth Ganesan. Together they conducted a study involving children and adolescents with healthy teeth and gums. Participants were grouped into three categories: normal-weight healthy, healthy obese, and obese with metabolic syndrome.

Saliva samples were collected from each participant and analyzed their bacterial, metabolic, and hormonal content. All three components showed distinct differences between the obese and normal-weight healthy groups. Notably, by integrating data from all three saliva components, researchers were able to identify individuals with metabolic syndrome.

These findings suggest the potential for developing non-invasive saliva-based tests to assess metabolic health—potentially even eliminating the need for some blood draws. Additionally, the results offer new insights into how obesity and metabolic syndrome may contribute to oral health issues. The study was published in the Journal of Dental Research, and the abstract is available on PubMed at this link.

May 5, 2025

Benefits of Blood-sugar Self-Review in Adolescents with Type 1 Diabetes

Dr. Catherina Pinnaro and her research team have now published a second report indicating benefits to reviewing diabetes device blood sugar data. The article is entitled “Adolescent-Initiated Retrospective Glucose Data Review is Associated With Improved Glycemia in Type 1 Diabetes Mellitus”, and was just published as a peer reviewed research article in Pediatric Diabetes (pubmed Link; free fulltext Link). This paper expands upon her group’s prior related paper (previously reviewed in this blog here). Whereas the prior paper studied whether blood sugar levels improved when family-members reviewed their child’s blood sugar data, the current paper examines the impact when the child/adolescent reviews their own data. Importantly, blood sugar levels were significantly improved in those adolescents who reviewed their own blood glucose data. Co-authors on the work from our division included Drs. Palmer, Norris, and Tansey.

April 16, 2025

Pediatric Research Day 2025

The 2025 Pediatric Research Day was held on the afternoon of April 11th, highlighting eight speakers, a “data blitz”, and a poster session. Our Division of Endocrinology and Diabetes was well represented. Two of our fellows had their abstracts selected for one of four speaker slots. Additionally, our faculty contributed to several poster abstracts. The fellow talks were as follows: Dr. Kyle Baum: “Impact of the incretin, retatrutide, on weight loss, lean body mass, and muscle physiology in mice”. Dr. Benjamin Palmer: “Assessing Sports Participation and Associated Barriers in Youth with Type 1 Diabetes Mellitus”