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Thyroid Eye Disease in Youth

Dr. Pesce

We have known for a long time that thyroid conditions can be linked to eye problems. This usually happens when someone has hyperthyroidism, especially if it is caused by Graves disease. The various eye problems associated thyroid dysfunction are collectively called “thyroid eye disease”. Sometimes, especially with Graves disease, the muscles behind the eye can become thickened and inflamed. One challenge is that thyroid eye disease has not been as well studied in children compared to adults. To learn more, Dr. Pesce from our Division teamed up with several ophthalmologists from the University of Iowa. They used ultrasound to examine the eye muscles of 20 children with thyroid disease. Most of the 20 children had Graves disease. Nearly all the children had abnormal enlargement of the eye muscles. Importantly, it was not possible to determine the severity of the enlargement from symptoms alone in children under 10 years of age. This suggests that referral to a pediatric ophthalmologist with thyroid eye disease expertise should be considered in young children with Graves disease. The article can be found on Pubmed at this link.

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Dr. Kanner Promoted!

Dr. Kanner

Please join me in congratulating Dr. Lauren Kanner for her well earned promotion!! In brief, Dr. Kanner has been promoted from Assistant to Associate Professor in recognition of her clinical expertise, her dedication to teaching, her compassion as a physician, and her national recognition as a rising expert in the clinical care of adolescents with ovarian issues. She joined the University of Iowa Hospitals and Clinics in 2018, having just completed a pediatric endocrine fellowship at the University of Wisconsin. During fellowship she began to cultivate expertise in the diagnosis and treatment of ovarian hormonal conditions. She has spearheaded several new clinical initiatives at the University of Iowa, including initiating the Pediatric Endocrinology Polycystic Ovary Syndrome Clinic. She also serves to direct the Pediatric Lipid disorder clinic. In addition she practices general pediatric endocrinology and diabetes care, and she serves to provide outreach pediatric endocrinology services in the Quad Cities and attends in the LGBTQ and cardiometabolic clinics. To her peers and trainees, she is treasured for her stalwart devotion to teaching. Her expertise in ovarian health has earned her a national reputation, evidenced by her holding various leadership and service roles with the North American Society for Pediatric and Adolescent Gynecology. In the education realm, she serves as the Assistant Director of Medical Student Education in the Department of Pediatrics. Once again, congratulations to Dr. Kanner!

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Diabetes Camp Hertko Hollow 2023 – Wonderful Summer Sessions

Some of the volunteer staff at Camp Hertko Hollow, 2023 (L-R): Drs. Lindower, Tansey, Palmer, Radig, Pinnaro, and Parra Villasmil.

Diabetes Camps are a summer highlight for many kids who live with diabetes. Camp represents a chance to experience outdoor fun, make new friends who understand what it is like to have diabetes and learn more about diabetes self-care, all while under the watchful eye of diabetes-knowledgeable camp counselors and staff. Several of the staff in our Division help support Camp Hertko Hollow (click for link), a diabetes camp in central Iowa with access to 400 acres of forest / outdoor recreation space. Dr. Pinnaro and Dr. Tansey serve to provide medical direction for the camp, and diabetes nurse Susan Huff has long volunteered to support the camp. Kids Week (ages 8-12) ran June 25-July 1 and Teen Week (ages 13-17) ran July 3-9. Also see the Camp website (link above) for details about Mini Camp and Family Camp opportunities. The doctors and nurses from our Division who have volunteered their time in camp this year: Dr. Pinnaro, Dr. Tansey, Dr. Parra Villasmil, Dr. Palmer, Dr. Tuttle and nurse Sue Huff.

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Announcing New Pediatric Endocrine Fellow: Dr. Baum

Dr. Kyle Baum

Today we are thrilled to announce that Dr. Kyle Baum has joined our division as a new pediatric endocrine fellow. He will serve three years in this role, after which he will be a full fledged board eligible pediatric endocrinologist. Dr. Baum received his Osteopathic Doctorate degree from Kirksville College of Osteopathic Medicine having completed undergraduate studies at Baker University in Baldwin City, Kansas. He just completed a three-year pediatric residency at the Sanford School of Medicine, University of South Dakota. While a resident he demonstrated an outstanding aptitude for and interest in pediatric endocrinology. In his spare time, he volunteered at Camp Gilbert for children with diabetes. His scholarly work was recently recognized by the Pediatric Endocrine Society, who awarded his abstract with a prestigious Presidential Poster that was presented in May at their national meeting. A warm welcome to Dr. Baum!!

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Dr. Tuttle Completes Pediatric Endocrine Fellowship

Dr. Tuttle

We are extremely proud of Dr. Alex Tuttle. For the past 3 years, Dr. Tuttle has been a pediatric endocrinology fellow in our program. Today he finishes this training and will officially become a “board eligible” pediatric endocrinologist. During these past three years, Dr. Tuttle has been an exemplary fellow, delivering excellent clinical care and demonstrating exceptional clinical teaching. His contributions include being an enthusiastic volunteer at Diabetes Camp. While a fellow, he created a new approach and platform to teach pediatric physicians how to manage diabetes in hospitalized patients. Earlier this year, he presented this work at the International Meeting of Pediatric Endocrinology. He will be missed by his patients, who admired his kind and thoughtful demeanor. We too will miss Dr. Tuttle, as he has accepted a faculty position at a another major midwest academic children’s hospital where he will also continue his clinical work in pediatric endocrinology and also work on advancing physician education as well. Congratulations Dr. Tuttle!

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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 17th 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 (#21), nephrology, neurology & neurosurgery, orthopedics, and urology.

“Our ongoing strong national ranking is a testament to the steadfast 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

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Guest Lecturer – Shanlee Davis, MD PhD

Shanlee Davis, MD PhD

We were graced today by a research talk from Shanlee Davis, MD PhD. Dr. Davis is an Assistant Professor at the University of Colorado School of Medicine. Her expertise involves cardiometabolic and reproductive health in youth with X and Y chromosome variations. She spoke today at our Pediatric Grand Rounds. She recently received a prestigious R01 research grant from the NIH to study fatty acid metabolism in persons with Klinefelter Syndrome. She received her MD from Mayo Medical School and her PhD from the University of Colorado. She is a physician scientist and directs a clinical research group. Her research career, despite being in its early stages, has already earned several awards including from the Pediatric Endocrine Society, the Endocrine Society, the Society for Pediatric Research, and from the University of Michigan. Dr. Davis spoke today on how prenatal cell free DNA screening has impacted care for those infants with sex chromosome aneuploidies.

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Dr. Parra Villasmil Named a CAPER Pancreas Scholar

Dr. Parra Villasmil

Children with recurrent pancreatitis are at risk to develop diabetes. However, current knowledge is insufficient to guide monitoring, screening, and therapy. Furthermore, there are no specific approaches to prevent diabetes from developing in those at risk. Additionally, there are very few pediatric endocrinologists with pancreatitis-specific expertise. To address these gaps, the Collaborative Alliance for Pancreatic Education and Research (CAPER) has created a program to identify rising physician specialists who can receive training to provide clinical care to these patients and to drive future research to better treat and even prevent endocrine complications from pancreatitis. We are pleased to broadcast that one of our Pediatric Endocrine Fellows, Dr. Parra Villasmil, has been selected as a CAPER Pancreas Scholar 2023-35. Dr. Parra Villasmil will receive mentorship from Dr. Melena Bellin who is a pancreas expert pediatric endocrinologist at the University of Minnesota. In this context, Dr. Parra Villasmil will develop a research project and participate in related national meetings. Congratulations to Dr. Parra Villasmil! We are not surprised that CAPER has recognized your talents and we look forward to her contributions to the field!

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Screening for Diabetes in Persons with Cystic Fibrosis: Current Situation on the Ground

Dr. Larson Ode

Many persons who have cystic fibrosis develop diabetes at some point. In its early mild stages, diabetes can have few symptoms. Despite the lack of symptoms, mild diabetes still can damage the eyes, kidneys, and nerves. Furthermore, in those with cystic fibrosis, diabetes can worsen lung disease and increase the risk of mortality. For these reasons, it is important to screen for diabetes in persons who have cystic fibrosis. To accomplish this, the recommendations are to perform an oral glucose tolerance test yearly in those over age 10 with cystic fibrosis. To assess how well this recommendation Is being carried out, a group of physicians, including Dr. Larson Ode from our division, surveyed medical centers. Unfortunately, less than half of centers were screening at least half of persons with cystic fibrosis. These results indicate that further progress is needed in screening persons with cystic fibrosis for diabetes. These results are published in the journal Frontiers in Endocrinology and can be found at the following links (pubmed & doi).

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Using a Scribe to Improve Outpatient Physician Care.

  • Dr. Kanner
  • Dr. Pesce

Endocrine conditions are generally treated at home. Treatment can be complicated. A major purpose of appointments with the endocrinologist is to learn more about treatment. Often, a personalized plan is needed, depending on one’s daily schedules and activities. As a result, visits to the endocrinologist often involve numerous suggestions and details. Recording all of these details into the medical record can be difficult and time consuming. Two physicians in our Division participated in a pilot project whereby a scribe accompanied the physician during outpatient visits with the purpose of documenting the discussions and details. The results from this pilot project have now been published. The findings indicate that scribes have variable impact on visit times and physician charting burden, with improvements seen in one sub-specialty (developmental-behavioral pediatrics) but not another (pediatric endocrinology) . Patient satisfaction was equally high (>95%) with or without scribes. Two physicians from our Division, Dr. Kanner and Dr. Pesce contributed to the project and published manuscript. The paper is entitled “The Value of Adding Scribe Services to Two Distinct Pediatric Subspecialties in the Era of the Electronic Medical Record” and is being published in the journal Clinical Pediatrics. The manuscript’s abstract can be found at Pubmed (link).