Pancreatitis often leads to hyperglycemia. However, there have been major limitations in understanding the involved pathophysiology. Several collaborators at the University of Iowa have now created a model to help understand the process. The research team found that cerulein injections led to pancretitis with elevated amylase and lipase. Acute accompanied the acute pancreatitis, with both impaired insulin levels and evidence of insulin resistance. Glucose tolerance normalized by 3 months. The research team included our Dr. Andrew Norris, but also pediatric gastroenterologist Aliye Uc and researchers and faculty from the Department of Anatomy and Cell Biology.
Save The Date! Dr. Lauren Kanner has announced that she will host our annual Off To College Class on July 14, 2021 at 5-6 pm. In past years, the class has been held in person, but like in 2020 this year will be held via Zoom. Students, parents, future roommates, and any others interested are welcomed to attend. If you are interested, contact us, either through the email link at Dr. Kanner’s webpage (link) or by contacting our diabetes nursing team.
For the past several decades, infants born in the USA are screened for congenital hypothyroidism. Like many beneficial programs, it is human nature to take the importance of this screening for granted. Dr. Pesce has just published an opinion piece that helps bring home the importance of newborn screening for congenital hypothyroidism. In this piece, she reflects on a child with congenital hypothyroidism who asks “what would have happened if I had not been screened?” Dr. Pesce then reflects on the consequences of untreated congenital hypothyroidism, including impaired mental development and impaired growth. She also notes how diagnosis of congenital hypothyroidism is typically delayed in the absence of screening. You can find her informative blog piece here.
An important question during the COVID-19 pandemic has been whether children and adolescents with type 1 diabetes have increased risk of severe COVID-19. Dr. Pinnaro from our Division was one of a group of pediatric endocrinologist across the country who sought to help answer this important question. Their findings have now been published in the Journal of Diabetes (link to article). Briefly, they found that children and adolescents with type 1 diabetes who developed COVID-19 were at roughly 20% risk of being hospitalized while infected. Importantly, however, the cause of hospitalization was typically related to diabetes, less so than due to severe manifestations of COVID-19 such as lung dysfunction. Diabetes ketoacidosis was the most frequent cause of hospitalization. This is not uncharted territory, because a variety of viral infections can also precipitate a variety of diabetes emergencies, including ketoacidosis , leading to hospitalization. Also importantly, it appears that type 1 diabetes does not strongly increase the risk of severe COVID. For youth with type 1 diabetes who developed COVID-19, the basics of sick day management become important, including glucose and ketone checking, supplemental insulin when needed, and copious fluids, just as with any infection. Please know that our group of diabetes nurses and doctors remain available 24/7 to assist with sick days. Join us in thanking Dr. Pinnaro for her hard work and research.
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.
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.
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.
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.
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.
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.
