Pediatric Research Day

Dr. Parra Villasmil

The 2024 Pediatric Research Day was held on the afternoon of April 12th, highlighting seven speakers , a data blitz, and a poster session. Our Division of Endocrinology and Diabetes was well represented. Dr. Parra Villasmil was selected as one of the three top abstract authors, and asked to present to her research work as a talk entitled “Dysglycemia in children with acute recurrent or chronic pancreatitis”. There were four posters that included authors from our Division as well.

Grand Rounds : When Does Overnutrition Become an Endocrine Problem?

Pediatric Grand Rounds Speakers: Feb 16, 2024

On February 16th, 2024, Drs. Kanner, Ramakrishna, and Parra Villasmil jointly delivered Pediatric Grand Rounds. Their talk was entitled “When Overnutrition Becomes an Endocrine Problem…Food for Thought“. They focused on the endocrine complications that can occur as a consequence of overweight and obesity in children and adolescents. Additionally, they touched on the practicalities of providing care to obese youth.

In the United States, nearly 1 in 5 children and adolescents are obese. In Iowa alone, over 50,000 youth are obese, per 2019 estimates (reference). Due to these high numbers, specialized obesity clinics are not a currently tenable solution. While most obese youth won’t develop endocrine complications, some may experience conditions such as type 2 diabetes, dyslipidemia, or polycystic ovarian syndrome.

Our Division accept referrals when these endocrine complications arise. Additionally, we welcome referrals for those rare cases where obesity is linked to endocrine conditions such as hypothyroidism or Cushing syndrome. Another reason for referral to endocrinology is when an obese adolescent and their family are prepared for the arduous process of bariatric surgery.

We extend our thanks to Drs. Kanner, Ramakrishna, and Parra Villasmil for sharing their expertise!

Screening for Diabetes in Persons with Turner Syndrome

Persons with Turner syndrome are at higher risk than normal to develop diabetes. It would be ideal to screen for diabetes to allow treatment early in the disease process. The natural history of diabetes in persons with Turner syndrome is not well understood. Likewise, the optimal screening approach is not known. To help address this knowledge gap, Dr. Pinnaro from our division led a team that compared results between multiple types of screening tests for diabetes assessed concurrently in persons with Turner syndrome. The screening tests compared were fasting plasma glucose, oral glucose tolerance test, and hemoglobin A1c. The results showed only partial concordance between the different tests. Interpreted conservatively, the data suggest that various hemoglobin A1c thresholds could be used to indicate need for closer evaluation for diabetes. The results are published in the journal Hormone Research in Paediatrics as an article entitled “Screening for Turner syndrome-associated hyperglycemia: Evaluating hemoglobin A1c and fasting blood glucose”. Study authors from our division were Drs. Pinnaro, Parra Villasmil, and Norris. The article’s Pubmed abstract can be found at this link.

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.

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!

Iowa Well Represented at National Pediatric Endocrine Society Meeting

The Pediatric Endocrine Society (PES) is a professional organization of over 1,600 endocrinologists with the purpose of advancing treatment of youth with endocrine disorders. The PES held its annual meeting May 5-8 in San Diego. Several of our division faculty attended the meeting. Dr. Pesce presented at one of the symposium session on Endocrinology in the Neonatal Intensive Care Unit. Dr. Parra Villasmil presenter her research, conducted under the mentorship of Dr. Pinnaro, on Screening for Turner Syndrome-associated Hyperglycemia. Dr. Parra Villasmil’s work was selected as one of the top-ranking abstracts, receiving a PES Presidential Poster award. In addition, our future fellow, Dr. Kyle Baum, currently a pediatric resident at Sanford School of Medicine, also had an abstract selected for a PES Presidential Poster award.

Dr. Pesce presenting at PES 2023
Dr. Parra Villasmil at PES 2023

Advancing Reproductive Health of Youth

The North American Society for Pediatric and Adolescent Gynecology (NASPAG) is a non-profit association dedicated to advancing gynecologic care for youth. NASPAG held its 37th annual clinical & research meeting March 24-26 this year in Nashville. Dr. Kanner from our division was one of the Planning Committee members directing the meeting. Fellow Dr. Parra Villasmil from our division also attending the meeting and presented a Roundtable lecture. We thank them for their efforts to improve health.

Dr. Parra Villasmil leading a Roundtable at NASPAG 2023.
Dr. Kanner speaking at NASPAG 2023.

Double Jeopardy: Two Dangerous Medical Emergencies Associated with Type 1 Diabetes Can Occur Simultaneously

Medical emergencies associated with diabetes include diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), and severe hypoglycemia. DKA occurs when the body’s insulin levels are too low, allowing excessive ketone production to the point that acidosis occurs in the blood. HHS occurs when blood glucose levels rise to extremely high levels and the body becomes dehydrated causing body fluids to become concentrated to the point that brain function declines. Children with type 1 diabetes are often susceptible to the development of DKA. Although HHS can occur in children with type 1 diabetes, it is not common. Importantly, both conditions are reversible with proper medical treatment, even though both conditions can be fatal if treatment is not started promptly. Occasionally, a child with type 1 diabetes can develop both DKA and HHS simultaneously. This is a very dangerous predicament, requiring immediate and expert/judicious treatment. Dr. Parra Villasmil and Dr. Tansey from our Division, in conjunction with members of the Pediatric Intensive Care Unit team, have just published a report of such a case. In this publication, they describe the critical condition of the child on arrival to the hospital and the subsequent careful interventions that were made to resolve the two conditions. The report can be found in the journal Cureus (Pubmed link).

Diabetes Camp Hertko Hollow Reopens!

Some of the volunteer staff at Camp Herkto Hollow, Kids Week 2022, including those from our Division: Dr. Tansey (far left), Dr. Pinnaro (2nd from right), Dr. Parra Villasmil (far right).

Diabetes Camps are a summer highlight for many kids who have diabetes. Camp represents a chance to have non-stop 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. Unfortunately, Camp Hertko Hollow, like most diabetes camps across the country, closed in 2020 and 2021 due to the COVID pandemic. This year, Drs. Pinnaro and Tansey were determined to help Camp Hertko Hollow reopen despite the challenges of ongoing COVID transmission. We are pleased to report that their efforts are paying off. Kids Week (ages 8-12) is off to a great start June 26-July 2, and Teen Week (ages 13-17) will run 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 week and/or next week include: Dr. Pinnaro, Dr. Tansey, Dr. Parra Villasmil, Dr. Tuttle, Dr. Palmer, and nurse Sue Huff.

“Our first year back at camp Hertko has been a great one. I’m so grateful to our dedicated and flexible volunteers who adapted to swiftly to our Covid-related protocols.”

Dr. Catherina Pinnaro

Announcing New Pediatric Endocrine Fellow: Dr. Parra Villasmil

Dr. Parra Villasmil

Today we are thrilled to announce that Dr. Graciela Parra Villasmil has joined our division as a new pediatric endocrine fellow. She will serve three years in this role, after which she will be a full fledged board eligible pediatric endocrinologist. Dr. Parra Villasmil received her Medical Degree from the Universidad del Zulia in Venezuela where she was an award winning student. She then completed a pediatric residency at the University of Iowa Children’s Hospital. While a resident she demonstrated an aptitude for and interest in pediatric endocrinology, and was highly involved in diabetes camp (see picture below) at Camp Herkto Hollow. She has assisted with pediatric endocrine clinical research both in Venezuela and while a pediatric resident at the University of Iowa, and has published her scholarship in the field of endocrinology (link 1 and link 2). Welcome Dr. Parra Villasmil!! We are also proud to announce that Dr. Sriya Subramani, who was a pediatric resident here, is also starting a Pediatric Fellowship, at University of Washington / Seattle Children’s Hospital. Congratulations Dr. Subramani!!

Diabetes Camp Hertko Hollow, some staff from teen week 2019. Division members include Diabetes Nurse Sue Huff on the far left, endocrine fellow Dr. Alex Tuttle on the far right, and new endocrine fellow Dr. Parra Villasmil second from far right. Dr. Sriya Subramani, front far right, also is a new endocrine fellow, at the University of Washington.