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 Herkto 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.