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

Dr. Curtis
Dr. Kanner

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.

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Breakthrough T1D Fundraising Walk

Breakthrough T1D is a philanthropic, nonprofit organization that raises funds to support research aimed at curing, preventing, and better treating type 1 diabetes. Many of you may know the organization by its former name from before 2024, JDRF, the juvenile diabetes research foundation. On Saturday, May 10, Breakthrough T1D held its annual fundraising walk in Cedar Rapids. Our Division participated on the beautiful day by walking and by helping at informational booths. Our volunteers included: Dr. Pinnaro, Dr. Kanner; diabetes nurses Ashley, Haley and Haylee; and diabetes clinical trial research assistant Ashley. Thanks to everyone for their efforts and time on this important cause!

Haley, Ashley & Ashley at the 2025 Breakthrough T1D walk.
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The Importance of Champions for Specific Endocrine Focus Areas

The knowledge base about human disease is exploding, yet there is so much that remains to be discovered. As pace of knowledge discovery quickens, it is becoming increasingly difficult to keep up with the entire field of endocrinology. For this reason, endocrine faculty often have areas of focus – diseases for which they help champion the cause. The Pediatric Endocrine Society has recognized the importance of this by creating nationwide “Special Interest Groups” or “SIGs” for a variety of focus areas. The SIGs enable interested faculty from across the country to collectively share knowledge and research. Here we recognize some of our faculty for their service and involvement with these SIGs. Thank you each for your service.

  • Dr. Alexandrou: Serves on the Turner syndrome SIG, and is a member of their advocacy group. Earlier this spring. Dr. Alexandrou presented journal club on Diabetes in Turner syndrome for this SIG.
  • Dr. Curtis: Has served on the obesity SIG.
  • Dr. Kanner: Serves on the lipid disorder SIG, working on an educational toolkit for pediatric patients affected by lipid disorders and their families.
  • Dr. Pinnaro: Serves as the research liaison for the Turner syndrome SIG.
  • Dr. Ramakrishna: Serves as the co-chair of the Adrenal SIG, whereby she organizes webinars, quarterly meetings, and advocates for injectable rescue steroid medications to be stocked in ambulances. She also is a member of the DSD SIG.
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Type 1 Diabetes Prep for College Event to be Held April 15, 2024, 5 pm

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Dr. Kanner

Save The Date! Dr. Kanner has announced that she will host our annual College Preparation Event on April 15, 2024 at 5 pm. The event focuses on preparation for college success for those with type 1 diabetes. 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. The event’s flyer is immediately below.

Flyer
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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!

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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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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).

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Off To College Class to be Held July 24, 2023, 5-6 pm

Dr. Kanner

Save The Date! Dr. Kanner has announced that she will host our annual Off To College Class on July 24, 2021 at 5-7 pm, 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. The event’s flyer is immediately below.

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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.
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Patient Choice Award Recipients

We are pleased to report that 6 of the pediatric endocrinology providers in our division have received Patient Choice Awards. These awards are given out by UI Health Care to recognize physicians for consistently providing patients with an excellent healthcare experience. The recipient physicians were:

  • Lauren Kanner
  • Katie Larson Ode
  • Julie Osterhaus
  • Liuska Pesce
  • Catherina Pinnaro
  • Mike Tansey

The Award was given to only 174 providers across the entire institution. The Award recognizes those who scored in the top 10% nationally in response to patient surveys asking whether the physician showed concern for patient questions or worries, gave explanations about problem or condition, made efforts to include the patient in care decisions, discussed proposed treatments (options, risks, benefits, etc), and whether they would be likely to recommend the care provider to others. Our division is fortunate to have these Award winning physicians on our team. We thank each of them for their wonderful work. Find more about the awards at this link.