from the division director
In late May, the division and family members gathered for a weekend picnic and celebration dedicated to four of our members who are leaving: Julie Osterhaus ARNP, Amy Sheehan RN, Cat Pinnaro MD, and Kyle Baum MD. Details on each can be found elsewhere on this site. Instead of those details, here is a picture of one of the gifts to Dr. Pinnaro!
Dr. Pinnaro will soon embark on a new chapter in her pediatric endocrinology career, marking the end of a decade (almost) of connection with our division. She first joined us as a fellow and went on to become an integral member of our faculty, leaving a lasting mark on our community. We are deeply grateful for Dr. Pinnaro’s many stellar contributions to our division’s missions, including enhancement of our fellowship program, provision of skilled clinical care to her patients, leadership of diabetes camp, and creation of meaningful clinical research endeavors. During her time here, she built a thriving clinical research program focused on understanding the increased risk of diabetes in individuals with Turner syndrome. Dr. Pinnaro’s insight, steady judgment, and collegial spirit have enriched our division in countless ways and she will be deeply missed. At the same time, we celebrate her accomplishments and the impact she will undoubtedly continue to have. We wish Dr. Pinnaro every success at the start of an age in her new faculty role at McMaster University.
In the following interview, Drs. Norris, Pinnaro, and Tansey discuss the clinical use of teplizumab therapy to delay the onset of insulin dependence in persons with stage 2 (i.e. pre-diabetes stage) type 1 diabetes. Our division was one of the groups that helped conduct the multi-center clinical trials that demonstrated the efficacy of teplizumab. The interview can be found on this Vimeo link.
Why does diabetes happen in some children who have experienced pancreatitis? A new study from Dr. Larson Ode and Dr. Pinnaro, along with a former research fellow Dr. Parra Villasmil, delves into this very question, uncovering unexpected patterns. Their work has been just published in the Journal of Pediatric Gastroenterology and Nutrition. The manuscript, titled “Early mechanisms of diabetes development in pediatric pancreatitis – a pilot study”, explores the complex interplay between pancreatitis and diabetes risk in children. Diabetes is a serious complication for children with pancreatitis, affecting nearly 9% during childhood and up to half over a lifetime. Despite this high risk, little is known about the underlying mechanisms or biomarkers that predict which children are most vulnerable. This study takes an important step toward filling that gap. Their findings revealed that 35% of participants exhibited dysglycemia, often linked to insulin resistance. Could insulin resistance be the key mechanism that drives diabetes risk? Another surprise finding was that dysglycemia was associated with higher pancreatic polypeptide levels. These results will help inform future studies that could pave the way for earlier detection and/or targeted interventions to prevent diabetes in this high-risk population. The manuscript is indexed on PubMed at this URL.
Early in the pandemic, pediatric endocrinologists began noticing a rise in new cases of diabetes among youth. To investigate this trend, a group of specialists formed a national consortium representing 23 pediatric centers across the country. Their findings revealed a significant increase in new diagnoses of type 2 diabetes during the pandemic, with cases more than doubling. This increase was observed across all sampled regions of the United States. In contrast, the rise in new-onset type 1 diabetes was less pronounced and did not reach statistical significance.
Encouragingly, the number of new type 2 diabetes cases appeared to return to baseline by the end of the pandemic’s second year.
While the study was not designed to determine the exact causes of the type 2 diabetes surge, the results suggest that the major contributing factors were transient in nature. These temporary factors may have included reduced physical activity, disrupted daily routines and eating habits, and increased psychosocial stress. Perhaps less likely to play a major role would be the physiological effects of the SARS-CoV2 virus itself.
The consortium has now published these findings in the Journal of Clinical Endocrinology and Metabolism. Dr. Pinnaro, from our division, was involved with the consortium’s creation, this research and the writing of the published manuscript. The abstract can be found on PubMed at this link.
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!
Dr. Catherina Pinnaro and her research team have now published a second report indicating benefits to reviewing diabetes device blood sugar data. The article is entitled “Adolescent-Initiated Retrospective Glucose Data Review is Associated With Improved Glycemia in Type 1 Diabetes Mellitus”, and was just published as a peer reviewed research article in Pediatric Diabetes (pubmed Link; free fulltext Link). This paper expands upon her group’s prior related paper (previously reviewed in this blog here). Whereas the prior paper studied whether blood sugar levels improved when family-members reviewed their child’s blood sugar data, the current paper examines the impact when the child/adolescent reviews their own data. Importantly, blood sugar levels were significantly improved in those adolescents who reviewed their own blood glucose data. Co-authors on the work from our division included Drs. Palmer, Norris, and Tansey.
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.
Almost immediately after birth, we begin burning fat for energy and warmth. Recently, members of our division studied whether this process is altered in infants with congenital disorders. The study focused on two specific disorders: congenital hypothyroidism and cystic fibrosis. The peer-reviewed study is now available online (PubMed link). The results indicate that infants with these disorders burn less fat than normal. Surprisingly, however, these infants burned relatively more of a specific fatty acid—linoleic acid. One possible explanation for this finding relates to higher levels of inflammation in these infants. This finding is particularly important for cystic fibrosis, as it may help explain why this condition often causes lifelong linoleic acid deficiency. The manuscript’s lead author is Dr. Pinnaro from our division, with Dr. Norris serving as the senior author.
Nope, the newest research results from Dr. Pinnaro are not related to a social media platform formerly represented by a blue bird. Rather, her latest research publication deals with the X-chromosome and how it modifies the risk a person has to develop diabetes. Specifically, the new results show that persons with Turner syndrome who inherited just a single X-chromosome have a higher risk of elevated blood sugar levels if that X-chromosome came from their mother compared to if it came from their father. The manuscript describing the results has been accepted for publication in the journal Hormone Research in Paediatrics (link to article on PubMed). The results may have implications for diabetes in the general population, as males necessarily inherit their X from their mother and for females the impact of risk differences between their two X chromosomes could be influenced by which parent each came from. Dr. Norris from our division also contributed to the manuscript.