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

Patient Choice Award Recipients

We are pleased to report that 6 of the pediatric endocrinology physicians 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
  • Liuska Pesce
  • Catherina Pinnaro
  • Mike Tansey
  • Eva Tsalikian

The Award was given to only 156 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.

Celebrating 100 Years of Insulin Therapy

Before 1922 type 1 diabetes was a rapidly fatal disease. That changed in the span of a few history-changing months. In the summer of 1921 four scientists at the University of Toronto began studying how to extract insulin from the pancreas and made quick progress. The first injection occurred on January 11, 1922, when an experimental insulin extract was administered to an adolescent who was dying of type 1 diabetes, saving his life. Soon thereafter commercial insulin production began and insulin use became widespread. However, there were many shortcomings of early insulin therapy, which was “regular” insulin extracted from cow and pig pancreases. These insulin preparations did not work in a uniform way from person-to-person. Extreme blood sugar swings were common and complications abounded. Thankfully, in the intervening century numerous improvements to insulin preparations and insulin delivery have been made. Dr. Pinnaro and Dr. Tansey from our division have just published an overview of these improvements in the Journal of Diabetes Mellitus. Their review is entitled “The Evolution of Insulin Administration in Type 1 Diabetes” (click on title for link to the article). Despite these improvements, insulin delivery for patients with type 1 diabetes remains imperfect. Importantly to this end, the article also discusses anticipated improvements that may help future generations of persons with type 1 diabetes. We are thankful for all those who worked to discover and improve insulin therapy, and look forward to future improvements! We thus thank all the diabetes research teams who are working tirelessly to improve diabetes care. This includes the Pediatric Diabetes research team here at the University of Iowa, whose dedication and expertise has helped advance diabetes care through carefully run studies. Finally, to those youth and families affected by type 1 diabetes, know that we look forward to every opportunity to work with you to optimize your insulin delivery and diabetes care. Advances in insulin therapy are happening rapidly. If your diabetes control is not what you think it should be, we would love for you to reach out to us to discuss options.

Type 1 Diabetes, Hyperglycemia, and Structural Brain Changes in Children.

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.

Diabetes Research Center Highlighted

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.

Glucose Control and COVID Hospitalization Risk in Persons with Type 1 Diabetes

Yesterday, data were published indicating that among persons with type 1 diabetes, higher average glucose levels are associated with increased risk of requiring hospitalization for COVID infection. The peer reviewed data was published in the Journal of Clinical Endocrinology and Metabolism ( doi permanent link ; pubmed link ). The data were collected via the national T1D Exchange study consortium. Drs. Pinnaro and Tansey from our division are part of this consortium and helped author the article. The data indicate that if you have type 1 diabetes, you should keep your blood sugars in range as much as possible to help prevent severe COVID. We remain happy to help you achieve this goal; our contact information can be found by clicking on the “clinical website” at the top of our links page.

Watching the Brain Remember: Differences Between Children with and without Type 1 Diabetes

With the advent of techniques to strengthen brain regions, such as transcranial magnetic stimulation, it is possible that this type of research will help delineate important future interventions.” –Andrew Norris

Dr. Tansey

Dr. Tansey and collaborators across the country have been studying brain function in children with and without type 1 diabetes. In a study published today (link) in the prestigious journal Diabetes, they report important differences between these two groups. They used functional magnetic imaging resonance (fMRI) to measure activation in various brain locations while the children were given memory tasks. Compared to children without diabetes, those with type 1 diabetes exhibited decreased memory performance relative to children without diabetes. Interestingly the children with type 1 diabetes showed greater increases in brain activation with harder tasks than those without diabetes, suggesting that their brains were working harder to compensate. More research is needed to understand how these effects of diabetes occur and how they might be modulated. With the recent advent of techniques to strengthen brain regions, such as transcranial magnetic stimulation, it is possible that this type of research will help delineate important future interventions. Also involved in the study from our Division were Dr. Tsalikian, Julie Coffey, Joanne Cabbage, Sara Salamati, and Rachel Bisbee.

Dr. Tansey Helps Answer the Challenges of Type 1 Diabetes Care During COVID-19

Dr. Tansey

As the COVID-19 pandemic began impacting the region in March 2020, it quickly became apparent that the pandemic would impact our Division of Pediatric Endocrinology & Diabetes ability to provide healthcare and would adversely impact many of the children and families for whom we provide care. In response to this arising situation, the Leona M. And Harry B. Helmsley Charitable Trust issued a call for grant proposals aimed at providing local solutions relating to type 1 diabetes care. Dr. Tansey answered this call, writing a proposal to aid with delivery of healthcare for those with type 1 diabetes cared for by our clinic. The goal of the Helmsley program is to “improve the lives of all people living with type 1 diabetes (T1D). Working closely with key players across the T1D ecosystem – patients, physicians, caregivers, researchers, government agencies, funders, pharmaceutical companies, device makers, insurers, and community organizations – we seek to improve care and ultimately prevent the disease.” I am pleased to announce that the proposal created by Dr. Tansey has been approved and funded, as of today. The funds will help our team provide services to our patients with type 1 diabetes, through improved telemedicine education opportunities, and will help provide services to those whom have been directly affected by COVID-19. My deepest gratitude to Dr. Tansey for taking the initiative and rapidly helping answer the challenges imposed by the COVID-19 pandemic.

Dr. Tansey Elected to the American Pediatric Society

Dr. Tansey

The American Pediatric Society (APS) was founded in 1888 and remains the most prestigious pediatric academic organization in North America. Election to the APS is highly selective, recognizing those pediatricians who have exhibited leading excellence in their pediatric-focused scholarship, advocacy, education, and leadership. We are thus quite proud to announce that our own Dr. Mike Tansey has been elected to the APS, effective January 1st, 2020. Dr. Tansey received his medical training at Loyola School of Medicine. He then completed a pediatric residency followed by a pediatric endocrinology fellowship at the University of Iowa. While a pediatric endocrinology fellow he became interested in diabetes-focused clinical research. He quickly showed great aptitude for the design of important and practical research studies to help address key knowledge gaps in how we manage diabetes in pediatric patients. He has developed nationally recognized expertise in continuous glucose monitoring and the impact of exercise on glucose levels in children with type 1 diabetes. He has given invited lectures at the annual American Diabetes Association scientific sessions. Dr. Tansey is an important contributor at the University of Iowa, where is an active clinical member of our pediatric endocrinology and diabetes program, but also serves as the Associate Vice Chair for Faculty Development in Pediatrics, and as the Interim-Chair Health Information Management Subcommittee. He also is the director of the Pediatric Endocrinology fellowship program. Finally, he provides important service to the state and region by being the (volunteer) Medical Director for Hertko Hollow Diabetes Camp for children, located in central Iowa. Congratulations Dr. Tansey for this well earned honor of being elected to the APS.

Continuous Glucose Monitoring in Persons Without Diabetes

Dr. Tansey

We have entered a new era whereby wearable continuous glucose monitors (CGMs) can provide a reasonable representation of a person’s blood glucose for days on end. These devices have been very useful for persons with diabetes. However, one difficulty has been understanding what glucose levels reported by these devices represent normal. To better addressed this knowledge gap, our own Dr. Tansey helped direct a study assessing CGM data collected from healthy persons without diabetes. The results are now published in the prestigious Journal of Clinical Endocrinology and Metabolism. The results from this study will be very useful, especially when assessing persons who might be in the process of developing diabetes to determine when their blood glucose levels deviate from normal patterns.