Endocrinology

School-Based Health Equity Initiative Improves T1D Management in Students
School-Based Health Equity Initiative Improves T1D Management in Students 1024 683 JoAnna Pendergrass, DVM

The Diabetes and School Health program is a school-based health equity initiative that has helped improve Type 1 diabetes management for students and increase confidence among school staff and caregivers in providing diabetes care. Children with Type 1 diabetes (T1D) face myriad daily challenges in managing their disease, which can be compounded if their home…

Integrating PCOS Research and Clinical Care for Adolescents
Integrating PCOS Research and Clinical Care for Adolescents 1024 575 Pam Georgiana
Black and white image of teen girl posing outside

Researchers at Nationwide Children’s are participating in building the first-ever national registry of adolescent Polycystic Ovary Syndrome (PCOS) patient data through a National Institutes of Health (NIH)-funded research grant. The grant will collect patient data from more than 12 multidisciplinary PCOS clinics, including Nationwide Children’s. PCOS is a hormonal imbalance that can cause irregular menstrual…

How Are Insulin Pumps Being Utilized for Patients with Type 1 Diabetes?
How Are Insulin Pumps Being Utilized for Patients with Type 1 Diabetes? 1024 683 Pam Georgiana

A multicenter observational study of 22,000 children and adults shows improving quality of life for patients with type 1 diabetes.    Type 1 diabetes diagnoses are increasing among children, particularly those in racial/ethnic minority groups. New technology, specifically insulin pumps and continuous glucose monitoring (CGM) systems, may improve quality of life and long-term outcomes. However,…

The Endocrinologists’ Role in Caring for TPIAT Patients
The Endocrinologists’ Role in Caring for TPIAT Patients 1024 500 Lauren Dembeck
illustrated cross section of islets from pancreas

Children with recurrent acute or chronic pancreatitis often suffer debilitating pain and may endure an impaired quality of life. They may be frequently admitted to the hospital, disrupting their daily routines and activities. Patients may undergo medical and endoscopic interventions for both diagnostic and therapeutic purposes and may be offered surgical interventions. Total pancreatectomy with…

Congenital Heart Disease and Extracardiac Phenotypes Associated With Novel Pathogenic Variant in GATA6
Congenital Heart Disease and Extracardiac Phenotypes Associated With Novel Pathogenic Variant in GATA6 1024 575 Jessica Nye, PhD

A study published in Pediatric Research describes a novel pathogenic variant in the gene GATA binding protein 6 (GATA6) associated with congenital heart disease (CHD), diabetes mellitus and necrotizing enterocolitis.   GATA is a family of transcription factors that encode zinc finger DNA binding proteins which are critical regulators during organogenesis. Pathogenic variants in three…

Associations Between Blood-Based and Biochemical Markers of Inflammation and Body Mass
Associations Between Blood-Based and Biochemical Markers of Inflammation and Body Mass 1024 575 Mary Bates, PhD

Blood-based markers of inflammation increased with increasing body mass in healthy adolescents. The chronic inflammatory disease atherosclerosis has its origins in childhood and adolescence; however, there are currently no simple methods to easily identify at-risk adolescents.  In a new study, researchers at Nationwide Children’s Hospital explored the relationships between blood-based and biochemical markers of inflammation…

Fertility Concerns in Boys and Men With Sickle Cell Disease
Fertility Concerns in Boys and Men With Sickle Cell Disease 1024 575 Mary Bates, PhD
Color photo of Black father holding infant on shoulder in front of nursery background with clouds on the wall

Sickle cell disease and its treatments may impact fertility, but more research is needed to help counsel this population. Sickle cell disease (SCD) affects approximately 100,000 Americans, most of whom belong to underserved, minority populations. Advances in disease-modifying therapies, such as hydroxyurea, have led to better clinical outcomes. However, as more individuals with SCD survive…

Is Growth Hormone Replacement Safe Following Central Nervous System Tumors?
Is Growth Hormone Replacement Safe Following Central Nervous System Tumors? 1024 683 Mary Bates, PhD

Research suggests the benefits of growth hormone therapy outweigh the risks for pediatric cancer survivors. In a new review paper, researchers from Nationwide Children’s Hospital evaluated the risks and benefits associated with administering growth hormone to pediatric patients after diagnosis of a central nervous system tumor. The authors conclude that the therapy has many important…

An Alternative Method for Diagnosing Central Adrenal Insufficiency in Newborns
An Alternative Method for Diagnosing Central Adrenal Insufficiency in Newborns 1024 683 Mary Bates, PhD
Baby in NICU

Researchers evaluate the utility of random cortisol levels to diagnose adrenal insufficiency. In infants with central adrenal insufficiency, adrenocorticotropic hormone (ACTH) fails to signal to the adrenal gland, leading to decreased cortisol levels. It is a potentially life-threatening condition requiring urgent diagnosis and treatment. Diagnosing central adrenal insufficiency typically involves a low-dose synthetic ACTH (cosyntropin)…

Improving Outcomes for Infants and Children With Congenital Hypothyroidism
Improving Outcomes for Infants and Children With Congenital Hypothyroidism 1024 575 Mary Bates, PhD
Toddler playing with toys

A quality improvement project identifies high-risk patients and ensures they receive necessary care.   Congenital hypothyroidism (CH) is one of the most common preventable causes of intellectual disability. In the United States and many other countries, newborns are tested a 24-72 hours after birth for CH as part of standard screening tests. This condition must…

Fertility-Related Care for Girls With Turner Syndrome
Fertility-Related Care for Girls With Turner Syndrome 150 150 Mary Bates, PhD

Recent survey of providers shows fertility counseling and referrals are delivered inconsistently in this population. Researchers from Nationwide Children’s recently assessed practices surrounding fertility-related care among clinical providers who treat girls with Turner syndrome. They found that fertility counseling and referral rates remain inconsistent and identified common barriers to fertility care in this population. Turner…

How are Depression, Diabetes Distress and Glycemic Control Related in Adolescents With Type 2 Diabetes?
How are Depression, Diabetes Distress and Glycemic Control Related in Adolescents With Type 2 Diabetes? 150 150 Mary Bates, PhD

For adolescents with T2D, obesity and attempts at weight loss may contribute more to depression and diabetes distress than the demands of diabetes management. Diabetes distress is a negative emotional response to living with diabetes, a life-threatening illness that requires chronic, demanding, self-management. It is frequently mistaken for depression and the two are interrelated. Previous…

Perceptions About Type 2 Diabetes Differ Among Adolescent Patients, Parents and Physicians
Perceptions About Type 2 Diabetes Differ Among Adolescent Patients, Parents and Physicians 1024 683 JoAnna Pendergrass, DVM

Differing perceptions about type 2 diabetes among teens, parents and physicians can create barriers to diagnosing and managing the disease.   Type 2 diabetes (T2D) is becoming increasingly prevalent in adolescents, with a median age of diagnosis of 13.5 years in the pediatric population. Managing pediatric T2D is challenging, given that traditional medical and non-medical…

Pediatric Bone Density Measures Require Adjusted Scoring for Accurate Interpretation
Pediatric Bone Density Measures Require Adjusted Scoring for Accurate Interpretation 1024 575 Katie Brind'Amour, PhD, MS, CHES

Understanding the limits of pediatric bone densitometry reports can make results more useful for clinical decision making. Dual-energy X-ray absorptiometry, or DXA, is the standard scan used to assess bone mineral density (BMD) in children. It uses very little radiation and has extensive normative data from pediatric populations, to which a child’s results can be…

Multiple Fractures in Children: When to Suspect Medical or Malevolent Causes
Multiple Fractures in Children: When to Suspect Medical or Malevolent Causes 1024 770 Katie Brind'Amour, PhD, MS, CHES
Girl with cast on her arm

Rapid growth and high-risk activities during childhood leave kids ripe for repeat fracture opportunities, but key factors can alert clinicians to possible underlying disease-related fragility or non-accidental injury. Fractures are common in childhood, with up to 40% of girls and as many as 50% of boys experiencing a fracture. There are many benign explanations for…

Identifying Early Urinary Biomarkers of Kidney Damage in Type 1 Diabetes
Identifying Early Urinary Biomarkers of Kidney Damage in Type 1 Diabetes 150 150 Mary Bates, PhD

Markers of renal tubule injury and oxidative stress indicate diabetic nephropathy before microalbuminuria. Diabetic nephropathy is a common complication of type 1 diabetes. Traditionally, measurement of microalbuminuria is used to screen children with diabetes for diabetic nephropathy. However, evidence suggests that damage to the kidneys may begin soon after diagnosis, much earlier than microalbuminuria can…

Featured Researcher — Leena Nahata, MD
Featured Researcher — Leena Nahata, MD 150 150 Natalie Wilson

Pediatric endocrinologist Leena Nahata, MD, is the founder and medical director of the Fertility and Reproductive Health Program at Nationwide Children’s Hospital and a principal investigator in the Center for Biobehavioral Health at the Abigail Wexner Research Institute at Nationwide Children’s. Although fertility-related decisions can seem far away for children, adolescents and their families, many…

Diabetes Distress Associated With Poor Glycemic Control in Adolescents With Diabetes
Diabetes Distress Associated With Poor Glycemic Control in Adolescents With Diabetes 1024 683 Mary Bates, PhD

Screening for diabetes distress, in addition to depression, could benefit adolescents with diabetes. Adolescents with type 1 diabetes are more likely to experience depression than their peers without diabetes, and symptoms of depression can directly impact adherence to diabetes care. Thus, both the American Diabetes Association and International Society for Pediatric and Adolescent Diabetes recommend…

Growth Hormone is Still Important Beyond the Growing Years
Growth Hormone is Still Important Beyond the Growing Years 1024 683 Rohan Henry, MD, MS

The History of Growth Hormone The first reported use of growth hormone (GH) as treatment for severe growth retardation occurred in the 1950s.1 Since that time, growth hormone’s importance in growth promotion has been clear. Its role in promoting normal metabolism even after growth has ended, however, was only recognized in the late 1980s.2 Beginning…

Protecting an ‘Open Future:’ Improving Fertility Preservation Decision-Making for Young Males With Cancer
Protecting an ‘Open Future:’ Improving Fertility Preservation Decision-Making for Young Males With Cancer 1024 575 Katie Brind'Amour, PhD, MS, CHES
Color photo of Black father holding infant on shoulder in front of nursery background with clouds on the wall

Evidence from a new study highlights the importance of family-centered decision processes and clinician facilitation in improving fertility preservation uptake prior to cancer treatment. Numerous cancer treatments can reduce fertility or render some patients entirely infertile, but fertility preservation (FP) services have historically had low rates of uptake. When a young person is diagnosed with…

Does Psychosocial Functioning Differ Among Children With and Without Differences of Sex Development?
Does Psychosocial Functioning Differ Among Children With and Without Differences of Sex Development? 1024 575 Lauren Dembeck
Parent and child holding hands

A multidisciplinary team of researchers recently found that children with differences of sex development (DSD) appear to be at greater risk for psychosocial problems relative to children with cleft lip and/or palate (CL/P) and unaffected peers. The study, which was published in the Journal of Pediatric Psychology, highlights the increased need for integrated interdisciplinary care with…

Reinforcing Education for Adrenal Insufficiency Self-Management Improves Patient Outcomes
Reinforcing Education for Adrenal Insufficiency Self-Management Improves Patient Outcomes 150 150 Lauren Dembeck

Patients with adrenal insufficiency (AI) receiving daily maintenance corticosteroid replacement therapy may develop signs and symptoms of AI when encountered with physical stress events, such as fever, infection, pain from injury or surgery. Patient education on stress dosing of hydrocortisone at the time of illness or injury is essential to prevent adrenal crisis, a life-threatening…

Comprehensive Type 1 Diabetes Wellness Score to Help Patients and Providers
Comprehensive Type 1 Diabetes Wellness Score to Help Patients and Providers 1024 683 Katie Brind'Amour, PhD, MS, CHES
Device for monitoring glucose placed on girl's arm

A quality improvement effort resulted in the first-known composite score to track multiple clinical indicators of diabetes-related health in patients with Type 1. Despite the traditional use of hemoglobin A1c (HbA1c) as the standard metric for diabetes control, it has its shortcomings, such as an incomplete picture of blood sugar variability and hypoglycemia risk. To…

Choking Education an Important Element of Care for Prader-Willi Syndrome Families
Choking Education an Important Element of Care for Prader-Willi Syndrome Families 1024 575 Katie Brind'Amour, PhD, MS, CHES

Choking prevention and intervention education offer a simple way to address this common cause of death among PWS patients. Individuals with Prader-Willi Syndrome (PWS) suffer from poor oral muscle control, generalized low muscle tone that can make it hard to swallow properly, a poor gag reflex and an insatiable desire to eat. Together with a…

Using Metrics to Improve the Delivery of Optimal Diabetes Care for Children With Type 1 Diabetes
Using Metrics to Improve the Delivery of Optimal Diabetes Care for Children With Type 1 Diabetes 1024 575 JoAnna Pendergrass, DVM

The Type 1 Diabetes Care Index is a new metric that tracks the delivery of diabetes care, with the goal to reach zero missed opportunities to deliver quality care. The complexity and chronicity of pediatric type 1 diabetes (T1D) necessitate a coordinated, multidisciplinary effort to effectively deliver the optimal standards of diabetes care, as outlined…

Reproductive Health Attitudes and Behaviors in Transgender/Nonbinary Adolescents
Reproductive Health Attitudes and Behaviors in Transgender/Nonbinary Adolescents 1024 683 Mary Bates, PhD

A survey suggests providers may need unique strategies for counseling sometimes disinterested youth on important reproductive health issues. Transgender and nonbinary adolescents have unique issues when it comes to reproductive health. They are at high risk for contracting sexually transmitted infections. Additionally, hormonal or surgical interventions begun in adolescence can risk impairing future fertility. Researchers…

How to Increase Continuous Glucose Monitoring Utilization in Patients With Type 1 Diabetes
How to Increase Continuous Glucose Monitoring Utilization in Patients With Type 1 Diabetes 1024 683 Katie Brind'Amour, PhD, MS, CHES

An innovative quality improvement project grew the use of CGM nearly six-fold in 2 years. A 2017 round-table meeting of the Type 1 Diabetes Exchange revealed that some diabetes clinics had a very small number of patients using continuous glucose monitors (CGM) — devices that allow patients to avoid repeated finger sticks to check glucose…

Predicting Acute Health Care Utilization in Patients with Pediatric Type 1 Diabetes
Predicting Acute Health Care Utilization in Patients with Pediatric Type 1 Diabetes 150 150 Jan Arthur

Study demonstrates the utility of a high risk assessment screening tool in differentiating between patients with versus patients without any acute health care utilization. The multidisciplinary Quality Improvement Team in the Section of Endocrinology at Nationwide Children’s Hospital, led by Manmohan Kamboj MD, FAAP, Division chief and section chief of Endocrinology, developed a brief risk screening…

It’s Not All About Weight: Treating and Managing Obesity in Pediatric Patients
It’s Not All About Weight: Treating and Managing Obesity in Pediatric Patients 150 150 Abbie Miller

Study highlights different metrics for measuring success of a weight management program for pediatrics. For pediatric patients who have severe obesity that is not well managed with the routine standard of care – diet, exercise and a meeting with a dietician – a more structured, multidisciplinary approach may be warranted. And for patients with endocrine…

What Pediatric Subspecialists Need to Know About Hypophosphatasia and Its Treatment
What Pediatric Subspecialists Need to Know About Hypophosphatasia and Its Treatment 1024 575 Katie Brind'Amour, PhD, MS, CHES

Patients with hypophosphatasia may present to a wide range of specialists. Here’s the latest on diagnosis, patient management and clinical need for its only medical treatment: asfotase alfa enzyme replacement therapy (AA ERT). Hypophosphatasia is a rare, inherited condition that results in low serum alkaline phosphatase, which leads to poor construction of bones and teeth.…

Looking to the Future: Optimizing Fertility Preservation Decisions in Pediatric Patients Newly Diagnosed with Cancer
Looking to the Future: Optimizing Fertility Preservation Decisions in Pediatric Patients Newly Diagnosed with Cancer 1024 575 Katie Brind'Amour, PhD, MS, CHES
Parent and child holding hands

Family-centered research aims to improve fertility preservation uptake and decision satisfaction among adolescents newly diagnosed with cancer.

Growth Hormone Also Has Metabolic Benefits
Growth Hormone Also Has Metabolic Benefits 150 150 Mary Bates, PhD

Endocrinology Considerations in Duchenne Muscular Dystrophy
Endocrinology Considerations in Duchenne Muscular Dystrophy 150 150 Jeb Phillips

Guidance on Counseling Children at Risk for Fertility and Sexual Function Issues
Guidance on Counseling Children at Risk for Fertility and Sexual Function Issues 150 150 Jeb Phillips

Many childhood medical conditions and treatments can affect reproductive health. A new report from the American Academy of Pediatrics explains when and how doctors should address those concerns. While fertility and sexual function are most often considered adult issues, even very young children may have conditions that will have an impact on reproductive health later…

How Can We Optimize Fertility Related Discussions With Male Survivors of Childhood Cancer?
How Can We Optimize Fertility Related Discussions With Male Survivors of Childhood Cancer? 150 150 Abbie Miller

A recent study suggests that fertility is a “later” issue for adolescents and young adults, rather than a “now” concern, leading to low rates of conversation with health care providers. Survival rates for pediatric cancers exceed 80 percent. But late effects can persist throughout the survivor’s lifetime. Among those late effects, infertility may have both…

Starting the Conversation on Sickle Cell Disease and Reproductive Health
Starting the Conversation on Sickle Cell Disease and Reproductive Health 1024 575 Katie Brind'Amour, PhD, MS, CHES

Adolescents and young adults with sickle cell disease — and their caregivers — care about future fertility. But what should doctors tell them? Until just a few decades ago, sickle cell disease (SCD) was often fatal in childhood. Now that more patients reach adulthood, clinicians and researchers need to ask — and answer — questions…

Hormonal Contraception Safer Than Expected For Women With Diabetes
Hormonal Contraception Safer Than Expected For Women With Diabetes 150 150 Abbie Miller

Women with diabetes often fall through the cracks when it comes to prescription contraception. A new study illuminates the issues and highlights safe options. The use of contraception to prevent unplanned pregnancies is an important aspect of women’s health. For women with chronic health conditions, family planning has important implications for the health of the…

Counseling Pediatric Patients on Fertility and Sexual Function
Counseling Pediatric Patients on Fertility and Sexual Function 150 150 Brianne Moore

How should we talk to patients and their families about these sensitive subjects? Since 2006, several medical societies have released guidelines for discussing fertility preservation prior to pediatric cancer treatment. According to the American Society for Reproductive Medicine, a “collaborative, multidisciplinary team approach” is vital for informing minors whose chemotherapy may affect their fertility status…

Zoledronic Acid Safe and Effective for Use in Children and Young Adults, Study Shows
Zoledronic Acid Safe and Effective for Use in Children and Young Adults, Study Shows 150 150 Tiasha Letostak, PhD

The medication improves bone density and reduces fractures in patients with neuromuscular disorders that lead to paralysis. Children with neuromuscular disorders that lead to quadriplegia (paralysis of all four limbs) or paraplegia (paralysis of the legs and lower body) are at risk for low bone density and prone to fractures, a medical condition known as…

Informing the Discussion on rhGH for Idiopathic Short Stature
Informing the Discussion on rhGH for Idiopathic Short Stature 150 150 Juan F. Sotos, MD

Growth hormone treatment for children with idiopathic short stature has remained controversial. Based on my experience and that of others, I recommend treatment. The use of growth hormone for idiopathic short stature has remained controversial in the field of endocrinology, mainly because of previous reports of its modest benefit and high cost. These reports led…

Mystery Rising: Why is T1D Incidence Rising Globally?
Mystery Rising: Why is T1D Incidence Rising Globally? 150 150 Katie Brind'Amour, PhD, MS, CHES

Type 1 diabetes used to be rare. Late 19th-century estimates put its incidence at about 0.004 percent of the world’s population. But by the end of the 20th century, most nations reported a number 350 times that rate. With many countries continuing to experience a steady rise in new cases of up to 4 percent…