Department of Pediatrics Biannual Report 2008-2009

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12 • Department of Pediatrics PEDIATRIC ENDOCRINOLOGY, DIABETES & METABOLISM FACULTY Roberto Izquierdo, MD, Professor of Medicine and Pediatrics; Section Head; Associate Medical Director, Joslin Diabetes Center Affiliate; Medical Director, Thyroid Cancer Center Lauren Lipeski, MD, Assistant Professor of Pediatrics Irene N. Sills, MD, Professor of Pediatrics; Director, New York State Newborn Screening Program; Director, Pediatric Endocrine and Diabetes Fellowship Susan E. Stred, MD, Associate Professor of Pediatrics; Associate Medical Director, KNOT Program AFFILIATED CLINICAL STAFF Kathleen Bratt, PNP, CDE Sheri Hill, RN, Diabetes Educator Lynn Horowitch, PNP Joanne Kearns, RD, CDE Khuyet Le, PA Barbara Lindenmayer, PNP Andrea Gross, RN, Diabetes Educator CLINICAL OVERVIEW The Section of Pediatric Endocrinology, Diabetes and Metabolism provides care for children and adolescents with the full spectrum of disorders of the endocrine system. Staff endocrinologists and nurse practitioners evaluate and treat children with diabetes mellitus, short stature, thyroid disease, Turner syndrome, hypopituitarism, disorders of puberty, congenital adrenal hyperplasia, metabolic bone disorders, and other hormonal disorders. Our Center is one of the original referral sites for New York State’s Newborn Screening Program for congenital hypothyroidism and 21-hydroxylase congenital adrenal hyperplasia. We were recognized as an Endocrine Specialty Center for Congenital Hypothyroidism, Congenital Adrenal Hyperplasia, and Diabetes by the New York State Department of Health in 2004. Diabetes mellitus is treated by a comprehensive group of professionals using the team model, under the direction of Dr. Izquierdo at the Joslin Diabetes Center at SUNY Upstate Medical University. The team includes nurse practitioners with a special interest in diabetes care, diabetes educators, including diabetes pump educators, dieticians, and an exercise physiologist. This multidisciplinary team provides care to children with type 1 and type 2 diabetes mellitus. On a consultative basis, we have support from adult and pediatric psychologists. Dr. Izquierdo and Kathleen Bratt direct the School Telemedicine Project, supported by a New York State Diabetes Center of Excellence Grant. This program provides diabetes care via telemedicine to students with diabetes in schools in our northern regions of New York. We are able provide pediatric DXA scanning and consultations on patients at risk for osteoporosis. In 2008, Dr. Sills attained certification as a clinical Densitometrist by the International Society for Clinical Densitometry. Dr. Irene Sills is a member of the Harry Benjamin International Gender Dysphoria Association, Inc. and directs our program to treat children with gender dysphoria and adolescents with transsexualism. Dr. Stred supervises the endocrine portion of the KNOT (Kids Now Off Therapy) Program, the latter providing comprehensive care to cancer survivors. Although more than 70% of all children diagnosed with a malignancy during childhood now survive, 40-50% of those experience significant endocrine dysfunction as a result of their treatment. RESEARCH HIGHLIGHTS Dr. Izquierdo’s research interests lie in type 1 and 2 diabetes mellitus, and thyroid nodular disease and cancer. He is the principal investigator for the Protégé Study, which is a multi-centered study that uses a monoclonal antibody to preserve beta-cell function in children and adolescents with type 1 diabetes mellitus. This improves glycemic control and prolongs the “honeymoon” phase of type 1 diabetes. He is also involve in the Diamyd clinical trial in which a GAD vaccine is administer to children early in the diagnoses of diabetes to preserve beta-cell function. Dr. Izquierdo continues as co-investigator of the TODAY study, a multicenter NIHsponsored trial to determine the best treatment options in children and adolescents with type 2 diabetes mellitus. Dr. Sills is interested in the natural history of type 1 diabetes. She is our Center’s principal investigator for TrialNet, which aims at identifying individuals at high risk for development of type 1 diabetes. Identified high risk individuals are then eligible to participate in trials designed to delay or prevent the development of type 1 diabetes mellitus. PUBLICATIONS Trief P.M., J. Sandberg, R.I. Izquierdo, P.C. Morin, S. Shea, R. Brittain, E.B. Feldhousen, R.S. Weinstock. Diabetes management assisted by telemedicine: patient perspectives. Telemedicine and e-Health 14(7):647-655, 2008. Izquierdo R, Shankar R, Kort K, Khurana K. Ultrasound- Guided Fine-Needle Aspiration in the Management of Thyroid Nodules in Children and Adolescents. Thyroid 19 (7): 703-705, 2009 Shea, S., R.S. Weinstock, J.A. Teresi, W. Palmas, J. Starren, J.J. Cimino, A.M. Lai, L. Field, P.C. Morin, R. Goland,
Bi-Annual Report • 13 R.E. Izquierdo, S. Ebner, S. Silver, E. Petkova, J. Kong, J.P. Eimicke for the IDEATel Consortium. A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus: 5 year results of the IDEATel study. J Am Med Inform Assoc, 16: 446-456, 2009. Sandberg J, Trief PM, Izquierdo R, Goland R, Morin PC, Palmas W, Larson CD, Shea S, Weinstock RS. A qualitative study of the experiences and satisfaction of direct telemedicine providers in diabetes case management. Telemedicine and e-Health 2009: 15: 742-750. Izquierdo R, Morin PC, Bratt K, Moreau Z, Meyer S, Ploutz- Snyder R, Wade M, Weinstock RS. School Centered Telemedicine for Children with Type 1 Diabetes Mellitus. J Pediatr 2009; 155:374-9. Shah SS, Faquin WC, Izquierdo R, Khurana KK. FNA of misclassified primary malignant neoplasms of the thyroid: Impact on clinical management. CytoJournal 2009; vol 6, issue 1. PRESENTATIONS AT SCIENTIFIC MEETINGS Izquierdo R, Weinstock RS, Morin P, Meyer S, Bratt K, Moreau Z, Ploutz-Snyder R. School Centered Telemedicine Study for Children with Diabetes. 68 th American Diabetes Association Scientific Sessions, June 6-10, 2008, San Francisco, CA. Izquierdo R, Barham K, Kort K, Khurana K, Hsu J, Numann P, Cico L. Intraoperative Use of Nck Sonography in the Management of Recurrent Thyroid Cancer. Endocrine Society’s 90 th Annual Meeting, June 16, 2008, San Francisco, CA. INVITED WORKSHOPS, CME PRESENTATIONS Izquierdo, R. “Multiple Small Feedings of the Mind: New Directions in the Management of the Patient with Type 1 Diabetes.” American College of Physicians NYACP Meeting. June 9, 2009. Izquierdo, R. “Studies in Thyroid Cancer”. Endocrinology, Diabetes & Metabolism Journal Club. February 1, 2008. Izquierdo, R. “Making Sense of Sensors”. School Nurse Teaching Day. September 13, 2008. Izquierdo, R. “New Directions in the Management of the Patient with Type 1 Diabetes”. Medicine Grand Rounds, SUNY Upstate Medical University. February 19, 2009. Izquierdo, R. “New Directions in the Management of the Patient with Type 1 Diabetes”. Pediatric Grand Rounds, SUNY Upstate Medical University. April 29, 2009. Izquierdo, R. School Nurse Diabetes Teaching Day: “Insulin Pump Therapy”. Upstate Golisano Children’s Hospital at Upstate University Hospital. October 24, 2009. Izquierdo, R. “Impact of Telemedicine on Medical Education”. Faculty Development Seminar. October 27, 2009. Lipeski, L. Vitamin D Deficiency. Onondaga Pediatric Society Meeting. February 24, 2009. Lipeski, L. Pediatric Obesity. Pediatric Grand Rounds. April 15, 2009. Lipeski, L. Thyroid function testing. Endocrine Conference. October 8, 2009. Sills, I. “Pediatric Endocrine Update” Annual Meeting of New York State Nurse Practitioners, 2008. Sills, I. “Gender Dysphoric Children and Transsexual Adolescents” Grand Rounds, Plattsburgh Hospital, 2008. Sills, I. “Gender Dysphoric Children and Transsexual Adolescents”. American Academy of Pediatrics Meeting 2009. Sills, I. “Transsexuality”. Psychiatry Grand Rounds 2009 GRANTS AND CONTRACTS Sills, I. NIDDK: Diabetes TrialNet: Natural History Study of the Development of Type 1 Diabetes (Principal Investigator for our center). Funding accrual based. Izquierdo R. NIDDK: Trial for the Treatment of Type 2 Diabetes in Children and Adolescents (co-investigator) Izquierdo R. A Phase 2/3, Randomized, Double-Blind, Multicenter, Multinational, 4-Arm, Controlled, Dose- Ranging Study to Evaluate Efficacy and Safety of Teplizumab (MGA031), a Humanized, FcR Non-Binding, Anti-CD3 Monoclonal Antibody, in Children and Adults with Recent-Onset Type 1 Diabetes Mellitus. (Dr. Izquierdo, principal investigator for our center). Industrysponsored Trial (funding accrual based) Izquierdo R. NYS Department of Health School Centered Telemedicine Program for Children with Type 1 Diabetes Mellitus (Co-Investigator). Izquierdo R. Diamyd: A Phase III, 3- Arm, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Investigate the Impact of Diamyd on the Progression of Diabetes in Newly Diagnosed with Type 1 Diabetes Mellitus. Industry-sponsored Trial (funding accrual based) SELECTED CLINICAL DATA Children in the diabetes mellitus program: .. . . . . . . . . 1000 Children with new onset diabetes seen in 2009: . . . . . . 100 Children followed with congenital hypothyroidism: . . 100 Children with diagnosed with congenital hypothyroidism in 2009: . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Children with congenital adrenal hyperplasia who are actively followed:. . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Children with septo-optic dysplasia who are actively followed:. . . . . . . . . . . . . . . . . . . . . . . . . . 30 Endocrine component of KNOT Clinic: . . . . . . . . . . . . . . 80
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Department of Pediatrics Biannual Report 2008-2009

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