Podcasts about pediatric endocrinologist

As we are having these necessary conversations on how to be prepared for unexpected medical events or natural disasters, I saw a friend of mine Sarah Hart Unger had one of her own. I asked her to come on the podcast so we could talk about what happened, how she handled it, what she learned from it, and how she may improve her preparedness. I'm Healthy Sarah shared how she was so excited to get back into running marathons. There she was in Miami in about mile 11 of her half marathon when all the sudden she heard her body say something wasn't right. She bunked (marathon runner speak for running out of steam) and she was surprised and disappointed, why was this happening? Her friend took her to the medical tent and they told her all was well. She was so confused because she was a runner and she considered herself a very healthy person. Five steps into leaving the tent something told her no, and to go back. Moments later she was on her way to the hospital. She was pleading with them to just let her get to the hospital to be put under so they could shock her heart there, not that moment in the ambulance! Sarah has been diagnosed with a rare condition called Arrhythmic Cardio Myopathy. What Systems were in place?  Thankfully Sarah was near where her in-laws live so they could support Sarah during her hospital stay and gave comfort to her daughters that someone was there comforting their mom. Sarah appreciated the medical team that took care of her, she felt heard, that they were honest with her, and was thankful for the way they cared for her. She wrote questions down because sometimes there wasn't anyone to ask if it was like 2am. And she had realistic expectations of how long it may take to get a diagnosis.  She got images in hand for additional specialists she wanted to see for second opinions. She advises to always ask for the images and reports. I feel like digital records help us to be productive and physical records help us to look, analyze, and see patterns. We're all under this false pretense that our records are digital. And they may be, but, do you want your doctor visit to consist of tracking results down or do you want it to be focused on the course of action for treatment? Remember the mini medical binder is available for free right now. If you even show up with that you are ahead of other people. You can just start putting the medical papers in a pile and bring them. Sarah is a Pediatric Endocrinologist and says that she'd rather have people show up with results and reports messy than not at all.  How to better prepare?  Sarah wishes she had her old labs and EKG's for comparison sake. I remember being able to show my doctor my cholesterol history and I avoided being put on medicine. I showed that for years my normal is in the “yellow” zone. Sarah also wishes she would have headed the advice to get another EKG years ago but life got busy and she forgot. Sarah stressed that we have to take care of ourselves just like we do our children. She accredits their amazing nanny for being able to step in and fill in the gaps. However, because they always plan their week out and share it with the nanny, they nanny knew how to fill out the schedule for the family. Sarah suggested a family member maybe come observe a couple days at your house to see the day to day unfold and be aware of what they may need to do in your absence. It's ok if the ship sinks a little like if someone has to miss soccer, that's ok. Sarah warned “Don't ever assume ‘I'm healthy, nothing can happen to me.” EPISODE RESOURCES: Mini Medical Binder Sunday Basket® Sign Up for the Organize 365® Newsletter Did you enjoy this episode? Please leave a rating and review in your favorite podcast app. Share this episode with a friend and be sure to tag Organize 365® when you share on social media.

Send us a textJoin us for an enlightening discussion with Dr. Nerissa Kreher, a trailblazing pediatric endocrinologist who successfully transitioned from clinical practice to the pharmaceutical industry as a Chief Medical Officer. In this conversation, Dr. Kreher shares her invaluable experiences and highlights the essential role of networking in her career transformation. She offers practical advice for introverted physicians on how to connect authentically with others and make the most of their unique narratives.Dr. Kreher's journey is a testament to the power of continuous learning, inspiring fellow physicians to remain open to acquiring new skills, even when the future feels uncertain. This episode explores the numerous roles that physicians can pursue beyond traditional clinical settings, showcasing how their innate leadership abilities can create a substantial impact within the pharmaceutical realm.By collaborating with experts across diverse fields such as finance and marketing, and crafting CVs that not only motivate but also celebrate achievements, we illuminate the untapped potential within the medical profession. I also recount my experience founding Pharma IndustryMDCoach during the COVID-19 pandemic to help physicians explore non-clinical career avenues, underscoring the vast opportunities for growth beyond the hospital environment. Don't miss this chance to gain insights from Dr. Kreher and ignite inspiration for your own career path.Connect with Dr. Kreher:https://industrymdcoach.com/https://www.linkedin.com/in/nerissa-kreher-md-mba-1387465/JThough I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.Learn more about female physicians' journey through burnout to thriving!https://www.theworthyphysician.com/booksLet's connect for speaking opportunities!https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speakerCheck out the free resources from The Worthy Physician:https://www.theworthyphysician.com/freebie-downloadsBattle of the Boxes21 Day Self Focus Journal

In this episode of Doc Talk, we dive deep into the complexities of Type 1 diabetes with Dr. Edelen, a board-certified, fellowship-trained pediatric endocrinologist. Dr. Edelen has dedicated her career to providing comprehensive endocrinology care tailored specifically for children. Together, we explore the challenges, advancements, and essential strategies for managing Type 1 diabetes in young patients. Whether you're a parent, caregiver, or medical professional, this episode offers valuable insights into ensuring the best possible care for children living with this condition. Hosted on Acast. See acast.com/privacy for more information.

Pediatric endocrinologist Doctor Quinten Van Meter joins Trending with Timmerie exposing the so-called transgender interventions harming children President Biden's push for harmful irreversible interventions. (3:07) The American College of Pediatricians join doctors calling on the medical community to end harmful transgender interventions. (23:17) Litany of the Most Precious Blood of Jesus. (35:31)   Resources mentioned :  Dr. Van Meter's website: https://acpeds.org/about/meet-our-board/president-quentin-van-meter-md Biological Integrity: https://biologicalintegrity.org/ Pediatricians, Doctors, and Medical Organizations Sign Declaration Urging Prominent U.S. Medical Organizations to Cease Harmful Interventions on Children with Gender Dysphoria https://acpeds.org/press/pediatricians-doctors-and-medical-organizations-sign-declaration-urging-prominent-us-medical-organizations-to-cease-harmful-interventions-on-children-with-gender-dysphoria The Bible teaches we are all pilgrims. https://relevantradio.com/2024/07/st-thomas-skepticism-and-doubt/  Litany of the Most Precious Blood of Jesus Lord, have mercy Lord, have mercy Christ, have mercy Christ, have mercy Lord, have mercy Lord, have mercy     God our Father in heaven have mercy on us God the Son, Redeemer of the world have mercy on us God the Holy Spirit have mercy on us Holy Trinity, one God have mercy on us Blood of Christ, only Son of the Father save us Blood of Christ, incarnate Word save us Blood of Christ, of the new and eternal covenant save us Blood of Christ, that spilled to the ground save us Blood of Christ, that flowed at the scourging save us Blood of Christ, dripping from the thorns save us Blood of Christ, shed on the cross save us Blood of Christ, the price of our redemption save us Blood of Christ, our only claim to pardon save us Blood of Christ, our blessing cup save us Blood of Christ, in which we are washed save us Blood of Christ, torrent of mercy save us Blood of Christ, that overcomes evil save us Blood of Christ, strength of the martyrs save us Blood of Christ, endurance of the saints save us Blood of Christ, that makes the barren fruitful save us Blood of Christ, protection of the threatened save us Blood of Christ, comfort of the weary save us Blood of Christ, solace of the mourner save us Blood of Christ, hope of the repentant save us Blood of Christ, consolation of the dying save us Blood of Christ, our peace and refreshment save us Blood of Christ, our pledge of life save us Blood of Christ, by which we pass to glory save us Blood of Christ, most worthy of honor save us Lamb of God, you take away the sins of the world have mercy on us Lamb of God, you take away the sins of the world have mercy on us Lamb of God, you take away the sins of the world have mercy on us Lord, you redeemed us by your blood. You have made us a kingdom to serve our God. Let us pray. O God, who by the Precious Blood of your Only Begotten Sonhave redeemed the whole world,preserve in us the work of your mercy,so that, ever honoring the mystery of our salvation,we may merit to obtain its fruits.Through Christ our Lord.R/. Amen.

Islet Cell Replacement Therapy – Featuring Manasi Jaiman, MD, MPH, Pediatric Endocrinologist and Diabetes Researcher with expertise in both drug and device developments in type 1 diabetes.TAKING CONTROL OF YOUR DIABETES® - THE PODCAST! ...With Expert Endocrinologists Living with T1D, Drs. Steven V. Edelman & Jeremy PettusIslet cell replacement therapy represents a promising advancement to cure type 1 diabetes. In this episode of the Taking Control of Your Diabetes podcast, our special guest, Dr. Manasi Jaiman, MD, MPH, a leading pediatric endocrinologist and diabetes researcher, joins hosts Dr. Jeremy Pettus and Dr. Steve Edelman to delve into the intricacies of stem cell research and its potential to transform diabetes treatments. Dr. Manasi Jaiman discusses her journey into diabetes research, the significance of islet and beta cells, and the advancements in programming stem cells for therapeutic purposes. She also explains the current methods for delivering these designed cells to patients, the importance of immunosuppression in cell therapy, and the progress made in encapsulation techniques. In this episode, we will talk about:The role of beta and islet cells in glucagon productionHow close we are to a cure for type 1 diabetesThe sources of islet cells and their importanceDifferent types of stem cells and their applicationsHow new stem cells are delivered to diabetes patientsThe importance of immunosuppression in cell therapyRecent advancements in cell therapy, including cell infusion and encapsulationThe challenges and timelines in finding a cure for type 1 diabetesHow to find and participate in clinical trials for diabetesThe importance of volunteering in clinical research**Tune in for 2 new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!** ★ Support this podcast ★

Martin de Bock is a Pediatric Endocrinologist and Associate Professor at the University of Otago, Christchurch, New Zealand. In this episode it talks with Scott about the importance of access to low-cost and reliable technology to manage Type 1 Diabetes, like the design for an open source low cost insulin pump that he and his colleagues are championing. Can YOU (should you?) create a DIY insulin pump from plans on GitHub?https://github.com/UCBioengineering/open_source_insulin_pumphttps://pubmed.ncbi.nlm.nih.gov/32837953/https://cmrf.org.nz/story/dr-martin-de-bock/

Grab your Metformin and settle in for a sweet conversation as we chat with Dr. Nancy Crimmins, Pediatric Endocrinologist at Cincinnati Children's Hospital. Dr. Crimmins tells us about when to screen for type 2 diabetes, how to diagnose and our go-to treatment options. She won't sugarcoat it!

When It Comes To Diabetes This Mother Knows Best (A Mother's Day Special) – Featuring Emily King, MD, Pediatric Endo Living with Type 1; and Mother to a T1D ChildTAKING CONTROL OF YOUR DIABETES® - THE PODCAST! ...With Expert Endocrinologists Living with T1D, Drs. Steven V. Edelman & Jeremy PettusThis Mother's Day, we extend our sincere gratitude to all mothers who either have diabetes themselves or have children living with the condition. We recognize your unwavering strength, support, dedication, and love in navigating diabetes. Step into this conversation with Dr. Emily King, a Pediatric Endocrinologist who has navigated type 1 diabetes since age eight. Dr. King shares invaluable insights about screening, signs, challenges, and family life from her journey to her child's diagnosis. In this episode, we will talk about:Who is Dr. King? What was King's experience being pregnant while living with type 1? What is the probability of a child getting type 1?Why should you screen your children for diabetes? How can you get your child screened for diabetes? What are some possible signs that your child could have type 1? What challenges does Dr. King face as a mom with a kid living with type 1?**Tune in for 2 new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!** ★ Support this podcast ★

Jon was diagnosed with type 1 diabetes at 11 years old. Today he is a Pediatric Endocrinologist. Eversense CGM This BetterHelp link saves 10% on your first month of therapy Try delicious AG1 - Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth  Get Gvoke HypoPen CONTOUR NextGen smart meter and CONTOUR DIABETES app Learn about the Dexcom G6 and G7 CGM Go tubeless with Omnipod 5 or Omnipod DASH  Get your supplies from US MED  or call 888-721-1514 Learn about Touched By Type 1 Take the T1DExchange survey A full list of our sponsors  How to listen, disclaimer and more Apple Podcasts> Subscribe to the podcast today! The podcast is available on Spotify, Google Play, iHeartRadio, Radio Public, Amazon Music and all Android devices My type 1 diabetes parenting blog Arden's Day Listen to the Juicebox Podcast online The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here or buy me a coffee. Thank you! Disclaimer - Nothing you hear on the Juicebox Podcast or read on Arden's Day is intended as medical advice. You should always consult a physician before making changes to your health plan.  If the podcast has helped you to live better with type 1 please tell someone else how to find the show and consider leaving a rating and review on Apple Podcasts. Thank you! The Juicebox Podcast is not a charitable organization.

Literature Review 1) In an excellent paper by Dr. Harlan and colleagues, we see a group looking at how to modify ultra processed foods to remain tasty for consumption but also healthy. The lead author is Dr. Rob Lustig, a pioneering Pediatric Endocrinologist from UCSF and upcoming podcast guest. From the paper: "Ultraprocessed food is established as a metabolic disruptor acting to increase adiposity, reduce mitochondrial efficiency, drive insulin resistance, alter growth, and contribute to human morbidity and mortality. Consumer packaged goods (CPG) companies are beginning to understand the detrimental impact of the food they market, and have employed substitution strategies to reduce salt, sugar, and fat. However, the harms of ultraprocessed foods are far more complex than any single component, and are not ameliorated by such simple substitutions." (Harlan et. al. 2023)......as well as information on Why ask why? and a recipe of the week. Enjoy, Dr. M

Alberta Premier Danielle Smith recently announced a series of policy changes affecting transgender and non-binary people. Our AMA guest Dr. Daniel Metzger is a Pediatric Endocrinologist at the B.C. Children's Hospital where he treats, among others, transgender patients. He answered your questions about gender affirming care.

Ozempic, Wegovy and Mounjaro are being trumpeted as a cure for obesity. While they are proven to induce weight loss, the underlying issues that cause obesity - ultra processed food - are largely unaddressed. Metabolical is Rob Lustig's latest book on the topic --- Send in a voice message: https://podcasters.spotify.com/pod/show/james-herlihy/message

In Episode #70, I have a discussion with Pediatric Endocrinologist, CEO and Founder of The Endocrine Co. in Orlando, Florida, Dr. Pauley. In, easy to understand terminology,  Dr. Pauley uncovers and details everything surrounding G.H.D. She explains what a growth hormone is and where it's created in our bodies. She details what exactly G.H.D is and what causes it. Dr. Pauley talks about the risk factors and the signs and symptoms to look for. She shares great information on how G.H.D. is diagnosed and how it's treated. We discuss how a parent can tell if their child is suffering from G.H.D. or if their child is short because of genetics. In the end, Dr. Pauley offers her advice to families when it comes to dealing with and treating G.H.D. In the end, I offer my 'Three Takeaways.' Please be sure to listen in to this in-depth and information packed episode. As always, thanks for listening. Take care.Support the show

To the uninitiated, interoperability may sound like a surgical term, but it actually refers to how IT systems and other technologies communicate with each other. The goal, of course, is seamless communication to improve efficiency and quality of care, but that's obviously a big challenge. Today on Raise the Line, we dive into this important issue with two people who come at it from different professional perspectives, but who share that goal. Oh, and they also happen to be brothers!  Jake Engle is a Senior Director at Oracle Cerner, a supplier of health information technology used at thousands of facilities worldwide. His brother, Dr. Sam Engle, is a pediatric endocrinologist at Children's Wisconsin. On the patient care side, Dr. Engle talks about the value of having a complete patient history in hand prior to appointments to maximize the efficiency of the time spent, but also to avoid doing duplicate tests. “Especially with kids, you never want to have to repeat labs if you don't need to. I feel very strongly about that.” From the tech side, Jake Engle addresses the challenge of trying to synthesize data from multiple sources such as EHRs, insurance records, public health databases or commercial products focused on one niche of healthcare. “I think the healthcare systems are a bit late to the game and it's much a more complicated game.” You'll also learn about efforts to make it easier for patients to access their health data, the need for data standards in the industry and how their personal relationship contributes to this work.  

Health is a vital sign. It is an important thing we monitor at well visits, which is why routine check-ups are important. But when is growth a concern? Tune in to hear me talk with Dr. Sarah Hart-Unger, a Pediatric Endocrinologist, about height and kids. We discuss: How percentiles play a role in height Average growth trajectory for kids Workup if height trajectory is a concern including imaging and labs When Growth Hormone is RecommendedYou can find Sarah's Podcasts 'The Best of Both Worlds' and 'Best Laid Plans' and lots more at theshubox.comSPONSORSay goodbye to unreliable and inconvenient temperature measurements. Get your iProven family thermometer DMT-77.  It's enhanced dual-mode takes forehead and ear measurements quickly and easily, perfect for all ages. With a vibration function and intelligent fever indicator, this is one of the best thermometers for babies. Order now and get a 20% discount at iproven.com/pedsdoctalk. 

Health is a vital sign. It is an important thing we monitor at well visits, which is why routine check-ups are important. But when is growth a concern? Tune in to hear me talk with Dr. Sarah Hart-Unger, a Pediatric Endocrinologist, about height and kids. We discuss:  How percentiles play a role in height  Average growth trajectory for kids  Workup if height trajectory is a concern including imaging and labs  When Growth Hormone is Recommended You can find Sarah's Podcasts 'The Best of Both Worlds' and 'Best Laid Plans' and lots more at theshubox.comSPONSORSay goodbye to unreliable and inconvenient temperature measurements. Get your iProven family thermometer DMT-77.  It's enhanced dual-mode takes forehead and ear measurements quickly and easily, perfect for all ages. With a vibration function and intelligent fever indicator, this is one of the best thermometers for babies. Order now and get a 20% discount at iproven.com/pedsdoctalk.  Learn more about your ad choices. Visit megaphone.fm/adchoices

TAKING CONTROL OF YOUR DIABETES® – THE PODCAST! ...With Expert Endocrinologists Living with T1D, Drs. Steven V. Edelman & Jeremy PettusParent to Parent: Taking the Reins – Featuring T1D Dad, John MardikianFather's Day is right around the corner and Dr. E is sitting down with John Mardikian, father of a daughter (Cici) who has been recently diagnosed with type 1 diabetes at age three. John tells the story of Cici's type 1 diagnosis, how his family adjusted after her diagnosis, and his recommendations for parents of children who have been newly diagnosed with type 1 diabetes. Questions We'll Cover in This Episode: What is the story of Cici's type 1 diabetes diagnosis? How was the first month after Cici was diagnosed with T1D? What was your experience with Cici's sibling who does not have diabetes? How did Cici's type 1 diagnosis affect your marriage? What systems are you using to help Cici manage her diabetes? What are your recommendations for parents of kids who have been newly diagnosed with type 1 diabetes? What should a parent look for in a pediatric endocrinologist? Episode 17: For Parents of Kids with Diabetes, with Pediatric Endocrinologist & CMO of ViaCyte, Dr. Manasi JaimanDexcom Continuous Glucose Monitor: https://assistance.dexcom.com/pap_selfservice/**Tune in for 2 new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!** ★ Support this podcast ★

Pediatric Endocrinologist, Katherine Vu-Boast, MD with UPMC Children's Hospital of Pittsburgh discusses ways parents and families can help a child who's living with type 1 or type 2 diabetes.

Pediatric Endocrinologist, Katherine Vu-Boast, MD with UPMC Children's Hospital of Pittsburgh discusses ways parents and families can help a child who's living with type 1 or type 2 diabetes.

Many physicians experience unhappiness and burnout in their daily jobs. But this can be changed. There is information available that can help you or someone you know to transition into other career opportunities. Pharma and biotech are two possible options, and Dr. Nerissa Kreher, today's guest, will explain more about these paths. Dr. Nerissa Kreher is a Pediatric Endocrinologist who realized she had other passions to pursue outside of traditional clinical medicine. As a result, she got an MBA from Northeastern University and, while working in research, decided to pivot into the pharma/biotech industry. Having more than 15 years of experience working for different companies, Dr. Nerissa Kreher also coaches other physicians looking to transition from clinical work to being in pharma. These are some of the topics we cover during the episode: - Statistics about physicians who made the jump to pharma- How much money can you make if you work in pharma?- The lifestyle of people working in pharma/biotech companies- Mistakes physicians make when trying to change jobs - The one characteristic that the most successful physicians have in commonDr. Nerissa Kreher decided to share her knowledge to elevate the profession. The biggest problem is not physicians being unqualified but getting in their own way. To succeed, removing impostor syndrome is crucial. Physicians have the skillset and knowledge to change their career path if they want to do it. First, however, they need to believe in themselves and apply strategically for these different opportunities. The chance of pivoting from an unfulfilled career to a dream position is very real. “The pharma/biotech industry can be incredibly fulfilling. There are multiple different roles that physicians can do, and so there is a nice fit for most physicians out there.” - Dr. Nerissa Kreher In This Episode: - Welcome back to another episode of the Limitless MD podcast- What made Dr. Nerissa Kreher start helping others who needed a change? - Why did Dr. Nerissa Kreher choose pharma as a career for herself? - Statistics about physicians who made the jump to pharma - How much money can you make if you work in pharma? - The lifestyle of people working in pharma/biotech companies - Why would female physicians choose to work in pharma? - Mistakes physicians make when trying to change jobs- The one characteristic that the most successful physicians have in common - How long would it take for a physician to get a job at a pharma company?- Dr. Nerissa Kreher's coaching program - Words of wisdom for people ready to explore this option - Part-time opportunities for physicians who still want to do clinical work - Different types of archetypes in medicine- How to contact Dr. Nerissa KreherResources: - Join our Free community of high-performing physicians: the Physician Wealth Accelerator https://limitless-md.mn.co/- https://vikramraya.com/programs/ -...

Joining us on Well Said is Dr. Taranjeet Ahuja and Dr. Sunita Cheruvu. Dr. Ahuja is an Assistant Professor of Science Education & Pediatrics and the Director of Humanism in Medicine and a Communications Co-Leader at the Zucker School of Medicine. Dr. Cheruvu is a Pediatric Endocrinologist and an Assistant Professor of Science Education & Pediatrics at the Zucker School of Medicine. We also have a special guest joining us, Dr. Ahuja's daughter, Mehek. All will be discussing this incredibly impactful disease of Pediatric Obesity affecting over 15 million children as of 2020.

Key Insights/Content Covered:Initial approaches to management of obesityReview indications for weight loss surgeryReview the FDA-approved medications for obesityOutline strategies for treatment of weight recidivismSpecial Guests:Layla Abushamat, MD, Endocrinology, Diabetes & Metabolism Specialist, Baylor St. Luke's Medical GroupYong Choi, MD, Weight Loss and Bariatric Surgeon, Baylor St. Luke's Medical GroupStephanie Sisley, MD, Pediatric Endocrinologist, Assistant Professor Baylor College of Medicine

Seg 1: Was sending benign balloons part of a bigger strategy? Guest: Michel Juneau-Katsuya, Former Chief of Asia-Pacific at CSIS and Author of “Nest of Spies” Seg 2: What is the response from the US government on the recent developments in the unknown balloon saga. Guest: Reggie Cecchini, Washington Correspondent for Global News Seg 3: Why involving police in mental-health calls won't reduce crime in Vancouver Guest: Stacy Ashton, Executive Director at the Crisis Centre of BC Seg 4: Should Canada adopt a more aggressive approach to treat childhood obesity? Guest: Dr. Mélanie Henderson, Pediatric Endocrinologist and Associate Clinical Professor at the University of Montreal Seg 5: How will Federal funding help with BC's healthcare crisis? Guest: David Eby, Premier of British Columbia Seg 6: The story behind Elenore Sturko's advocacy for compassionate care Guest: Elenore Sturko, BC Liberal MLA Learn more about your ad choices. Visit megaphone.fm/adchoices

Should Canada adopt a more aggressive approach to treat childhood obesity? Guest: Dr. Mélanie Henderson, Pediatric Endocrinologist and Associate Clinical Professor at the University of Montreal Learn more about your ad choices. Visit megaphone.fm/adchoices

Listen in as I and Dr. Mehra answer your burning questions about puberty, what to look for, and discuss what is normal versus not. Dr. Rinku Mehra is a board-certified pediatric endocrinologist in the DC Metro area, offering medical care for children 10-21. She specializes in treating menstrual and hormonal conditions in girls and young women. Topics we discuss: Growth spurts Breast development Pubic hair What's normal? What signs do you need to look for early puberty? When should we worry about delayed puberty? When do you need to see a doctor about irregular periods? PCOS (polycystic ovarian syndrome) . . . **This is not medical advice, just medical education. Please ask your doctor medical questions as they pertain to your specific situation. Educational purposes only. #skywomenshealth #fortworthgynecology #osteopathy #womenshealthfortworth #integrativegynecology #gynecology #osteopathicmedicine #fortworthlocal #fortworthbossbabe #fortworthmom #fortworthmoms #physicianentrepenuer #womeninmedicine #dfwomen #fortworthweekly #fwtxmag #health #wellness #puberty #PCOS #growth #period #mensturalcycle #growth #OBGYN   ---------- Dr. Carolyn Moyers, DO is a board certified OBGYN and Neuromusculoskeletal Medicine physician, and founder of Sky Women's Health, a boutique practice in Fort Worth, Texas. Welcome to the Sky Women community where we are all stronger together. COME SAY HI!!! Instagram: https://www.instagram.com/skywomenshealth https://www.instagram.com/thepregnancypaindoc Facebook: https://www.facebook.com/skywomenshealth Email: hello@skywomenshealth.com Sky Women's Health: Https://www.skywomenshealth.com 1125 S Henderson St, Fort Worth, TX 76104 To become a patient: email hello@skywomenshealth.com or call 817-915-9803. WATCH SKY WOMEN PODCAST here: https://youtu.be/XexQrp5Jxgg Listen to the SKY WOMEN PODCAST here: ITUNES: https://podcasts.apple.com/us/podcast/sky-women/id1541657642 SPOTIFY: https://open.spotify.com/show/79VnnWYtGJwlB7NrjBck7o?si=qWXpiBtPSS6OVOt0ki8EiQ --- Send in a voice message: https://anchor.fm/skywomen/message

TAKING CONTROL OF YOUR DIABETES® – THE PODCAST! ...With Expert Endocrinologists Living with T1D, Drs. Steven V. Edelman & Jeremy PettusFor Parents of Kids with Diabetes – Pediatric Endocrinologist and CMO of ViaCyte Dr. Manasi JaimanQuestions We'll Cover in This Episode:•  What was your path to ending up as a pediatric endocrinologist?•  What was your path to ending up in diabetes research?•  What is your advice to parents of a newly diagnosed child?•  What devices and therapies do you recommend to parents of a newly diagnosed child?•  What has been the evolution of the development of the artificial pancreas?•  What's going on in the world of regenerative medicine as it relates to a cure for diabetes? •  What can we look forward to in the next 10-20 years of diabetes research?Dr. Jammin's Lecture for Parents of A Newly Diagnosed Child: https://youtu.be/a5eQ9RpKETA **Tune in for 2 new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!** ★ Support this podcast ★

Insulet has paid the guest speakers of this podcast, Dr. Grazia Aleppo and Dr. Amy Criego, a fee to participate in the making of this podcast. Dr. Grazia Aleppo and Dr. Amy Criego have an ongoing commercial relationship with Insulet and receive financial compensation for this relationship. Synopsis: In the inaugural episode of Beyond the Bolus, recorded live from the 82nd American Diabetes Association Conference, Nancy and Dena meet with Endocrinologists Dr. Grazia Aleppo and Dr. Amy Criego to discuss ADA highlights and understand how technology advancements are translating into day-to-day wins for people with diabetes. They discuss NEW extension data from the Omnipod 5 Automated Insulin Delivery System and their clinical pearls and real-world experience with Omnipod 5 during the pivotal trial and extension. They share the challenges and wins for both the adult and pediatric populations and the tremendous impact that technology can have in simplifying life for people with diabetes. Guest Bios: Dr. Grazia Aleppo, MD is an Endocrinologist at Northwestern Memorial Hospital in Chicago, IL. Her primary clinical interest is exploring diabetes technology, particularly the application of insulin pump therapy and real-time CGM sensor therapy and has contributed to over 70 publications and medical journals. Dr. Amy Criego, MD is an established Pediatric Endocrinologist and Medical Director at the Park Nicollet International Diabetes Center, involved in programming and clinical research. Having lived with T1D herself, she appreciates a team approach to diabetes care and management to allow patients and families flexible and active lives while maintaining good control. #Omnipod #ClinicalData #AIDSystems #DiabetesTechnology #82ndADA Please speak with your Healthcare team before making any changes to your diabetes management. This podcast provides general information and discussions about health and related subjects. This information and other content provided in this podcast, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. If you or any other person has a medical concern, you should consult your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that you have heard in this podcast or read in any linked materials. The opinions and views expressed on this podcast and website have no relation to those of any academic, hospital, health practice or other institution. **Please consult the Omnipod® 5 Automated Insulin Delivery System User Guide for more information.

Insulet has paid the guest speakers of this podcast, Dr. Gregory Forlenza and Dr. Diana Isaacs, a fee to participate in this podcast. Dr. Gregory Forlenza and Dr. Diana Isaacs have an ongoing commercial relationship with Insulet and receive financial compensation for this relationship. Synopsis: In the second episode of Beyond the Bolus, Nancy and Dena examine the importance of the diabetes care team as they walk a day-in-the-life with Dr. Gregory Forlenza and Dr. Diana Isaacs. Over the episode, these experts discuss the value of a team approach within their practices, the benefits of shared medical appointments and telemedicine visits and practical tips for finding and utilizing a technology champion. Guest Bios: Dr. Gregory Forlenza, MD is a Pediatric Endocrinologist and Associate Professor at the Barbara Davis Center for Childhood Diabetes, University of Colorado, and his research is focused on technology to improve the health and lifestyle of people with type 1 diabetes. Dr. Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES is a Clinical Pharmacy Specialist and the Remote Monitoring Program Coordinator at the Cleveland Clinic Diabetes Center. Her primary clinical interests include medication management, diabetes education, running a robust CGM shared medical appointment program and insulin pump training. #DiabetesTechnology #CareTeam #Telemedicine #DayintheLife #PatientCare Please speak with your Healthcare team before making any changes to your diabetes management. This podcast provides general information and discussions about health and related subjects. This information and other content provided in this podcast, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. If you or any other person has a medical concern, you should consult your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that you have heard in this podcast or read in any linked materials. The opinions and views expressed on this podcast and website have no relation to those of any academic, hospital, health practice or other institution. **Please consult the Omnipod® 5 Automated Insulin Delivery System User Guide for more information.

There comes a time when we all grow up, and puberty is where all the hormonal magic happens. Puberty can be at different times for everyone, but when should pediatricians get concerned that it is too late, or too early? Join us with our guest Dr. Juanita Hodax, Pediatric Endocrinologist, to discuss hormone pathways, Tanner stages, and approaching puberty in a gender inclusive way.

Dr. Nerissa Kreher is a Chief Medical Officer of a biotech company and a Pediatric Endocrinologist. She transitioned into biotech early in her career and brings 15 years of experience in the biotech/pharmaceutical industry. Things to expect in this episode:Dr. Nerissa talks about how she got started in the pharmaceutical industryShe explains the differences in job titles of medical affairs,  clinical development,  and drug safetyA description of her work/life balanceHow moving between companies allowed her to climb the ladder to successThe importance of networking to get a foot in the door for pharmaceutical jobsWE WANT TO HEAR FROM YOU!!!!  TELL US WHAT YOU WANT TO HEAR ON FUTURE EPISODES!!!!FILL OUT THE DOCS OUTSIDE THE BOX PODCAST SURVEY (in partnership w INCROWD)INCROWDMAKE EXTRA MONEY AS A RESIDENT OR ATTENDING - COMPLETE MEDICAL SURVEYS WITH INCROWDWATCH THIS EPISODE ON YOUTUBE!https://www.youtube.com/drniidarkoJoin our communityText word PODCAST to 833-230-2860Twitter: @drniidarkoInstagram: @drniidarkoEmail: team@drniidarko.comPodcasting Course: www.docswhopodcast.comMerch: https://docs-outside-the-box.creator-spring.comThis episode is sponsored by:Set For Life Insurance. What the Darkos use for great disability insurance at a low cost!! Check them out at www.setforlifeinsurance.comLocumstory. Learn how locum tenens helps doctors make more and have the lifestyle they deserve!. Check them outHERE!

Dr. Yaa Kumah, currently a Pediatric Endocrinologist and the Biomedical Informaticist at Vanderbilt University Medical Center, speaks with Adam and Dan on how computers and emerging technology can rehumanize the patient and provider experience. She emphasizes throughout the conversation about the change that the COVID-19 pandemic brought, and how providers became more willing to try new technology and implement different approaches to enhance the patient experience. She touches on the 21st Century Cures Act which aims to streamline delivery for drugs, accelerate research and improve health services to patients overall. This leads to “humanizing” the patient experience through transparency. The challenge then is how patients are giving feedback on these tools and the follow up process on simplifying the process for them.

This podcast presents an approach to the diagnosis and management of phenylketonuria. This podcast was developed by Jennifer Butler and Umairah Boodoo, medical students at McMaster University, in collaboration with Dr Hannah Geddie, Assistant Professor and Pediatric Endocrinologist at the Division of Pediatric Endocrinology in the Department of Pediatrics at McMaster University.

In this episode, Pam speaks with Dr. Elham Amiri about all Type1 and Type2 Diabetes as well as Childhood Nutrition and how to navigate parenting and teach your children to make healthy choices in a world of fast and processed food.   Join the Diapoint mailing list for exclusive insights and offers: diapointme.com/join-the-diapointme-mailing-list/   Visit the D-Shop where we offer beautiful, practical diabetes supplies and lifestyle accessories: https://www.diapointshop.com/    Home study program for parents of school-aged children with Type 1 Diabetes: https://www.diapointlearning.com/courses/the-ultimate-type-1-diabetes-school-game-plan    Diabetes resources: https://www.diapointme.com/diabetes-wellness-resources/    Diapoint is the place for people touched by diabetes. For more information and full details of our work, visit diapointme.com where you'll also find our social media links and any resources mentioned in the episode. Subscribe to the podcast so you get notifications for all our episodes, and please share it on social media or with anyone you think could benefit from this free content  

In today's episode, Dr Mitch Geffner joins Ask Dr Jessica to discuss all aspects of children's growth.  How much growth should we expect to see in a child every year? What determines a child's final height? Does diet matter?  And if so, how important is it to eat healthy with regards to growth? And what about genetics--if a child has a tall grandparent or uncle, does that play a role in final height?  And what about getting enough sleep?  When should a parent see a doctor if they have concerns about height? How can a parent find out if their child is a "late bloomer"?  We answer all of these common questions and more!Dr Geffner currently works Children's hospital of Los Angeles as a pediatric endocrinologist.   He has been the author of over 150 peer-reviewed research articles and he is the pediatric endocrinology editor for UpToDate—an important online resource for doctors.Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children.  Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. Do you have a question you want Dr. Jessica to answer?  Send an email to: askdrjessicamd@gmail.com. Website: www.askdrjessicamd.comFollow her on Instagram: @AskDrJessicaSubscribe to her YouTube channel! Ask Dr JessicaSubscribe to this podcast: Ask Dr JessicaPlease note this channel does not take the place of advice from your own medical doctor.  If you have any medical concerns, please seek medical attention.

Listen now and see what it's like to be a pediatric endocrinologist!

On this episode I welcome Dr. Nadia Merchant, Pediatric Endocrinologist and Geneticist at Children's National Hospital in Washington, D.C. We discuss the following and so much more:The difference between Type 1 and 2 diabetes Presenting symptoms of Type 1 diabetes Common ages to be diagnosedCOVID/diabetes linkFor more information and to give, check out the Juvenile Diabetes Research Foundation and the Children's National Hospital Foundation.

Pam discusses the care and treatment of kids with diabetes with Dr. Asma Deeb, a leading pediatric endocrinologist in the Middle East and North Africa region who specializes in diabetes in children. Dr. Asma, who is the founder of the Arab Society for Pediatric Endocrinology and Diabetes (ASPED - @asped_news), shares her expertise and views on how far Type 1 Diabetes has come, and what the future of diabetes looks like. Join the Diapoint mailing list for exclusive insights and offers: diapointme.com/join-the-diapointme-mailing-list/ For more information and full details of our work, visit diapointme.com where you'll also find our social media links and any resources mentioned in the episode. Subscribe to the podcast so you get notifications for all our episodes, and please share it on social media or with anyone you think could benefit from this free content.

Dr. Robert Lustig joins Ethan on American Glutton to talk about his latest book; Metabolical: The Lure and Lies of Processed Food, Nutrition and Modern Medicine. Ethan hears Dr. Lustig's viewpoints on a variety of topics. Listen in for this and much more

Dr. Robert Lustig joins Ethan on American Glutton to talk about his latest book; Metabolical: The Lure and Lies of Processed Food, Nutrition and Modern Medicine. Ethan hears Dr. Lustig's viewpoints on a variety of topics. Listen in for this and much more

Dr. Jessica Kremen, Pediatric Endocrinologist at Boston Children's Hospital, shares about her work with transgender children and adolescents. With so many recent legislations directed at transgender youth, how do we navigate separating politics from patient and family autonomy? Mentioned In This Episode: BE-U https://www.childrenshospital.org/centers-and-services/programs/a-_-e/be-u

James Comer, U.S. Representative for the 1st District of Kentucky and Ranking Member on the House Oversight Committee, gives an update on vaccine passport mandates, the Pentagon warning military service members that the religious exemption is not a “blanket check,” and the House Oversight Committee Republicans calling for a field hearing on the border to investigate a dramatic surge in COVID-19 positive immigrants in U.S. custody. Jeff Landry, Louisiana Attorney General, talks about his joint initiative with Alabama Attorney General Steve Marshall to gathering information on social media censorship. Jon Schweppe, Director of Policy and Government Affairs for American Principles Project, discusses how to fight back against mounting Big Tech censorship and American Principles Project's bigtechfunding.org initiative. Dr. Quentin Van Meter, Pediatric Endocrinologist and clinical associate professor of Pediatrics at both the Emory University and Morehouse Schools of Medicine, talks about the Texas Department of Family and Protective Services' statement that transgender surgery for children is child abuse, and the American Academy of Pediatrics and American Medical Association pushing transgender ideology. --- Support this podcast: https://anchor.fm/loving-liberty/support

Dr. Iglesias is a pediatric endocrinologist. We had a great time talking about what a normal day looks like and the ins and out of having a private practice.

The Thyroid Nodule and Carcinoma Clinic at Children's Mercy Kansas City is the only pediatric clinic of its kind in the region to provide the comprehensive evaluation, diagnosis, treatment, and long-term management of thyroid nodules and differentiated carcinoma. In this episode, Naim Mitre, MD, Pediatric Endocrinologist and Medical Director of the Thyroid Nodule and Carcinoma Clinic at Children's Mercy, discusses the incidence of thyroid cancer in children, how thyroid nodules are diagnosed, and the importance of treatment.

Dr. Raman is a Program/Fellowship Director and Pediatric endocrinologist. Today, she talks with me about the 'Bread and Butter' cases and life in the hospital.

Today on Inspired by HERstory is Dr. Shamita Trivedi. Dr. Trivedi is a Pediatric Endocrinologist who pursued her RYT-200 Yoga Teacher Training while staying full-time as a practicing Pediatric Endocrinologist. Yoga remained a part of her journey throughout all of her schooling and physician training. Her Yoga practice deepened when she found she needed some Balance and Centering as her life in the hospital was diverging from her real life. Now, she happily is fully herself in all of the roles she fills including being a full-time physician as well as starting her own Virtual Yoga studio, Jeet Victory Yoga! During this episode, she talks more about: How she decided to pursue her RYT-200 Yoga Teacher Training while staying a full-time physician How yoga has helped her handle stress as a physician And how you can have more than one passion FOLLOW HER JOURNEY Website: jeetvictoryyoga.com Instagram: @jeetvictoryyoga FOLLOW MY JOURNEY: Instagram Brand Photography: https://www.instagram.com/kaitlyncassocreations/ Travel Photography: https://www.instagram.com/kaitlyncasso/ Podcast: https://www.instagram.com/inspiredbyherstory/ Website https://www.kaitlyncasso.com/ How to Create a Podcast Course: https://kaitlyncasso.podia.com/how-to-create-a-podcast-course --- Support this podcast: https://anchor.fm/kaitlyn-casso/support

Dr. Tandy Aye, pediatric endocrinologist at Stanford Medicine and senior author of a study that appears in the March 2021 issue of the Journal of Adolescent Health speaks to Lianne Castelino of Where Parents Talk, whereparentstalk.com about the study's findings and key takeaway for parents of children who may be exploring their gender identity.

In this episode, Dr. Emily Sims joins us to discuss her research focused on diabetes risk factors and treatments to predict or slow diabetes progression. Tune in to learn more about her recent publication on teplizumab, titled "Teplizumab improves and stabilizes beta cell function in antibody-positive high-risk individuals".  Click here to read the full paper. 

John Fund, Columnist for National Review and Newsletter Editor at the Committee to Unleash Prosperity, on the unfolding energy crisis in the Midwest and South – and the role of green energy in creating the disaster. Valerie Richardson, Washington Times Reporter, on New York Governor Cuomo defending the controversial nursing home directive and blaming staffers and visitors for the spread of the virus. Angela Hill, State Senator for Mississippi, on the Mississippi State Senate voting to protect girls’ sports. Dr. Quentin Van Meter, Pediatric Endocrinologist and clinical associate professor of Pediatrics at both the Emory University and Morehouse Schools of Medicine, on Leftist activists trying to ban researchers from studying the effects of transgenderism. --- Support this podcast: https://anchor.fm/loving-liberty/support

Our guest for this episode of M.ED is Dr. Kathleen Timme. Dr. Timme is a Pediatric Endocrinologist at the University of Utah and Primary Children's Hospital as well as the Director of Educational Development for the Graduate Medical Education and the Associate Program Director for Fellow Education and the Pediatric Education Enterprise at the University of Utah. Dr. Timme's clinical interests include type 1 diabetes and general endocrinology including disorders of growth, puberty, and the thyroid. Her research experience is in medical education, developing programs to help physicians become better educators. She is pursuing a Master of Education degree through the University of Cincinnati and Cincinnati Children's Hospital. Dr. Timme also has her own podcast titled Teaching in Medicine that can be found here: https://anchor.fm/teachinginmedicine You can find additional resources on adult learning theory and free AMA CME credit: information at https://medicine.utah.edu/students/programs/md/curriculum/ruute/preceptor/cme-podcast.php Enjoy!

Today's episode is for all those parents who are worried about their child's growth and development. For this, we have with us a special guest who is a dear friend and a Pediatric endocrinologist. He has done a specialization in paediatrics followed by a  Post Doctoral Fellowship in Pediatric and Adolescent Endocrinology. He holds special expertise in the management of Juvenile Diabetes Mellitus. Apart from being an avid reader and a  nature enthusiast he is great with kids. We have answered questions like: 1. The child will grow as tall as its parents, myth or fact? 2. A girl cannot grow after attaining menses- what one should know. 3. Can growth hormone be given to children who do not have growth hormone deficiency? And is it permissible? 4. It is normal to get menses early these days - myth or fact? 5. I didn't grow much because I didn't exercise or cycle enough in childhood- busting the myth 6. Is there a way to increase my child's height? You can connect with Dr. Alok Sardesai on Facebook as Alok.sardesai.1 and on Instagram as dr.aloksardesai Do subscribe to my podcast so you will be notified each time a new episode is online. you can visit my website doctormommyspeaks.com/podcasts for all the show notes and other resources on health and parenting. and while you're at it, don't forget to subscribe to our newsletter. Do review our podcast wherever you listen, it will help others to find this podcast. You can connect with doctormommyspeaks on Instagram, Facebook, Twitter, Linkedin. or leave a voice message. I would love to hear your thoughts, comments, feedback or any problem that you would like to share and get expert advice on. Until then, Happy Parenting. --- Send in a voice message: https://anchor.fm/doctormommyspeaks/message

Dr. Abby Hollander is a Professor of Pediatrics and Diabetes at Washington University School of Medicine in St. Louis. She is Board certified in Pediatrics and Pediatric Endocrinology. Dr. Hollander’s clinical interests include all pediatric endocrine disorders and diabetes mellitus. She is a co-leader of a multidisciplinary team providing care for children with disorders of sex development and adolescents with gender dysphoria.Dr. Hollander has a focused interest in treatment of endocrine problems in children with brain tumors and has been a member of the multidisciplinary neuro-oncology team for St. Louis Children’s Hospital for over 15 years. Resources for transgender youth and their families:Parent support group—Transparent; URL: www.transparentusa.orgSt. Louis Children’s Hospital Transgender Center URL: www.stlouischildrens.org, search for Transgender Center; medical co-directors are Christopher Lewis, MD and Sarah Garwood, MD

Dr. Rebecca Geliebter, a Pediatric Endocrinologist, discusses childhood weight concerns and the best means of management.

Dr. Rebecca Geliebter, a Pediatric Endocrinologist, discusses childhood weight concerns and the best means of management. This podcast is powered by JewishPodcasts.org. Start your own podcast today and share your content with the world. Click jewishpodcasts.fm/signup to get started.

Dr. Candice discusses what you need to know about childhood diabetes with Pediatric Endocrinologist, Dr. Ashley Shoemaker.

In this episode, Adebola Giwa joins Monica Westley to discuss his bench and clinical research in the type 1 diabetes space. Dr. Giwa is a research investigator in The Hamad Laboratory. His bench research is focused on identifying unconventional lymphocytes and studying their role in the pathogenesis of type 1 diabetes to possibly target them for future immunotherapies. His clinical research involves multi-center clinical trials utilizing islet cell transplants to reestablished insulin production and other beta cell function in people with established type 1 diabetes. Checkout his recent publication:Current understandings of the pathogenesis of type 1 diabetes: Genetics to environment

09 June 2020: The UAE is among the top 10 countries with high prevalence of diabetes in the world, with the disease affecting nearly 20 per cent of the population. Dr Abdulla Aljneibi, Pediatric Endocrinologist at HealthBay on Al Wasl Road, joins us to talk about the disease in children, what signs parents should be looking out for and how we can prevent it.

With all that is going on in our society with COVID pandemic and other media heated stories, Do you think that the topic of the LGBTQ and the concerns and issues of it have been shelved? Is it a plan to silently continue to go against GOd's plan? Dr. Quentin Van Meter is a Pediatric Endocrinologist in Atlanta, Georgia, he is affiliated with the Children's Healthcare of Atlanta and the President of the college of Pediatrics. Dr. Van Meter spent 20 years in the Navy Medical Corps and is the clinical associate professor of Pediatrics at both Emory University and Morehouse Schools of Medicine. Sobering Up to What's Important Episode Highlights: Around $30,000 dollars a year is spent to pharmaceutical companies for puberty blocking medication. Do parents struggle with the topic of LGBTQ in their homes with their children? Are we as a society being guilted into accepting something that is not in God's plan? Transgender affirmation does not cure the underline issues of an individual. With our culture tending to the LGBTQ community and the issues of parents of underage kids, what is even considered sexual perversion anymore? Picture via: Pixabay

Atrium Health doctor Mark Vanderwel answers questions on the minds of many parents these days. We will be adding a transcription later today. Quick turn around on this episode! If you saw the original Facebook live, skip ahead 17 minutes - it dropped out after some audio issues but Stacey & Mark picked it back up again, off of FB. You can watch the full interview here Check out Stacey's new book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription Stacey Simms  0:00 Diabetes Connections is brought to you by one drop created for people with diabetes by people who have diabetes by real good foods real food you feel good about eating by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:19 This is diabetes connections with Stacey Sims.   Stacey Simms  0:24 Hey everybody, welcome to another episode of the show. So glad to have you here. I hope these episodes are helping. Today we are talking with a pediatric endocrinologist starting off by talking about Covid 19, of course, and things that people with diabetes specifically type one needs to keep in mind but then going down the line of listener questions things that my local Facebook group chimed in with things that the diabetes connections group chimed in with. Because if you're not seeing your endocrinologist for longer than expected, which is the case for a lot of us kids and adults, what should you You'll be doing and that's a lot of what we talked about what to do in between how to make sure that you are taking care of what you need to take care of some things you might not have thought about. And just a great chat with Dr. Mark Vanderwel, this was originally done as a Facebook Live Alright, that's only half the truth. This was originally done as a stream yard which is a an audio and video hosting system hosted Facebook Live, which crapped out halfway through and then mark and I jumped onto zoom and record it that way. So the whole video I kind of stitched it together. The whole video is up on YouTube, on diabetes connections there. It is also on our Facebook page. And here is the audio. That's what we're running is the audio of the initial Facebook Live and then everything that you didn't hear. So if you watch the Facebook Live already, the new stuff is about 17 minutes in from the beginning of the interview. If you want to skip ahead, I'm not coming back at the end of the interview. I do want to say, though, that I appreciate all of the messages I'm getting about, you know, putting out episodes. Look, we're all looking for things to do at our homes. We're all looking for good, reliable information. I am hoping to do more episodes like this more zoom Facebook stuff. So let me know what you'd like to hear. I've also been collecting audio from you from people in the audience. And I'm going to be releasing that episode and kind of figuring out how to use that great audio people just keep me posted on what's happening in their homes and what's on their minds. So I'm not really sticking to a schedule. And I guess what I'm trying to say is, I'm sorry, if you were expecting every episode on Tuesday, and sometimes on Thursdays like we normally do, but I don't know about you. I've already lost all track of days of the week. So we're just gonna put out episodes when they're ready to go. And if you want to still listen on Tuesdays, that's awesome. If you want to let me know that that is or isn't working for you. That's great, too. I just think we all need to be here for each other in these wild times. Thank you so much. All right, so here is my talk with atrium health Dr. Mark Vanderwel, welcome to everybody who is watching. I'm so glad to have you with me for this little bit of an unusual circumstances bear with us. This is the first time I've done something like this. I am Stacey Simms, the host of diabetes connections and with me is Dr. Mark Vanderwel, a pediatric endocrinologist here in the Charlotte, North Carolina area with atrium Health. Dr. Vanderwel. Thanks for joining me,   Dr. Mark Vanderwel  3:26 Stacey. It's an honor as always,   Stacey Simms  3:29 well, we should say before we get going, we do have some disclaimers. But the very first thing in full disclosure that people need to know is that this is my son's endocrinologist and I've known Dr. V, as I've called him many times on the show and in my book for more than 13 years now. So we've never done an interview.   Dr. Mark Vanderwel  3:48 Yeah. At least recorded interview for for diabetes connections. We did some back in your radio days. Oh, that's right.   Stacey Simms  3:56 Yeah, I thought you were implying that I like interviewed you when I All right.   Dr. Mark Vanderwel  4:02 So it has been a long time since we've communicated it never on this platform.   Stacey Simms  4:05 Well, I really appreciate you jumping in because as you know, people have a lot of questions nervous times right now. So the The first thing we need to do is is do some disclaimers, obviously, while Dr. Vanderwel is our pediatric endocrinologist, he is not yours. So please, any comments questions that you may have addressed them to your own physician as well? Nothing I will put words in your mouth here, nothing that Dr. Vanderwel says today should be taken as your own personal medical advice. We're here to get general answers to general questions. And that's really about it. So I'm gonna put you on the spot a little bit, I think. But as you listen and watch at home, just you know, let's use some common sense here.   Dr. Mark Vanderwel  4:43 Yes, I'm not speaking for the pediatric endocrinology community in general. I'm speaking for myself and different physicians have different perspectives on how they take care of kids with diabetes. Different physicians will have different perspectives on Covid 19. And what I am saying is my perspective And it will not even apply universally to all of the patients I take care of because we know you are all different. Similarly, I am not a pediatric infectious disease specialist. I'm not I am not an epidemiologist, and I'm not a fortune teller. And I think we're all worried and we do not know what's going to happen in the future. And a lot of what we're talking about is just predictive, then we don't know.   Stacey Simms  5:21 All right, so good things to keep in mind. Also, this is first being broadcast live on Facebook. If for some reason as you're watching it, just bonks out or something crazy happens. We're recording the audio, this will be rebroadcast as a podcast, it may be broadcast in video in some other forms. If you have questions or comments. We're using technology called stream yard, and I can see your comments on Facebook, but we're not actually on Facebook. So there's a big delay, most likely, so bear with us. And I do have a lot of questions that I took in advance. So if we don't get to your question today, I promise it may not be with Dr. Vanderwel schedules permitting, but we are going to be addressing Senior questions going forward. And you know, we're just here to see what we can do. So we want to just jump right in. Sure. Let's go. All right. So my first question is really just about what you're hearing these days because I'm talking to you at home, you're not in the office offices is closed, but are you still getting close? Okay, so what are people asking?   Dr. Mark Vanderwel  6:16 Yeah, so, you know, I think the the primary things are, will we still have appointments? And the answer is we will eventually have virtual appointments. Although a lot of people will also need to be rescheduled, we don't only take care of kids with diabetes, and there are some conditions that we do need to see face to face. In general though, I think most of our kids with Type One Diabetes will be able to seen by a virtual visit, and we'll talk a little bit about that in just a minute. We do still have nurses answering phone calls in our office, I'm not sure what other offices are doing. So we have nurses answering phone calls. We have a physician that's on call 24 seven for hospital based medicine. And so we will we are creating a schedule. That's why our office is closed. We're working on developing virtual visits. And we've never done this before the platform that atrium uses was originally designed for perhaps five, six pediatricians to use to handle only general pediatric calls. And now this platform is being spread out to be used by pediatric specialists, as well as general pediatricians. And I think more than 100 physicians and, uh, and other providers are going to be on this platform. So we're still learning how to do it. And that's why we canceled appointments for a few weeks, but we will have virtual visits up and running hopefully, by next week, Tuesday,   Stacey Simms  7:34 because we're going to be in that soup, right? Yeah.   Dr. Mark Vanderwel  7:38 Your name on my schedule when I was telling everyone that exactly.   Stacey Simms  7:43 Alright, well, I won't call your office and ask what you're doing with me. I will let them reach out to us. When you're talking about virtual and again, this is kind of specific to your office. I don't even know yet. Do we on the other side have to do anything yet or you'll read? Yeah, we'll watch. No,   Dr. Mark Vanderwel  7:58 we we Will for our type one diabetes patients will likely have a medical assistant call you first maybe on the day of the appointment maybe beforehand to review any changes in medications, any new allergies, the types of things they usually ask you while they were checking you back in. And then in preparation for the phone call with a physician, we are going to ask you to gather diabetes data for us whether it's a pump, download a CGM, download a meter download, and that'll be the main thing that we as physicians will review. So we'll tell you more. We'll try to talk through a little bit more about how to do that. Although hopefully you all know how to do that. The physician will also will hopefully again, this is all new. We'll have all that information online.   Stacey Simms  8:42 If you're watching, you kind of saw me roll my eyes there. Dr. Vanderwel knows this but it's a little embarrassing to admit, I never upload anything in advance. I tell them please don't be mad at me. I think the only time I ever logged into T Connect is to upgrade the pump. So   Dr. Mark Vanderwel  8:57 well you know, I think the thing is, we We'll be able to get that data without, without advanced uploading, I don't want to come that 100%. But I think if your data is there, we should be able to access it. But we're gonna learn that over the next three to five days.   Stacey Simms  9:12 That's what we're all be learning it, I am sure. Um, in terms of questions that people have in between these appointments, you know, one that came to mind this morning was, you know, if I, if I need refills, if I'm worried about supplies, are you here? I know most people just call their physician pharmacies are open, but are you hearing anything about issues, shortages, that sort of thing with supplies   Dr. Mark Vanderwel  9:35 whatsoever, and I hope we don't, um, you know, Covid 19 is going to affect people in every sector. And I hope we don't get to a stage where there's problems with pharmaceutical production at this point, there is no anticipated problem with production of insulin production of test strips production with any other diabetes related spies. And so No, I do not foresee that as a problem. I know there's the temptation to stockpile And that's one of the things that we've seen in the general public, obviously, with toilet paper, hand sanitizer, etc. And there's that desire Should I stockpile my insulin? Well, we can't commit insurance fraud. And so as physicians, I cannot write a prescription to your pharmacy saying suddenly that a child who used to use 20 units of insulin a day is all of a sudden requiring 200 units of insulin per day, so that your insurance will cover additional insulin, I can't do that. That's illegal. And so we will be honest with the pharmacies. I'm not sure how you can get extra insulin just in case that might be something better to work with your pharmacy in terms of what they will cover or what they will allow your insurance to cover. But I do not foresee a deficiency in any diabetes related supplies.   Stacey Simms  10:45 Let's jump in and talk about Covid 19 best that we can. One of the questions that seems to be coming up over and over again is you know, we've all seen in the early days of this at least, the charts that came in from China and Italy saying they're the comorbidities and diabetes Sure, can you do you know what that means? Because one of the questions was, is it all type two is it you know, work?   Dr. Mark Vanderwel  11:06 Right so earlier this morning I saw some data recently published in the New England Journal of Medicine related to the children 10 and under. And the only fatality in the Chinese data that was published was a 10 month old, who had had intussusception, which is basically when your intestines telescope on each other. And so the child was already previously ill because of that, and there were no other fatalities in that population under age 10. I do not have the data for other age groups stratified out but that was what I saw on the New England Journal of Medicine earlier today. When the word diabetes is used, obviously, that is a big word and often refers to both type one and type two diabetes. And so as far as I can tell from all the Chinese data, when it says diabetes is referring to the big group of both and everyone's worried at greater risk, because I have type one diabetes, or let's face it type two diabetes? And the answer is, we do not think that people with type one or type two diabetes are at any greater risk of contracting Covid 19 than the general population. So there's no increased risk of picking up this virus as far as we know. Now data changes every day. That's the caveat here. We are still learning but at this point, there's no reason to think that people with diabetes type one or two are more likely to get Covid 19. Just like any virus, whether it's the flu, whether it's the cold, being sick, when you have diabetes makes taking care of diabetes more difficult, and we see that frequently during flu season, that when people are feeling sick, and they may not be eating or drinking quite as well, they have the predisposition to go into diabetic ketoacidosis. And so my answer to how do people with type one diabetes are people who have children who have type one diabetes, better take care of their children, either if They have been exposed to the virus or if they are already showing symptoms of a viral infection. And the answer is us you're sick. And by Sick Day protocol, I mean check for ketones. Even if your child's blood sugar is 124, you can still get ketones if they are not eating or drinking very well. So remember, ketones are what happened, or what happens when your muscles become desperate for energy. And usually with people with diabetes that happens when you don't have enough insulin in your system to help your body take the sugar out of the bloodstream and get it into the muscle cell to be used for energy. But sometimes ketones can happen if you're just not eating or drinking very well. And so ketones can happen even with a blood sugar 124 if your child has been sick, or if she is vomiting or if he is not eating very well because he feels sick. ketones also can be happening more often in the presence of fever. So although as far as we know right now, nausea and vomiting are not necessarily symptoms of Covid 19 like they are the flu. For example, fever is When you develop fever, that can also cause greater metabolic need, your muscles become more desperate for energy that can lead to the production of ketones and cause an increased risk of diabetic ketoacidosis. So my summary is related to kovat, 19 and diabetes, your child is not at greater risk, their immune system should still work just fine to fight off the virus However, they are at greater risk for developing diabetic ketoacidosis in the context of a viral illness.   Stacey Simms  14:29 A couple of follow up questions on that with keep checking for ketones. Do you recommend a keto blood meter? Are you comfortable with sticks and easily?   Dr. Mark Vanderwel  14:40 Yeah, I mean, most people check urine for ketones a blood ketone meter can give you more up to date information, for example, that tells you what's in your blood sugar level. That's what's in your blood right now. Whereas your urine is often saying, well, we made this urine an hour ago and it's been sitting in the bladder for an hour so it's not as up to date as before. glucometer as a blood ketone meter is, but still I think you can get the information you need from, from urine, ketosis, I don't feel you have to rush out and get a blood ketone checker just because of our current situation. I mean,   Stacey Simms  15:13 I'll be honest with you, and I don't know if this is true confessions time, we've never we've never purchased a blood ketones. This was the time I thought maybe, you know, the back of my head was like, should I get on Amazon? And then I got on Amazon, and there were so many and I thought, oh my god, I'm gonna buy a terrible one. So, um, stick with what we know maybe for me?   Dr. Mark Vanderwel  15:31 Yeah, I mean, there are many other things to worry about. And if you felt comfortable checking your child's urine for ketones, there's no need to suddenly change to use a blood glucose blood ketone meter.   Stacey Simms  15:42 Well, he's 15. So maybe,   Dr. Mark Vanderwel  15:43   Stacey Simms  15:46 I'm sorry, this if you're just joining us, we did have a bunch of disclaimers that this is not medical advice you should be taking personally, but this is my son's pediatric endocrinologist. So I might sneak in some personal questions. We'll see. But the follow up question. fever. And then I'm going to ask you that question about repro fantasy. Before I even get to that one, do you recommend? I've heard that sometimes it's better to let the fever go, you know, not to 104 but to 101, things like that.   Dr. Mark Vanderwel  16:17 That is a great question Stacy and I am no longer a general I should say this. I am board certified in general pediatrics, but I have not practiced general pediatrics for 15 years. However, that all being said, fevers makes you uncomfortable. When your temperature is high, you don't feel good, but many people are excessively afraid of fever as something that can hurt you, either in the short term or the long term and in general fever just makes you uncomfortable. So when we're sick, and we have a fever, we often for other illnesses have taken an antibiotic whether it's acetaminophen, whether it's ibuprofen, and what some, some French suggested Scientists have suggested is that ibuprofen and other anti inflammatories may blunt your immune response as of right now that information what's the exact word I had it pulled up is still up for debate. It is not necessarily something that is. That is a stocking answer that we say you must not use ibuprofen in the case of a fever related to Covid 19 unproven was the word I was looking for unproven so let's let's get the elephant out of the bag. What is killing people with Covid 19 is not fever. What is killing people with Covid 19 is respiratory distress is the inability to get breath in and children with diabetes are at no greater risk for developing that than children who don't have diabetes when it comes terms in terms of managing fever. Yes, ibuprofen is a anti inflammatory, ibuprofen at this point. We don't know if it's safe or not. My recommendation, though, is is to say, you know, we want to make sure you're drinking. We want to make sure you can keep fluids down. And if you are so uncomfortable that you can't drink or keep fluids down because of the high fever, then yes, we probably should treat the fever and at first maybe you treat with IV or with acetaminophen. But if all you have is ibuprofen, and you're you're miserable, at this point, it's still unproven that ibuprofen will make Covid 19 worse or prevent you to impair your ability to fight it off.   Stacey Simms  18:27 Well, and will continue to follow that obviously,   Dr. Mark Vanderwel  18:29 just new information.   Stacey Simms  18:31 It's unproven, but I mean, I can't lie. I still you know, I take ibuprofen here and there I immediately was like, No, because it's it's scary.   Dr. Mark Vanderwel  18:39 Sure. Yeah.   Stacey Simms  18:41 I went and checked everything in the house. How much acetaminophen do we have? What What else? Oh, because acetaminophen isn't so many cold medicines, sir. Let me ask you that people with type one and type two people with diabetes. Let's just say that who use CGM know that with Tylenol acetaminophen come warnings with death. calm. Now my understanding is Dexcom je six you can take 1000 milligrams of Tylenol safely by safely means it's not going to burn out your sensor you can is nothing to do with them anything beyond the sensor we're talking about here is that what you were understanding?   Dr. Mark Vanderwel  19:15 My understanding and just for clarification even in previous versions of Dexcom if you're using g five if you're using g four acetaminophen does not prevent it from working. It just may mean the readings it gives you are not as accurate as they might be without acetaminophen in your system. But that's also my understanding for the for the Dexcom g six,   Dr. Mark Vanderwel  19:35 just think or stick. Agreed?   Dr. Mark Vanderwel  19:37 Yeah, if you feel your ducks comm isn't accurate whether you have acetaminophen on board or whether you don't have acetaminophen on board, poke your finger.   Stacey Simms  19:46 Right? Which means that a lot of people need to make sure that not only do we have a meter and test strips, but that we have the batteries or that our stuff is plugged in because um I know A lot of us are very reliant on CGM. Let's just put it that way. And I'm looking at my phone, not to be rude, but to look at the next few questions. So as you're watching,   Dr. Mark Vanderwel  20:10 I know you go Okay, fair enough.   Stacey Simms  20:15 That was more for these guys. But seriously, um, I'm curious too, with, with not knowing when many of us will see our children's, endo next, or if we're adults are watching. Are there things that we should be doing? To check in between? I mean, I know that I'll give you an example. You always check penny for you know, scar tissue.   Dr. Mark Vanderwel  20:40 Right? Like lipohypertrophy. Exactly. Okay,   Stacey Simms  20:42 so go for it. Tell us what we do. Yeah,   Dr. Mark Vanderwel  20:43 so, so lipohypertrophy is when you will put your infusion side in the same place too often, or you give yourself insulin injections in the same place too often. And the downside of that is not only does it look funny, but it can prevent the insulin that you give yourself from getting into The bloodstream, and then it doesn't get from the bloodstream to the eventual target tissues of liver and muscle. So if you are thinking you're giving yourself a bolus, but you're giving it giving it into an area of life or hypertrophy, then perhaps the insulin isn't doing what it needs to do. And that can obviously be dangerous and increase your risk of decay. So, yes, I do think that parents should be checking your child for life or hypertrophy in the same way that their endocrinologist probably does regularly. And the thing that I would probably say is, the easiest way to do is just make sure it doesn't feel like a tricep, you know, flex your tricep right here. And you can feel a little bit of muscle tissue right there. And light by hypertrophy feels a lot like that. It feels kind of clumpy. It doesn't hurt the child, but it feels it like oh, it seems like there's a big clump of subcutaneous tissue here. You can even see like oh hypertrophy a lot of times and I might wind up doing that when I'm doing virtual visits is just have the kid in the room and say, Show me where you Put your palm but just look to make sure it's not looking clumpy now, I'm not going to do anything. Like make them show me their family or anything like that. But you know, their arms, their belly, that sort of stuff. Yeah, I might do that at the opposite.   Stacey Simms  22:13 That makes a lot of sense, though. You know. And another thing I was looking at my list of questions when we were talking about supplies, one of the interesting things is people seem to be posting quite a bit about not being able to get those little alcohol wipes. Yeah, we haven't used those in a very   religiously for years. Sure, sure. Is that something people need to be concerned about? Should I be getting out the rubbing alcohol and checking to make sure as a pediatric   Dr. Mark Vanderwel  22:36 endocrinologist I should say the standard line Yes, the proper protocol for either giving an insulin injection or putting a new infusion site in or putting a new Dexcom in or poking a finger is to wipe that area with alcohol first. That being said, You are probably not the only family. I take care of Stacy where your child does not use rubbing out Color an alcohol swab every time. So yes, we want clean skin. We know that giving an injection or anything that punctures the skin. without alcohol, there is a slightly increased risk of getting an infected site. There's bacteria everywhere. Obviously there are viruses everywhere. But when we're thinking about using alcohol swabs, we're thinking about killing the bacteria on the skin or removing the bacteria from the skin so that you can give a cleaner injection, or a cleaner infusion site or a cleaning Dexcom or cleaner Dexcom site etc. So if you can't get alcohol swabs, you still need to give your child insulin and you still need to figure out what her blood sugar is. So all in all, what's better to give a shot with alcohol to give a shot without alcohol swabs or to give no shot at all. They go in that order best is with second best is without third best is no insulin at all in that's not best. That's bad news. So   Stacey Simms  24:00 So, you know, another thing, that I have a whole bunch of questions here that I'm trying to get to the right order to go in,   when, when we're talking about these in between visits for a long time, and again, I know that you may be limited as what you can say, because we are talking in official capacity. So some of this is on, you know, I don't say on the record off the record, but you'll understand. So there are a lot of people who are very comfortable adjusting pump settings. Sure. There are a lot of people who aren't, you know, what's your advice for a family? And this was a question that came up in our group. I'll say, Michelle asked this, how do you advise or empower, newer diagnose parents on taking pump settings into their own hands? You know, are there ways to tell when something is a basal issue or a QRP? Sure.   Dr. Mark Vanderwel  24:46 Yeah, so first of all, I'm speaking for myself, I'm not speaking for every pediatric endocrinologist out there. I feel comfortable with my patients adjusting insulin settings without my permission, you do not need my permission to adjust your pump settings or your insulin dose. Is, however other pediatric endocrinologist may feel differently. I'm not speaking for all of us. In general, if your basal rate needs adjustment, that means that your child has been going a long time without eating. And her blood sugar either goes up, or her blood sugar goes down in the absence of all other factors. Best time is overnight. So if your kids waking up with a high blood sugar in the morning or higher than it was when he went to bed, that probably means he needs more basal. If he's waking up with a lower blood sugar than it was when he went to bed in the absence of the correction dose at nighttime, then chances are he needs less basal insulin. And kind of the same thing goes for carb coverage, if you notice every time after a meal, and I'm not talking about just that postprandial spike on a Dexcom because that is related not to the insulin quantity but to the timing of the insulin absorption. But let's say two hours, three hours, three and a half hours after every meal. If your kids blood sugar is going up that means That she needs a stronger carbohydrate factor. And remember, Stacy, I know you've written about this in your book, the factor is the denominator, right. So of insulin to carb ratio of one to 10 is stronger than insulin to carb ratio of one to 15. It's the denominator of the fraction. Similarly, for the instant correction factor, if you're giving a dose of insulin through the pump, or through the sliding scale that you've written down, and your child's blood sugar doesn't come far enough, universally, don't make adjustments based on just one thing, let her wait for a pattern to develop. But if you're noticing that you're that your child's blood sugar never comes down far enough after you give them a correction dose. That means let's make the correction factor stronger. And by that I mean maybe change it from 60 to 50, or from 50 to 40 or from 40 to 35, etc. Vice versa, if you are scared to to give a correction dose because your child's blood sugar because it doesn't come in or comes down too far after for extra dose that make it a little weaker. And by doing that I've seen baby move it from 50 to 60 From 60 to 75, or 75 to 90, etc.   Stacey Simms  27:04 So if you're watching this, and I covered my face and kind of made a joke, the reason is because in the book, I do talk about this, but I have definitely made the mistake of thinking that a smaller number meant less insulin.   Dr. Mark Vanderwel  27:18 So it is confusing. It is it, just think about it in terms of the denominator of the fraction, a half a pizza is bigger than a quarter of a pizza, even though two is smaller than four.   Stacey Simms  27:30 You know, and that brings, I know this, this interview is getting a little bit away from Covid 19. But we've got plenty of time to talk about that. The just a follow up on the calling your physician and you know, there are a lot of wonderful presenters like yourself, who will take a call every day for a month from a nervous mom of a newly diagnosed kid. But there are a lot of parents who worry that they're bothering the doctor for things like that. Obviously, it never bothered me. But all kidding aside, can you assure people that if they're calling for instance adjustments that   Dr. Mark Vanderwel  28:00 it's okay. Yeah, it is absolutely. Okay. Like I said, I want you to feel empowered to do that on your own. But if you need help, we are there to help. And my office still has CDs answering the phone during daytime hours, you can take blood sugars and help make adjustments. The physician on call over the night or weekend can also do that, although it's probably easier to do that during office hours while we have CDs answering the phone because they can pull up the child's chart whereas if you call me on a Saturday afternoon, I'm not going to have your child's chart at my fingertips to make those adjustments. So yes, but please don't feel you are on your own. And please don't feel you are bothering us. Yes, when we take call. We also are seeing patients in the hospital and we are usually seeing patients in the office although now we may be doing more virtual visits. We are doing other things. It's not like all we do is just feel phone calls. We are doing other things and so we appreciate that one. If it's not an emergency, if it can wait until morning. That'd be great to wait until more But there are emergencies. And we also understand that when people have a child with diabetes, they worry at three o'clock in the morning, and if they're worried enough, please call us. Yes, that's what we're there for. But remember, we also are not general pediatricians. And so when it comes to Covid 19, if you are worried that potentially your child may have been 19, that is a better question for your primary care provider rather than us. We are not your general pediatricians. However, if you're feeling like your child was getting sick, and you're having trouble managing their blood sugar's because they're sick. That's a question for us.   Stacey Simms  29:32 Well, and that was what I was just going to ask if someone says, Oh my gosh, I think my child has Covid 19 and they have type one diabetes, what would you advise them to do?   Dr. Mark Vanderwel  29:43 I think we're still learning more and more, you know, testing is not really readily available and everything that I've heard about testing to this point, it's been difficult to get a test now hopefully, that'll change soon. Um, and However, our primary care providers are at the frontline of giving of getting people coded testing. figuring out who needs to be tested? So I would defer that question to your primary care office because they will have the most up to date answers about whether you should simply, well, we should all be quarantined ourselves, right, we should all be practicing social isolation, but especially if you have any suspicion that you or your child has Covid 19 you need to stay in your house. And you do not need to expose any other people to this. So in that situation, though, whether do you bring your kid for a Covid 19 test? Or do you just try to isolate them and pray that they get better and again, they should I mean, kids with type one diabetes are not at greater risk for developing Covid 19 or having the respiratory complications, it just makes them more likely to get ketones. So anyway, um, if your kids healthy enough to just stay at home and continue that quarantine. Right now, that's probably what we're recommending, although things may change anytime,   Stacey Simms  30:57 and I guess you've answered this, but I'm going to ask them Again, just in a different way, to be perfectly clear the evidence as we're speaking right now, would say that if a child comes down with Covid 19 has type one diabetes, there is nothing different   Dr. Mark Vanderwel  31:11 to ground at home. Just Just differently from a diabetes management perspective perspective, make sure they're hydrated check for ketones if they're actually acting sick, even if their blood sugar seems fine. Um, follow your sick day protocol. But yes, nothing different compared to your other children who might not have type one diabetes.   Stacey Simms  31:32 Um, something else I wanted to ask. Gosh, I should have closed the blinds. Whoo. It's getting hot in here. One of the things I meant to ask when you talked about the time in between visits because I had a lot of questions on this in our Facebook group. People are saying like me, Benny's appointment was supposed to be in two weeks, we'll do a virtual visit, but I assume we're not going to get that a one. See that? We usually get quarterly.   Do you? Look we have a CGM so I can see what it probably is. But do you ever recommend a homemade one T tests.   Dr. Mark Vanderwel  32:01 Okay, you and I, about a one says yes, yes. So again, I'm not speaking for every pediatric endocrinologist out there, but people definitely overrate the importance of A1C, and so many people come into my office on pins and needles because they're so nervous about what that number is going to be in. As we've said before, you've heard me say it. And I think that's one of the reasons you and I get along so well is because we have a similar perspective, and everyone has different perspectives. But my perspective is, the ANC is just a number. And it's right now the best number we can get in a six minute turnaround test, tell us to summarize blood sugars, but it's just that it's just a number. And as we have more CGM data available, I think we're going to learn that time and range, maybe an even better predictor of avoidance of long term complications, because that's what we're talking about, right? We're talking about not necessarily trying to get your kids A1C to be less than x. We We are talking about trying to help your child be as healthy as she can be when she is 85 or 90 years old, right? And so it's not about the agency, there are plenty of kids I take care of where I'm worried. This kids having way too many low blood sugars, it's affecting their lifestyle. And I'd be much happier if they're a once you jumped up a half point or a full point if they had fewer low blood sugars. So my perspective on it once you may be different than many of my colleagues, I don't think it's worth it for you to check anyone see in the middle of between office visits, especially if you have the capability of looking at a continuous glucose monitoring system that can tell you time and rich.   Stacey Simms  33:38 Is it homey? Once the test even accurate? I've always wondered about   Dr. Mark Vanderwel  33:41 Yeah, I mean, I think so. I mean, I have not seen I'm sure there are studies out there comparing the home a woman c test to a serum drawn that means coming from your arm type of A1C test versus a finger poke A1C test, which we do in our office. Um, I honestly have not looked at those studies, so I can't answer your question. But my guess is yes, it's probably pretty close. Okay, so   Stacey Simms  34:04 I have another one. You know, all these people in my group know you very well. And the question, I've lost the question, Where did I put it? Ah, here it is. Okay. So it's a two parter. The first part is all about technology. Have you mentioned time and range? You mentioned CGM advice for parents. This is a question who says, Are we overly reliant on technology? Or is that a thing? Does she need to worry about being isolated? If something doesn't work?   Dr. Mark Vanderwel  34:35 Yeah, I mean, you use what you have. I mean, we didn't have dex comes when Benny was first diagnosed. We didn't have insulin pumps, when I was, you know, or there were they were out there, but they were not commonly used when I was a resident. Um, when my senior partner Dr. Parker was doing his medical school, they didn't even have finger stick blood sugars, right. And so diabetes management is changing and we not relying on technology, but the technology has been good. And it's helped make diabetes easier, not a cure, but a little easier unless you become a slave to that technology. And you can definitely overreact to the readings on a Dexcom. I know plenty of people who will not put their phone away because they always want to know what every second what their child's blood sugar is. And that's not healthy either.   Dr. Mark Vanderwel  35:22 I know what you're talking about.   Stacey Simms  35:26 I'm only half kidding. But yeah, nothing really can be a problem. I think the bottom line for that too, is if as you're listening, you think, gosh, I don't even know where our meter is. Or do I have test strips? You know, that's the kind of thing that you'll definitely want   Dr. Mark Vanderwel  35:40 to check but you do need to have a beat. You need to have a meter even when your child wears a Dexcom or a Libra or Medtronic CGM. You will need a backup way to check blood sugar. So yes, please have a meter and strips and lancets that's the finger poker available.   Stacey Simms  35:55 lancets we all have 5000 of those.   Dr. Mark Vanderwel  35:57 Yes.   Dr. Mark Vanderwel  35:59 Last question was Do bow ties help you in your practice?   Stacey Simms  36:03 choice only.   Dr. Mark Vanderwel  36:04 So, my grandfather always wear bow ties, you actually might be able to see him right over here at Grand Prix right over there over my shoulder. Always wear bow ties. Um, and so I got that from him. Um, and someone said, I looked smarter when I bought a bow tie. And I was like, you know, great. I like looking smart, even though I so, but to be honest, yes, um, especially in this age of viral transmission, you're probably not going to see me wear a tie when we do a virtual visit. And you may not see me wear a tie as much in the office in the near future. The reason that many of the pediatricians through Boston Children's Hospital other of the older pediatricians wear bow ties rather than long straight ties is because there's less germs from this than there are from something dangling and so I will for virtual visits, I probably will not I almost certainly will not have a bow tie on and for the for visiting the office, I probably won't either just to have one less thing on mice around me that can collect your   Dr. Mark Vanderwel  37:06 which is your grandfather in the medical field or, you   Dr. Mark Vanderwel  37:09 know, furniture industry.   Stacey Simms  37:13 All right. So before I let you go, because this is the first time I've ever had you on the podcast, hopefully not the last. But you know, it was in the interest of kind of feeling a little strange about, you know, that kind of relationship, my son's endocrinologist and that sort of thing. But now, I this has been great.   I'm curious, you know, you've been in practice for us at 15 years. I finished   Dr. Mark Vanderwel  37:34 my fellowship in 2005. So this is this will be my 15th. year as of July one or the end of my 15th year.   Dr. Mark Vanderwel  37:42 Yeah, we caught you   Dr. Mark Vanderwel  37:44 right at the beginning. Right, exactly. You were one of my may not my very first but one of my first patients now, I shouldn't say that. But yeah,   Stacey Simms  37:51 I mean, in the first couple of years,   Dr. Mark Vanderwel  37:52 right, exactly in the first few years. Exactly. So   Stacey Simms  37:54 I'm curious, you know, it's hard to sum up in just a few minutes, but from then to now. already mentioned the technology have things. It's kind of a pet question. I was gonna say, Have you seen things change, but I really want to know, like, how is it to be a pediatric endocrinologist from then to now? I mean, it's got to be difficult with insurance things and all that sort of stuff. But are you still happy? This is a field you chose?   Dr. Mark Vanderwel  38:20 Yes. I love my job. I love taking care of kids with diabetes. I kids with diabetes are only about 30 to 35% of my patient volume. And so I take care of 60% of other kids that I also love taking care of. It's the dream job. And yeah, I did not grow up thinking I wanted to be a pediatric endocrinology. I didn't know I really wanted to be a doctor. When I was in high school. I mean, there are some people that say they knew it from age two for me, that was not the case. But every step along the way, I've kind of thought yeah, maybe I do want to be a doctor. And then I go to medical school and yeah, maybe I do want to be a pediatrician and then I do my pediatric rescue. See and yeah maybe I do want to become a pediatric specialist etc so each step has kind of led me along the way and it's been a great choice I love taking care of your own as well as the all the other kids that I take care of. It's a dream job except for the paperwork.   Stacey Simms  39:15 Alright, so I'll check in with you again if I can during this time who knows how long we're going to be at home you guys doing? Okay, you can have your own everybody   Dr. Mark Vanderwel  39:22 do everyone's healthy. You know? I mean I I'm worried I mean, not about my kids not necessarily about my health I mean when one of those middle age brackets right but I'm worried about my parents, my grandparents who are still alive, you know, I'm, I am worried about I'm worried about the economy of not only our country, but the world I'm worried about, about the financial well being of my patients, even though I'm you can kind of get the sense I'm not really all that worried about the health of my patients with Covid 19 as long as they Following Sick Day protocols and but that doesn't mean go out and get exposed because obviously we need to contain this virus. I am worried about our world. But I'm not necessarily worried about the children that I take care of related to cope with it and I just don't want them spreading this terms to their grandparents.   Dr. Mark Vanderwel  40:17 I think you're absolutely right on that. Well, we will leave it there. And hopefully we can check back in and I will see you for a virtual visit. I'm sure we'll be hearing from   Dr. Mark Vanderwel  40:28 that.   Stacey Simms  40:31 But I do appreciate it. Thank you so much.   Dr. Mark Vanderwel  40:33 Yes, thanks for getting the word out states you remember, wash your hands stay inside socially distinct yourselves.   Dr. Mark Vanderwel  40:41 But don't forget to call your parents all the people you love.   Dr. Mark Vanderwel  40:50 Diabetes Connections is a production of Stacey Sims media. All Rights Reserved or wrongs avenged   Transcribed by https://otter.ai

In the fourth episode of Specialty Spotlight, Ziad and Christopher interview Dr. Andrea Ens, a Pediatric Endocrinologist at LHSC. A graduate of Schulich, Dr. Ens talks about her career path in Peds and Endocrinology, her experiences being a woman in Medicine, her research involvement in an up and coming field known as Social Pediatrics, and the dynamics of being in a dual-physician household.

  Families are the people we trust to care for us - and for each other - when times become difficult. At Nemours, we serve patient families with care, compassion and experience - and we become families within our own teams.  Nemours associates share the importance of family involvement in the care process, and how the strong bond of trust between teammates ultimately benefits patients.  Featuring: Shara Bialo, MD, Pediatric Endocrinologist, Nemours Speciality Outpatient Clinic, Deptford, New Jersey Keith Fishlock, PhD, APRN, Emergency Department Clinical Specialist, A. I. Dupont Hospital for Children, Wilmington, Delaware The EEG Neurodiagnostic Team, Nemours Children's Hospital, Orlando, Florida: Helen Cano Jennifer Campbell Jessica Cooley Gabriel Guzman Viviana Rico Leslie Rosa

Dr. Paul Hruz, M.D., Ph.D., is the guest on this Episode of Inter Vitam et Mortem: Between Life and Death: Interviews and Discussion with a Catholic Bioethicist. Dr. Paul Hruz is a Pediatric Endocrinologist; as a physician and a scientist, Dr. Hruz is frequently invited to share his expertise as a speaker on the topic of gender dysphoria. Dr. Hruz has authored several scholarly peer-reviewed articles regarding medical treatment of individuals with gender dysphoria. In this episode, Dr. Hruz and Dr. Mary Anne Urlakis discuss the sensitive topic of gender dysphoria; focusing on the bioethical, medical, and human anthropological dimensions of the topic, including need for compassionate pastoral care for individuals who suffer from this condition. (September 2, 2019)

Dr. Ron Rosenfeld has spent over 30 years of his career researching human growth hormones in efforts to understand one of the most fundamental, complex yet poorly understood of the biological processes: growth. We talk with Dr. Rosenfeld to discuss his research breakthrough and the ethical dilemmas that consequentially stemmed from it. Originally aired on 5 April 2019 at KZSU Stanford.

Session 100 Dr. Kara Connelly, a transgender medicine specialist. A pediatric endocrinologist by training in an academic setting, she has been out of training now for six years. Today, we talk about Transgender Medicine, why we have it, and why it's important for transgender patients. [04:13] Interest in Transgender Medicine Kara drew inspiration from patients and their families going through hoops they had to go through to access care. Knowing how challenging and difficult it was, she felt passionate about trying to make healthcare easier and more accessible. Additionally, this was in the realm of pediatric endocrinology that it naturally felt like they could build what they did to help more patients access the care they needed. [05:00] Traits That Lead to Being a Great Transgender Medicine Specialist Communication is the most important piece of being a great transgender medicine specialist. This goes for pediatric endocrinology as well. This being said, you also have to be a good listener and open to hearing people's stories and their needs. You also need to have an open mind in helping them access what they need. With pediatric endocrinology, you have to be able to tailor conversations based on who's listening. Be able to get the same points across to patients across different age ranges. [06:26] Types of Patients Kara mentions that one of the things that has been continuing to shift is where patients are accessing care. In this regard, pediatric patients are different from adult patients. Currently, they see patients as specialty care providers. They're often referred to by their primary care providers who are likely to have not had any training in the area since this wasn't included in their medical training. Not long ago, Kara didn't have any access to transgender medicine when she was a medical student. So it's still relatively new for many pediatricians. A lot of family medicine providers are gaining more experience because of their work with adult transgender patients. But many pediatricians are still wanting to refer to specialty care. As part of pediatric endocrinology, one of the treatments they offer is pubertal suppression or sometimes referred to as puberty blockers. These are medications that pause puberty and used for patients who are not transgender and go through puberty too early. This can also be accessed by transgender youth who don't want to go through the physical puberty changes that are not aligned with their gender identity. They also prescribe prosperity hormones to many patients who are not transgender. The patients come to see them pretty often after 3-4 months. They're prescribing hormones in starting puberty so they build relationships with these patients. For young adult and adult transgender patients, they usually access hormones through their primary care providers. So there are not a lot of adult patients that access these medications from adult endocrinologists. However, there also adult endocrinologists that are active in transgender health. [09:44] Focus on Transgender Health There aren't enough trained providers to be able to provide the care that is needed for this patient population. Kara explains that transgender health will be part of medical training and by that time, there will be more primary care providers with the knowledge and expertise to do the care. Pediatric care is a little bit more complicated than adults. But in adults, it usually involves prescribing hormones and monitoring for side effects which are low and rare. It's easy to get the training that's needed to become an expert in transgender health. So it's just a matter of training people. Taking care of this population is critical because transgender people in the U.S. and in the world, are not able to access a lot of the rights and healthcare that other populations are able to. It's important that as a society, we're able to gain awareness of what this means and how important it is to be able to provide basic healthcare needs to all patients. We have to recognize the significant disparities that transgender patients face by not being able to have their basic healthcare needs met. There are studies demonstrating high rates of transgender patients not accessing basic healthcare. This includes primary care and preventative care – because of the fear that they will be rejected by their healthcare provider or their healthcare clinic setting. [13:43] Typical Day Kara doesn't think she has a typical day. Working in an academic setting, she does clinical care, medical education, and a bit of research.  Clinical care is in the outpatient setting done at the clinic in their hospital. She also travels to three different cities for outreach clinics. She provides pediatric endocrinology care to patients outside of the major city she lives in who don't have access to a specialist. She provides telehealth care where she sees patients from her office while the patients are sitting in a clinic in another city. She also sees patients whenever she's on call providing inpatient service. They mostly see patients children with Type 1 diabetes as well as consults with other services in the hospital. That said, each day is a little bit different in terms of where she's seeing patients or whether she has an admin or nonclinical day. Nonclinical time is spent on scheduled roles with undergraduate medical education. She works with medical students in their preclinical years. She also works the rotation for pediatric endocrinology for students and residents rotating with them. She does didactic teaching, focused primarily on transgender health throughout their hospital and throughout their state. Her research is also primarily focused on transgender health, mentoring students and residents. She also helps oversee projects pediatric endocrinology fellows are doing in their field. [16:15] Academic vs Community Kara chose the academic setting primarily because of her passion for teaching and education. She loves seeing patients. Her primary interest is clinical work but it's not all that she wants to do. Kara wanted to be able to incorporate the education piece and research into her career. And the academic setting is the best place to do this. [16:55] Taking Calls Kara takes calls as a pediatric endocrinologist. She hasn't experienced getting any calls for transgender medicine. As a pediatric endocrinologist, their group takes calls evenly, where they do a week of call at a time. They're the main person somebody will call if they have questions about any of their patients. On the weekends, they see patients in the hospital for a couple of hours. Then she gets to come home and live her life through the rest of the day and the weekend. She doesn't get very many calls so she doesn't really feel it's interrupting her home life.  During the week, it can get pretty busy as they could get inpatient consulting and they still do clinics. So while the weekday calls can be busy, the nights are not too bad. Kara thinks this is partly because they're in an academic setting. They have pediatric endocrinology fellows who take the calls from the patients during the day and night. The attending doesn't get a lot of those calls. Basically, she gets 9 or 10 weeks of calls per year. [19:10] Transgender Medicine as a Full-Time Career Kara does transgender medicine as a pediatric endrocrinologist and sees pediatric patients. A lot of the transgender specialists in the country are trained as adolescent medicine providers. If you want to do this as a full-time career, you can do more of general adolescent pediatric care but also have a special interest in transgender care. Basically, it's up to the individual to decide what percentage of their practice they want to focus on. Moreover, there are different ways to provide care for transgender patients. As they continue to build more capacity for training providers and acceptance and understanding of the needs of this patient population, it will no longer feel as a specialized field. It will feel like being able to prescribe medications for high cholesterol patients. [21:06] Work-Life Balance Kara thinks that one of the best things about pediatric endocrinology is the lifestyle. They have low acuity and high complexity patients. But generally, their patients do well and it's their role to help them stay healthy. She feels their field is very conducive to being able to have a family. She has two young children but still gets to spend time with them even if she works full-time. She may miss out on school activities during the day if she had not been able to plan ahead for them. But she has a lot of vacation time she can use if she knows about activities in advance. Also, when she's on call at night, she never had to go back into the hospital. Even if the patients are sick in the hospital, they have residents seeing them as well as the ICU team. [22:40] Training Path to Becoming a Transgender Medicine Specialist Basically, the training path depends on what specialty somebody wants to go into. If you're interested in transgender medicine, the first question to ask is what patient population, specifically, age, are you interested in working with. What other skills do you hope to attain and have and work on? Kara went into pediatric endocrinology even before she knew about transgender medicine. But she always knew she wanted to work with pediatric patients. She did 3 years of pediatric residency and another 3 years of pediatric endocrinology fellowship. In pediatric endocrinology fellowship, you will likely get training in providing care to transgender youth. In fact, this is one of the things that the Pediatric Endocrine Society is actively working on. They're building a curriculum for pediatric endocrinology fellows where they would have standardized training for transgender care. In the primary care setting, you may do a family medicine residency and then become a family medicine doctor who can see youth and adults and provide transgender care. This may also look the same for somebody who wants to be a general pediatrician and be able to provide transgender care. So they go through three years of pediatric residency and then practice. Surgical care is more specialized and requires additional training. This has not been incorporated into the residency training yet. But there are special training fellowships for gender-affirming surgical care. This can be done after finishing the surgical residency training. At this point, there is no board certification for transgender medicine. There are groups or organizations dedicated to transgender healthcare such as the World Professional Association for Transgender Health (WPATH). It's an organization of professionals dedicated to providing transgender care. To match into pediatric endocrinology from general pediatrics is not very competitive. There are more training physicians than there are applicants. Kara believes that this is a great field to enter if you want your pick as far as training program and where you want to live." The pediatrics side can be competitive depending on which programs you want to apply for. [27:00] Subspecialty Opportunities From a primary care standpoint, you can specialize in transgender care. In pediatric endocrinology, when they're providing care for transgender patients, they do prescription of pubertal suppression medications for different conditions regularly. But it's not really specialized training. [28:34] Bias Against DOs and Working with Primary Care and Other Specialties Kara is not seeing any problems with DOs having access to training. When working with primary care providers, Kara wants them to understand how to create an affirming care environment. People who identify themselves as transgenders want to go into the clinical setting not knowing if they're going to be respected. They have to understand the basic things like using the right names and pronouns and how to ask the questions. They need to make sure all the people the patient is going to encounter are being consistent in being affirming and using the right names and pronouns. Secondly, primary care should be sensitive about physical exams. People who identify as transgender or gender-diverse are often really anxious or uncomfortable about the chest exam or the genital exam. So help them understand the purpose of the exam and why it's necessary. Then make sure they give permission and consensus first before the exam is done. Lastly, when a patient comes in for any reason, focus on the reason why they're there. If they want to start hormones, that's specific to transgender care. This is important for emergency room providers to recognize and just ask the questions pertinent to the reason why they're presenting. Other specialties pediatric endocrinologists work with include general pediatrics, adolescent medicine, psychology, and psychiatry. In transgender health, they have an integrated team of many clinical providers that provide care for all ages. They work closely with primary care providers in family medicine, internal medicine, OB/GYN, urology, and plastic surgery. [32:50] How to Start a Dialogue with Transgender Patients Several clinics use written forms, which is an easy venue for the youth to write things down.  It's important to leave the forms as open as possible so they don't feel like they have to check boxes. For example, it's important not to have a male or female box for gender identity. And specify gender identities separate from sex assigned at birth. Verbally, pediatricians can just ask the youth about their gender identity and whether they feel comfortable with it. And it would feel more natural if this is something you ask all patients. Just opening the space to have that dialogue and making that just a routine part of every well adolescent visit will start to feel more natural. Sometimes, pediatricians could ask very young children (as young as 3 or 4) whether they're a boy or a girl. This is a simple way to open the conversation to very young children. Sometimes, this could be the first place where young children are able to say who they are.  [36:35] Special Opportunities Outside of Clinical Medicine There are tons of opportunities for advocacy and getting closely involved with community partners. You can work on having resources outside of the clinic setting for gender-diverse youth. For example, you can get involved with support groups for parents and youth. [37:34] What She Knows Now that She Wished She Knew Kara finds transgender medicine to be a very rewarding career as you get to build relationships with parents and patients. This is something that she loves about her specialty. And it's really unique for this specific population. Another thing she had no idea about getting into this specialty is how hard and complex the care is. They face so many barriers in terms of getting insurance coverage for some of the basic needs of these patients.  In fact, 30-40% of the care she provides to patients is battling insurance companies just to get approval for basic things. But it's gotten better though. Their state Medicaid plan will cover all transgender-related medications and surgeries. But a lot of commercial insurance plans won't. And if ever they do cover treatments, it can be very costly. Hence, they have a specialized team of people who can work on this aspect. They have a full-time medication authorization specialist who focuses on getting authorizations for the medications prescribed for patients. [40:30] Most and Least Liked Things What she loves most about transgender medicine is being able to develop meaningful relationships with patients. It's great to have a place where they can come and know that every conversation is safe. They can ask any questions. Kara also loves working with families and help them overcome resistance and fears they experience around supporting their child's identity. From the pediatric endocrinology standpoint, Kara loves working with patients of all ages. She loves working with kids that have chronic health conditions and getting to know them over the years. On the flip side, dealing with insurance companies is one of her least liked things. Another thing is the Electronic Health Record. She appreciates it in terms of the way it has improved communication among providers and between patients and providers. But it can be pretty cumbersome and can take up a lot of time. That being said, you have to be really strategic around the ways you use it. In their case, they're building teams consisting of more medical assistants and nurses that can help triage those questions and issues. Nevertheless, if she had to do this all over again, Kara would do it without doubt. [47:00] Final Words of Wisdom Find a mentor or somebody in the field that you respect who's doing something you think you might be interested in. It's so valuable to have a mentor in the field that can help you really understand what that field is like. This could be in the form of shadowing or doing a scholarly project with them. Understand what their life is like and if it's something you want to pursue. Your mentor could also help you make connections with other people, whether it's the same field or a different field. There's so much value in face-to-face contact with people. It's so hard to get swallowed up in the paper of applications without the ability to show who you are as a person and the skills you bring. Links: Meded Media World Professional Association for Transgender Health (WPATH)

Can Puberty Be Stopped? Featuring Dr. Gabrielle Grinstein, MD, Pediatric Endocrinologist, NYU Langone Health

Jake A. Kushner M.D., Medical Director, McNair Interests, provides a thorough overview of his research and study of diabetes. Currently, Dr. Kushner serves as the Medical Director for McNair Interests. He is a renowned diabetes researcher as well as a pediatric endocrinologist with a particular expertise in biotechnology, biomedical research, type 1 diabetes and other specific endocrine disorders. Dr. Kushner is the former Chief of Pediatric Diabetes and Endocrinology and McNair Medical Institute Scholar at the Baylor College of Medicine and Texas Children's Hospital. He has worked with the National Institutes of Health, served on the type 1 diabetes advisory council for Lexicon Corporation, and been a strategic advisor for Sanofi. Dr. Kushner discusses his background as a pediatric endocrinologist and how he came to be interested in the research and study of diabetes. Dr. Kushner is a respected, nationally recognized expert in type 1 diabetes research. His background in medicine is significant and includes endocrinology and diabetes, specifically caring for children with type 1 diabetes, as well as cystic fibrosis-related diabetes, and treating children who have hypoglycemia. He explains type 1 diabetes, and talks about how it affects many people worldwide.  Dr. Kushner delves into the complex issue of insulin and how the body reacts and responds to nutrients. He explains in detail, the storage of glucose, carbohydrates, and how the body processes everything that comes into it, as well as how stress affects everything. He talks at length about the kinds of meals that people eat, and explains how specific foods are processed by the body for use, including what the body needs, especially for those who have special dietary requirements due to health conditions or disease. Dr. Kushner is a UC Berkeley graduate and earned a medical degree from Albany Medical College in New York. Dr. Kushner completed his medical residency in pediatrics at Brown University. Additionally, Dr. Kushner engaged in a clinical fellowship at Children's Hospital Boston and a prestigious research fellowship at the Joslin Diabetes Center, the world's largest diabetes research center, at Harvard Medical School in Boston. 

Pediatric Grand Rounds for Wednesday, February 21, 2018 Samuel J. Casella, MD, MSc. Dr. Casella is the Associate Director of CHaD for Patient Safety and a Pediatric Endocrinologist at the Children’s Hospital at Dartmouth-Hitchcock.

Pediatric Grand Rounds for Wednesday, November 15, 2017, 2017. Our presenter is Frances Lim-Liberty, MD. Dr. Lim-Liberty is a Pediatric Endocrinologist at the Children’s Hospital at Dartmouth-Hitchcock.

A Day in the Life is a podcast for medical students, by medical students, in which attendings are asked about their training and daily life. In this episode, Allison McLellan speaks with Dr.Michelle Y. Rivera-Vega, a pediatric endocrinologist at Nemours Children's Hospital in Orlando, Florida.

A Day in the Life is a podcast for medical students, by medical students, in which attendings are asked about their training and daily life. In this episode, Allison McLellan speaks with Dr. Shilpa Gurnurkar, a pediatric endocrinologist at Nemours Children's Hospital in Orlando, Florida.

Many parents don’t realize the importance of recognizing early onset of puberty and the issues it can cause that persist into adulthood if not diagnosed when still young. There is a misconception that puberty is occurring years earlier than just a decade ago and this is not true. Dr. Jerrold Olshan, Pediatric Endocrinologist and Diabetes specialist with Maine Medical Partners Pediatric Specialty Care is here to discuss the ramifications of early puberty, how it can be treated and what may or may not be contributing to changes when puberty occurs.

Designed with the patient in mind, the Great HeighTS Turner Syndrome Clinic at Children’s Mercy Kansas City is a one-day clinic where patients can see multiple specialists in one, convenient location. Not only does this minimize the number of medical visits for families, but it also gives the girls with this rare disease, and their parents, an opportunity to meet and interact with others who are going through the same situations they are.Joe Cernich, MD, a Pediatric Endocrinologist at Children’s Mercy Kansas City, is here to discuss Turner Syndrome.

This episode is the first in a two part series on Type 1 diabetes. This episode addresses the pathophysiology of T1DM and also reviews acute complications. This podcast was written by Alkarim Velji and Dr. Rose Girgis. Alkarim is a medical student at the University of Alberta. Dr. Girgis is a Pediatric Endocrinologist and Divisional Director of Pediatric Endocrinology at the Stollery Children’s Hospital in Edmonton and an Associate Professor of Pediatrics at the University of Alberta. These podcasts are designed to give medical students an overview of key topics in pediatrics. The audio versions are accessible on iTunes. You can find more great pediatrics content at www.pedscases.com. Related Content: Podcast: Type 2 Diabetes

This episode is the second in a two part series on Type 1 diabetes. This episode addresses insulin therapies and gives an overview of special considerations in the adolescent population. This podcast was written by Alkarim Velji and Dr. Rose Girgis. Alkarim is a medical student at the University of Alberta. Dr. Girgis is a Pediatric Endocrinologist and Divisional Director of Pediatric Endocrinology at the Stollery Children’s Hospital in Edmonton and an Associate Professor of Pediatrics at the University of Alberta. These podcasts are designed to give medical students an overview of key topics in pediatrics. The audio versions are accessible on iTunes. You can find more great pediatrics content at www.pedscases.com. Related Content: Podcast: Type 2 Diabetes

This podcast gives students an overview of childhood obesity.  It covers the increasing prevalence of obesity among children, associated health risks and gives an approach of how to talk to children and their families. This podcast was written by Chantelle Champagne and Dr. Mary Jetha. Chantelle is a medical student at the University of Alberta. Dr. Jetha is a Pediatric Endocrinologist at the Stollery Children’s Hospital in Edmonton and an Assistant Professor of Pediatrics at the University of Alberta. These podcasts are designed to give medical students an overview of key topics in pediatrics. The audio versions are accessible on iTunes. You can find more great pediatrics content at www.pedscases.com. Related Content: Podcast: Physical Activity and Sedetary Behaviour Podcast: Type 2 Diabetes

Gnanagurudasan PrakasamMD (USA) DCH (India) MRCP (UK) MHA (USA)Dr. Prakasam holds an MBBS DCH (India) and MRCP-Pediatrics (UK) and is Board Certified in Pediatrics & Endocrinology in the United States. In addition, he has a Masters in Health Administration (MHA) from the University of Southern California.Dr. Prakasam holds several positions, including Medical Director for the Pediatric Endocrinology, Diabetes and Healthy Life Style program for children at the Sutter Medical Center, and Medical Director for the Telemedicine Program and ehealth for the Sacramento Sierra Region for Sutter Health. He is the Founder and a Member of the Board of Directors for the Subishta Medical Consultancy in India, and also involved in various positions in 2 start ups in the US and one in India. He is currently the Chair of the eHealth Committee at Sutter Health for the region, President of the Leadership Council of American Diabetes Association in Northern California, and a Board Member for the American Heart Association in Sacramento.He successfully started a private endocrine practice in 2001, which now has 4 Pediatric Endocrinologists and five satellite offices, taking care of more than 4,500 patients, over 1,000 with Diabetes. The practice has the biggest pediatric insulin pump program in the western USA and is involved in several clinical trials in the field of diabetes and growth. He organized several comprehensive pediatric endocrine CME programs in Sacramento, and is an active participant of CME programs in several hospitals globally.Dr. Prakasam has started and successfully run a low-cost telemedicine program in India for the past six years. He has cared for more than 400 patients through the system, and conducts low-cost medical education programs from the US and UK.He conceived, designed, and initiated the first multidisciplinary and age appropriate, healthy lifestyle program for children in the Sutter Health system, enabling the first coordinated program between Sutter Health system and CSUS.He started the first telemedicine program at Sutter Medical Center, and wrote the guidelines and advised the formation of the first newborn screening program in Vietnam. He has been the Web Medical Consultant for Magic Foundation, a non-profit organization for children with growth disorders.He sits on the Board, and is a member of Business Improvement and IT Committees for the Children's Specialists of Sacramento Medical Group, and is an Advisory Committee Member for the Pediatric Endocrine Program at Sutter Medical Center. He also serves as an advisor, speaker and marketing consultant for several pharmaceutical companies, while running a unique patient support online program for children with diabetes, lifestyle issues, and growth hormone deficiencies.His current projects involve creating a network for health care in India, his country of origin, by using his multinational experience and eHealth background, and works on consumer and provider web communications.He is happily married for 18 years to a Pediatrician/Entrepreneur, and they have two beautiful children, 15 and 10.