Looking for better tests to identify kids with Prediabetes and Type 2 Diabetes

Finding better diabetes testsAs a pediatric endocrinologist, I see many overweight or obese children who are referred for evaluation of prediabetes or type 2 diabetes.

You may be asking, what is type 2 diabetes? It’s the type of diabetes that is associated with carrying excess weight. Only adults used to develop type 2 diabetes, but now unfortunately more and more kids are getting the disease as well.

And what is prediabetes? It’s a condition where individuals don’t have high enough blood glucose levels to be classified as having diabetes, but have a much higher risk of developing type 2 diabetes in the future compared with other kids.

Pediatricians often refer overweight and obese kids to specialists like me for evaluation of these conditions, but they all don’t necessarily need to see us. The problem is that it’s currently hard to distinguish a child with a high BMI who is at risk for developing diabetes from one who is not; if we knew which tests could best identify kids with prediabetes and diabetes, we could save some patients the step of seeing a pediatric endocrinologist, and get the ones who DO need to see a specialist in for an appointment sooner. The challenge is all about getting the right kids to a specialist at the right time, thereby making our healthcare delivery system more efficient and providing better care to those who need it.

Continue reading

My name is Carl, and I study genes that cause brain tumors in my fight to help Block Out Cancer.

Carl Koschmann, MDEarlier this year, I became a Pediatric Neuro-Oncology Fellow at the University of Michigan C.S. Mott Children’s Hospital.

What does this mean exactly? Aside from this bringing yet another year of training (this will be 27th grade for me!), I will spend a year learning how to take care of children diagnosed with brain tumors, working with incredible pediatric neuro-oncology clinicians, Dr. Patricia Robertson and Marcia Leonard, APRN.

In addition to my clinical work, I will also continue working in the Castro/Lowenstein Lab that focuses on learning more about malignant brain tumors. Drs. Lowenstein and Castro have established tremendous success in developing gene therapies to treat brain tumors, one of which is now the basis of a Phase I trial in adult patients here at the University of Michigan. Continue reading

What we know about the respiratory virus EV-D68 (Enterovirus D68)

Enterovirus d68In late August, Children’s Mercy Hospital in Kansas City, Mo., began seeing an unusual number of children experiencing respiratory problems. The patients tested positive on a respiratory panel administered by the hospital, but that panel could not identify the specific virus. Staff sent the samples to the Center for Disease Control and Prevention (CDC) for further analysis. The CDC determined that the patients were suffering from Enterovirus D68 (EV-D68).

There are about 100 different types of Enterovirus. From June to October every year, some type of Enterovirus usually circulates in the United States. If you’ve ever had a summer cold, it was probably caused by an Enterovirus. EV-D68 specifically is something we don’t typically see in the U.S., but it has been around since the 1960s.

While we’ve seen an increase in patient volume at the C.S. Mott Children’s Hospital emergency department and in our Intensive Care Unit, we cannot conclusively say that these patients have EV-D68. The only way to know is to have lab samples examined by the CDC, which we are working on now.

Continue reading

Sharing the voices of children with cancer

Trisha Paul, author of "Chronicling Childhood Cancer"Last year, I was invited to be a guest writer on this blog to talk about my experiences volunteering at Mott Children’s Hospital with children on the pediatric oncology unit and how it inspired me to begin an exciting project to share their stories.

Since that time, we’ve been able to turn our dream into a reality.

Our new book, “Chronicling Childhood Cancer,” has been published and shares the voices of ten youth who were undergoing cancer treatment.

Through verbal conversations, written texts, and/or visual representations, these children with cancer shared with me their personal and intimate experiences.

It has been an honor to listen to these children, to give them a chance to have their voice be heard. The written and drawn narratives in the book, some of which are excerpted in the below slideshow, illuminate aspects of childhood cancer that too often remain hidden.

Continue reading

My name is Kristan, and I help reduce anxiety for kids fighting to Block Out Cancer.

Kristan Freitag, Child Life SpecialistI always knew I wanted to work with children, I just wasn’t sure what avenue that would take. During one of my school breaks my sophomore year at Central Michigan University, I did what is called an alternative break. I joined a group volunteering at St. Jude Children’s Hospital. I fell in love with the Child Life profession while I was there.

I love my job. I first interned at Mott about five years ago and then joined the team as a Child Life Specialist. Today, I work with pediatric patients in our radiation oncology unit. Before I started here, there was not a Child Life Specialist on this unit and about 40 percent of the patients had to be sedated for their radiation treatment. Because most of the kids receive radiation multiple days in a row, sedating them so frequently was a concern. We’ve been able to reduce that to about 2 percent.

Continue reading

What’s in a name? 22q Deletion Syndrome

22q Deletion SyndromeHave you ever heard of DiGeorge syndrome? How about Velocardiofacial syndrome? 22q deletion syndrome? Maybe your answer is yes, but it would not be surprising for the answer to these questions to be no.

That is part of the problem.

One in every 2,000 to 4,000 children born have 22q11.2 deletion syndrome, making it almost as common as Down syndrome. Yet it’s an unfamiliar term to most people.

Continue reading