A New Epidemic- Baystate is Well-positioned to Combat Type II Diabetes in Children
Last month it was announced that Baystate Children’s Hospital, in its first-ever recognition by the magazine, had been named in the U.S. News & World Report’s 2013-14 Best Children’s Hospitals rankings.
As chief of the Division of Pediatric Endocrinology, I am pleased to say that our hospital ranked 34th nationally in care for children in the pediatric diabetes and endocrinology specialty.
What makes this recognition especially satisfying is that, after providing answers and data in an extensive questionnaire — questions about our facility and programs, the volumes of patients with different diagnoses seen and cared for at our hospital, as well as their outcomes, among other questions — we learned that, when compared to other top programs in the country, we rank among the best. In order to score well, a hospital needs to have a big-enough program to offer state-of-the-art diagnosis and treatment for a variety of endocrine problems, some of them quite rare. And what this ranking tells the public is that they will find world-class care in the treatment of pediatric endocrinology disorders at Baystate Children’s Hospital.
Children coping with diabetes and other endocrine disorders require a high level of specialized expertise. And we see time and again that having this level of expertise here in Western Mass. makes a tremendous difference in helping kids and families manage these health challenges. In addition to the health impact of the care itself, it also saves time in the care and expense — and gives the kids more time to be kids and enjoy time with family and friends.
Our ranking also comes at an important time in the practice of pediatric endocrinology, especially as type II diabetes, once seen mainly in adults and formerly referred to as adult-onset diabetes, has now been declared a new epidemic in children and young adults.
Diabetes is one of the most common chronic diseases in children and adolescents, with about 151,000 people below the age of 20 years so afflicted. And there are no signs of the numbers slowing in children. Our goal as pediatricians is to diagnose as many children as possible with any nuances of type I diabetes before they exhibit any serious symptoms. We look to parents to identify symptoms as early as possible and to make an appointment with their child’s pediatrician.
When most children are diagnosed with diabetes, more often than not, it is assumed to be type I. However, there has been a worldwide explosion over the past few decades in the incidence of type II diabetes among young people. This has been attributed to a sedentary lifestyle devoid of exercise and too much time spent in front of the television or computer, combined with a diet rich in fast foods, leading to many overweight and obese kids.
In addition to diabetes, over the years referrals for early puberty, especially in girls, have been increasing. While doctors continue their research into this problem, we do know that, similar to the increase in type II diabetes, obesity may play a role, as well as possible environmental exposures.
Our program is composed of a team of doctors, nurses, certified diabetes educators, nutritionists, a social worker, and a staff who care deeply about the children and families that they serve. More than 500 children and adolescents with diabetes receive intensive, personalized care from this team. Children with aberrations in growth or puberty; thyroid, adrenal, or pituitary dysfunction; and myriad other endocrine issues are referred to us for consultation by pediatric primary-care practitioners throughout the region.
In addition to the specialized expertise we provide — we see children and families from as far away as New York, Southern N.H., Vermont, and Northern Conn. — one of the unique qualities of our program is our outreach into the community. We have endocrine programs in Pittsfield and Deerfield, and, beginning this summer, we’ll see patients in Northampton.
Also, with partial support from a grant from the Mass. Department of Public Health, the Baystate Children’s Hospital diabetes team has partnered with school nurses in Springfield and surrounding cities and towns to bring diabetes care to the schools. Dr. Rushika Conroy, a pediatric endocrinologist with a special interest in obesity and metabolic diseases, oversees our type II diabetes clinic, as well as a new bariatric-surgery program for older adolescents. And Dr. Kinga Pluta, who is trained in both pediatric and adult medicine, has a special interest in type I diabetes and is a certified diabetes educator and expert in insulin-pump therapy.
As the area’s only academic medical center, we train the next generation of doctors, and that includes pediatric endocrinologists through a fellowship program, which I oversee. Two recent graduates have remained with us here in Western Mass. at Baystate to serve the many children and families in our community. Dr. Ksenia Tonyushkina has a special interest in thyroid disorders in children and, in collaboration with the Mass. State Newborn Screening Program and other tertiary-care centers in the state, is studying the course of congenital hypothyroidism.
Also, Dr. Chelsea Gordner has developed and runs a transition clinic which helps adolescents with chronic endocrine conditions more easily navigate a successful passage into young adulthood. And Dr. Edward Reiter is nationally known for his work in the areas of human-growth-hormone deficiency and puberty disorders.
What I would also like to emphasize in our treatment is not just our many positive outcomes, but something else that makes us very strong —and that is the incredible dedication of our team members who often go that extra mile for families. There have been instances when our nurses and staff have provided free medical supplies to families in desperate need who could not afford them at the time. Some of our nurses have also traveled out to the patient, as far away as Deerfield, in order to make a needed blood draw when transportation to our office was an issue. And there are plenty of other seemingly small things that mean so much to our patients, such as taking the time to entertain a nervous child or fitting in a family who has shown up a day or so late, or even early, for their appointment.
Parents interested in more information about our services for children with endocrine disorders can visit www.baystatehealth.org/
Holley Allen is chief of the Division of Pediatric Endocrinology at Baystate Children’s Hospital.
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