Fifty years ago, type 1 diabetes was the only type of diabetes considered prevalent among children. Today, endocrinologists have seen a dramatic increase in type 2 diabetes among children and adolescents.

“We have seen a 10-fold increase in type 2 diabetes since the early1990s,” said Dr. Michael Gottschalk, director of Rady Children’s Endocrinology/Diabetes Division. “We used to get one or two cases a year and now we see 15 to 20, and it keeps growing.”

Physicians believe type 2 diabetes is linked to the large increase in overweight or obese children. Their goal is to get good weight control with type 2 patients through a balanced diet and exercise.

One of the services the division offers is a diabetes center, which treats more than 500 patients. The diabetes team includes a dietician, social worker, three nurses, who are certified diabetes educators, and six attending physicians. The center has an active program for insulin pumps and offers parents and children diabetes education to learn to manage their diabetes. To optimize blood sugar control, the center also offers continuous glucose-sensor monitoring.

The University of California, San Diego (UCSD) provided endocrinology services at Rady Children’s prior to the UCSD/Children’s merger of pediatric clinical programs in 2001. At that time, the Endocrinology/Diabetes Division became a part of Children’s Specialists of San Diego.

The division supervises an active program for growth hormone replacement and has two research protocols for growth hormone treatment. Rady Children’s is also involved in a new program for evaluating and treating children with early pubertal development.  Dr. Karen Klein specializes in puberty issues. Dr. Ron Newfield has recently opened a Lipid Disorders Clinic on Rady Children’s campus.

Research is an important component of the division. Endocrinologists are involved in a number of national research protocols to assess different types of insulin for type 1 diabetes and oral medications for type 2 diabetes.

Dr. Gottschalk just concluded studies of a new drug for type 2 diabetes that increases the amount of insulin in the body. Dr. Hayek is director of The Islet Research Laboratory at the Whittier Institute, where he is working on a cure for type 1 diabetes.

“Our physicians’ research interests have developed their expertise in treating the diseases we see in our clinical program,” said Dr. Gottschalk. “We participate in both clinical trials and bench research and our discoveries in the lab translate back into clinical trials.”

The division is participating in a four-year NIH preventive medicine grant to study obese children at risk for developing type 2 diabetes. They will enroll 100 children early next year and study how diet and lifestyle changes impact their weight, blood pressure and lipid, glucose and insulin levels.

Attending physicians see patients in San Diego, El Centro, Encinitas and Murrieta.

To schedule an appointment, call central scheduling at (858) 966-5999.

Children's Specialists Division of Endocrinology/Diabetes

© Children's Specialists of San Diego - Physician-to-Physician News - No.8, Fall 2004