Divisional Overview
The Division of Pediatric Endocrinology in the Department of Pediatrics is dedicated to improving the health of children through clinical care, teaching, and research.  The faculty in the Division currently includes four pediatric endocrinologists.  In addition, two Pediatric Nurse Practitioners, who are also Certified Diabetes Educators, provide care for children with diabetes.  One clinical nurse performs specialized endocrine function testing, provides education in endocrine disorders, and coordinates the four large post-marketing surveillance programs of growth hormone therapy for the Division.  Two clinical nurses, one of whom is a Certified Diabetes Educator, and an APN clinical nurse specialist (2 FTE) provide in- and out-patient diabetes education, instruct patients in intensive insulin regimens, including CSII, and maintain a high level of in-patient diabetic care through education of the hospital nursing staff.  In addition, a dietitian, a social worker, and a child psychologist are available to offer nutritional guidance and psychosocial evaluation and advice..

Clinical Services
Clinical care for infants, children, and adolescents with growth disorders, complex endocrine system disorders, diabetes, and metabolic bone disease is comprehensive and state-of-the-art.  The Division is an official referral center for the newborn screening programs for the states of Missouri and Illinois.  In calendar year 2007, 5410 new and return out-patient visits were made to the Division’s clinics in the Ambulatory Care Center at Cardinal Glennon Children’s Hospital and in the South County Glennon Care facility.  Children are also seen every other month in a rapidly-expanding outreach program at Southeast Missouri Hospital in Cape Girardeau, MO.  Beginning in August 2008, patients will also be seen in the Glennon Care facility at Anderson Hospital in Maryville, IL.  In addition, one faculty member is responsible for patient care on the in-patient service.  Most newly-diagnosed diabetic children are hospitalized for a brief period to initiate therapy and education.  Consultations to assess and assist in the management of complex in-patients are also provided, as requested by other services. 

To make an appointment, please contact us at one of the following locations:

Medical Education
The teaching programs of the Division of Pediatric Endocrinology are closely intertwined with both the Department of Pediatrics and the Division of Endocrinology in the Department of Internal Medicine.  In addition to departmental conferences, which include Grand Rounds and Practical Pediatrics, eight lectures in the Core Curriculum lecture series for residents and a lecture every 8 weeks for third year medical students are given by Division faculty.  A popular elective is offered to residents, and third and fourth year medical students are supervised in the out-patient clinics.  Finally, the Division assists in the training of fellows from the Division of Endocrinology in the Department of Internal Medicine by its supervision of fellows in a one-month rotation and its participation in a combined case conference monthly.

Research
Members of the Division of Pediatric Endocrinology have participated in clinical trials of growth hormone (GH) therapy and have contributed patient information to post-marketing surveillance programs for many years.  In addition, in response to the growing epidemic of type 2 diabetes in childhood, Division faculty members have participated in industry-sponsored trials investigating drugs for type 2 diabetes in children and are currently participating in the NIH-funded, multi-center TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) Study. 

Highlights:
The research studies of Dr. Susan E. Myers in the Division of Pediatric Endocrinology, Dr. Barbara Y. Whitman, and their collaborators have continued to contribute significantly to our understanding of the efficacy of GH treatment in children and adults with Prader-Willi syndrome (PWS).  In April 2008, Dr. Myers and her colleagues published the results from the United States multi-center trial to evaluate the effectiveness and safety of GH in GH-deficient adults with Prader-Willi syndrome (J Clin Endocrinol Metab 2008; 93:1238-1245).  A 12-month open-label trial with 6-month dose-optimization and 6-month stable-treatment periods was conducted at out-patient facilities at four U.S. academic medical centers.  Lean and obese adults with Prader-Willi syndrome with diverse cognitive skills, behavioral traits, and living arrangements were recruited from clinical populations.  Human recombinant GH was initiated at 0.2 mg/day and was increased in monthly 0.2-mg increments to a maximum of 1.0 mg/day, as tolerated.  The study demonstrated that GH improves body composition, normalizes T3, and is well tolerated without glucose impairment in adults with Prader-Willi syndrome.
Dr. Sherida E. Tollefsen is the principle investigator and Dr. David P. Dempsher is the co-investigator of the Saint Louis University site of a large multi-center study entitled "Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY)", which is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health.  This study represents the treatment arm of Studies to Treat Or Prevent Pediatric Type 2 Diabetes (STOPP-T2D).  The research protocol is designed to evaluate the efficacy of three treatment regimens (metformin alone, metformin plus rosiglitazone, and metformin plus intensive lifestyle intervention) on time to treatment failure based on glycemic control.  Secondary aims are as follows: to compare and evaluate the safety of the three treatment regimens; to compare the effects of the three treatments on the pathophysiology of type 2 diabetes; to evaluate the influence of individual and family behaviors on treatment response; and to compare the relative cost effectiveness of the three treatment regimens.  Nationwide, 750 subjects will be randomized into one of these treatment regimens and followed for at least two years.  By the end of the 2007-2008 academic year, 51 subjects had been screened, 45 subjects proceeded to run-in, and 35 subjects had been randomized at the SLU site.  Dr. Tollefsen is a member of the Steering Committee and chairs the Laboratory Monitoring Committee for the TODAY Study Group.

Faculty
Sherida E. Tollefsen, MD, Director
Susan E. Myers, MD
David P. Dempsher, MD, PhD
Mark C. Eddy, MD

Medical Secretary
Pamela Ahlf

Senior Patient Coordinator
Rosie Williams

Nursing Staff
Bonnie Wolff, RN,CPNP, CDE                
Laura Meier, RN, CPNP, CDE
Cherie Smith, RN, BSN                    
Emily Laughter, RN, CPNP
Melody Williamson, RN, BSN, CDE
Michele Lewis, RN, BSN

Return to Divisions Main Page