Meet Tiffany Grant, Kovler’s New Associate Director of Clinical Research!

Ms. Tiffany Grant!

Kovler is thrilled to announce that Tiffany Grant, RN, FNP has joined the University of Chicago Kovler Diabetes Center’s team as Associate Director of Clinical Research! At Kovler, more than 150 scientists work toward novel treatments, prevention and even potential cures for type 1 and 2 diabetes, obesity, and diabetic complications. Indeed, along with providing our patients with the best quality care, Kovler also constantly strives to remain at the forefront of diabetes research. Under Tiffany’s guidance in clinical research, Kovler is confident that we are well-headed that direction.

Tiffany received her BSN and FNP degrees from Rush College of Nursing and have been in the medical profession since 2003. Over the last ten years, she has worked in a variety of clinical settings including Rush Medical Center , a private family practice clinic, Walgreens Take Care Clinics, and at Radiant Research in Chicago . Although she has had experience with various therapeutic areas, for Tiffany, diabetes has always been her personal passion, and she is delighted to bring her experiences and passion to Kovler as the newest member of the Kovler team! Here is what Tiffany has to say about her new role at Kovler:

Tiffany, what do you hope to gain out of this new experience with working for Kovler?
I am incredibly excited to be collaborating with Kovler’s world-renowned team and hope to bring energy and vision to the role clinical trials play in developing new tools for management and treatment of diabetes and other endocrine disorders.

We know that you have just started working this new position recently, but we would love to know what a typical work day for you would look like! What are some things that you are working on right now?
At the moment my days consist of further familiarizing myself with all the outstanding work being done by Kovler in clinical care, research, education and community engagement. In addition, I am collaborating with members of the Kovler staff and the Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism as we collectively work towards creating a more streamlined and uniform program for the initiation, management and development of sponsored and investigator-initiated diabetes clinical research.

Current research underway at the Kovler Diabetes Center covers most aspects of pediatric and adult diabetes and obesity at both the clinical and basic laboratory levels. For more information about Kovler’s team of scientists and our areas of research, visit our page at http://kovlerdiabetescenter.org/home/about-us/our-scientists/ !

Reflecting on 2012, Looking Forward to 2013!

As we come to the end of the year, the Kovler Diabetes Center at the University of Chicago has much to celebrate.

In 2012, our doctors and nurses treated thousands of individuals with diabetes. Diabetes experts also established or strengthened clinical partnerships throughout the world and provided diabetes management and prevention education at events large and small across Chicagoland and the U.S. You can read more about the amazing work over the last fiscal year in our first-ever Kovler Annual Report.

Based in the heart of one of the world’s great academic institutions, Kovler scientists are doing innovative research informed by a century of scientific discoveries and breakthroughs at University of Chicago. Our genetics team recently identified new genes that cause diabetes. Their work could lead one day to a better understanding of the effects of gene mutations on insulin production and metabolism, and provide pathways to treatments that once seemed unimaginable.

Alongside research, this type of outstanding, personalized patient care is at the heart of Kovler’s mission. From infants through adulthood, we provide the nation’s only fully-integrated pediatric and adult diabetes programs. Our Family Behavioral Health and Wellness Program is forging a national model for family-centered diabetes care. And three doctors in the Kovler Diabetes Center, including director, Dr. Lou Philipson, were recognized by U.S. News & World Report in its ranking of the nation’s top physicians in the field.

This year, we launched critical initiatives including our volunteer initiative Kovler Krew, InTransit Teen Advisory Panel, Peer to Peer program in our Southside Community and held multiple Kovler for Kids events throughout the city. To learn more about the work we do and ways to get involved, visit the Kovler website. You may also contact Peggy Hasenauer, Executive Director, directly via email peggy.hasenauer@uchospitals.edu or by calling 773.834.4789.

This year, as you and your family choose charitable causes, we hope you will consider Kovler Diabetes Center.  Your charitable support is critical to expanding clinical research programs and telemedicine initiatives, as Kovler’s leadership embarks on an expanded model for virtual diabetes care and greater access to diabetes clinical trials – bringing new discoveries and possible cures directly to those with diabetes.  For more ways to learn how to give to Kovler, please visit this website and be sure to note Kovler in the memo section.

From the Kovler Diabetes Center Family to yours, we wish you a wonderful holiday season and happy New Year filled with health and happiness.

Peggy Hasenauer, MS, RN
Executive Director
The University of Chicago Kovler Diabetes Center

World Diabetes Day 2012: A Message From Kovler

To our friends-

Dr. Philipson and I just returned from a press conference to celebrate Illinois’ Diabetes Awareness Day (& World Diabetes Day) at the Thompson Center with Governor Quinn.  Distinguished guest speakers included our own Lou Philipson, alongside the new IL Dept of Public Health Commissioner, IL House Leader Tom Cross, and young diabetes advocate and ADA camper Katie Ervin.  Tune in to your news this evening to see if we get picked up!

The room was full of energy and our speakers created a much needed sense of urgency around diabetes in IL.  Thanks to our partners with the IL Diabetes Policy Coalition, the ADA, JDRF and NKFI, we have developed a tradition of partnership in Chicago and IL that will carry on in the years to come.

In addition, I want to thank all of you for your tremendous work to support Kovler and the entire diabetes community. We will connect soon re: our year-end annual report, and we are brimming with great ideas and great connections for 2013 and look forward to sharing those with you.

Thank you again,

Peggy

Peggy Hasenauer, MS, RN

Executive Director

University of Chicago

Kovler Diabetes Center

Kovler Nutrition Tips in Action: Carrot Muffins

In addition to the outstanding classes that are offered by Kovler’s certified diabetes educators, our American Diabetes Association recognized team frequently lends their expertise to our social media community by sharing nutrition tips on Facebook, Twitter, and the KovlerDaily blog!  I was recently inspired by an intriguing piece of advice:

Upon reading the tweet, I decided to test out the suggestion in my own kitchen. With guidance from educator Julia Socke, I made several modifications to a recipe for a favorite treat of mine – carrot muffins – and was able to determine the extent to which those modifications improved the treat’s nutritional value!

The Ingredient List:

1 cup raisins (I used ¾ cup of raisins and added ¾ cup of chopped walnuts for protein)
2 cups warm water
2 cups all-purpose flour
1 tablespoon baking powder
2 teaspoons baking soda
1 teaspoon salt
1 teaspoon ground cinnamon
4 eggs
1 cup vegetable oil (I used 1 cup of applesauce, per the tweeted advice!)
¾ cup brown sugar
3 cups shredded carrots

The finished product definitely passed my taste test, but I wanted to know exactly how much of a difference was made by the recommended modifications! After reviewing both the original recipe and the modified version, Julia delivered some impressive news.

The Modified Muffins

 

 Her advice:

1. Decreased the calories by 32%
2. Reduced both total and saturated fat by 66%
3. Reduced trans fat by 100%
4. Increased fiber by 24%
5. Increased protein by 18%

I am amazed by the health benefits that can come from a 140 character tweet, and I will definitely continue using the advice of Kovler’s nutritionists in the future. Thanks, Julia!

     -Kirsten Gindler, Kovler Collegiate Extern

To make Julia and Kirsten’s modified carrot muffin recipe: 

1. Combine raisins and water in a small bowl. Let soak for 15 minutes. Drain raisins, discard water and set raisins aside.
2. Preheat oven to 350 degrees F (175 degrees C). Grease muffin cups or line with papermuffin liners.
3. In a large bowl, sift together flour, baking powder, baking soda, salt and cinnamon. In a separate bowl, combine eggs, apple sauce and brown sugar; beat well. Combine egg mixture and flour mixture; mix just until moistened. Fold in carrots and drained raisins. Spoon into prepared muffin cups.
4. Bake in preheated oven for 20 to 30 minutes.

Meet Kirsten: A Kovler Extern

My name is Kirsten Gindler and I am in my second year at the University of Chicago.

Over the past several years, I have become passionate about the ways in which nutrition and lifestyle choices impact the health of communities and individuals. This has motivated my educational objectives as a public policy student, but also my enthusiasm for the work that the Kovler Diabetes Center is doing in the diabetes community, a vast and diverse group of people whose members include loved ones such as my childhood best friend and several of my relatives.

I do not have diabetes, so when I started at Kovler, one of my first objectives was to learn as much as I could about the disease that we work so hard to treat, prevent, and cure. Here are a few of the things that I learned:

• Diabetes is one of the fastest growing chronic diseases in the world, and it affects 8.3% of the U.S. population.
• Diabetes accounts for almost $200 billion in medical costs per year in the U.S. This includes direct costs, as well as indirect costs such as disability and work loss.
• While diabetes may cause many complications, these risks can be minimized by proper care and treatment.
• Healthy lifestyle choices, such as weight loss, physical activity, and good nutrition, cause significant reductions in the development of type 2 diabetes. These interventions are significantly more cost-effective than medications!

Attentive, comprehensive care and community education are essential to the health and success of the diabetes community! At Kovler, our approach combines the excellence of our physicians and nurses, the innovation of our educational programming, and the century-long tradition of our research to provide the highest level of diabetes care from infancy through adulthood.

I am so proud to support this mission as a member of the Kovler team!

To learn more, please take a moment to read over the 2011 National Diabetes Fact Sheet: National estimates and general information on diabetes and prediabetes in the United States, published by the Centers for Disease Control and Prevention.

Meet Maura: A Kovler Extern

Hi, my name is Maura Connors and I am excited to be an extern at the Kovler Diabetes Center! I am a rising second year at the University of Chicago and am planning to major in Geographical Studies, with the hopes of pursuing a career in marketing, advertising, and public relations.

Diabetes is such a widespread issue that affects friends in my sorority and some of my family members. I am very excited to work at an institution that is on the forefront of new advances and treatments for diabetes, as I know how much of an impact these discoveries could have on the lives of my loved ones. I love working with the other Kovler Collegiate Extern team members to organize events (like the upcoming Comer Classic and JDRF Walk), in addition to working with the social media team to promote Kovler events and programs (including our teen advisory panel, “InTransit”). I am eager to learn more about diabetes and gain experience in the field I hope to eventually work in!

Meet Carrie: A Kovler Extern

Hi, I am Carrie, and I am very excited to be working for Kovler as a communications extern! I am currently studying biological sciences and visual arts at the University of Chicago, and I plan on going to medical school after graduation.

My work at Kovler has not only given me a better understanding of diabetes, but has also opened my eyes to the everyday struggles of those who are affected by the disease. Thus, it is very important to me that all patients have equal access to support for their condition as well as key resources for their treatments. Needless to say and perhaps what makes my job at Kovler so enjoyable is that Kovler, too, passionately champions these goals.

Currently, Kovler hopes to extend diabetes resources and care globally to the underserved. In China for example, studies have shown that the prevalence of diabetes in people over the age of 20 has increased to about 9.7 percent in the recent years. Among those who are affected by diabetes, a shocking 60 percent are undiagnosed—this means that about 92.4 million people have the disease, and about 56 million are untreated! These alarming statistics translate to the need for immediate action, and has spurred Kovler’s interest in a potential collaboration with the University of Chicago Center in Beijing to promote wellness events and conferences that would ultimately engage scholars and the Chinese public.

Very soon, I will be meeting with the Office for International Patients on the University campus to discuss the ongoing care for international diabetes patients, and the possibility for Kovler to be involved in an international effort to help diabetes patients.

My work at Kovler will also give me the opportunity to represent diabetes patients through photography. I hope to capture the not only the struggles of those affected by the disease that I hope will advocate access to quality diabetes care, but also their triumphs that I hope will be an inspiration for everyone. Not only has working for Kovler given me the ideal balance between the medical and visual disciplines that I hope to achieve in my future career, working for Kovler has been—and I expect that it will continue to be—very rewarding experience.

Kovler Hosts Conference on Diabetic Nephropathy

We are excited to announce that the Kovler Diabetes Center, in partnership with the ASH Comprehensive Hypertension Center, hosted an August 9^th conference exploring the topic of diabetic nephropathy. This conference brought together some of the brightest scientific minds to discuss issues surrounding kidney function and diabetes. Topics of discussion included nephropathy progression, biomarkers, nomenclature and clinical trials.

The University of Chicago Medicine’s very own Louis Philipson, MD, PhD, FACP, George Bakris, MD, and Michael Eadon, MD presented their work, elucidating the importance of kidney care among populations living with diabetes.

Dr. Louis Philipson

Dr. Philipson, director of the Kovler Diabetes Center and Professor of Medicine and Pediatrics, centered his portion of the conference around the importance of glycemic control in relation to nephropathy progression. Dr. Eadon’s presentation focused on the assessment of kidney function, the comparison of old and new biomarkers and their abilities to predict nephropathy progression, and decisions regarding renal imaging. Dr. Eadon is a nephrology fellow at the University of Chicago. Finally, Dr. Bakris, director of the ASH Comprehensive Hypertension Center, presented fascinating information on topics including nomenclature of nephropathy staging, surrogate markers of nephropathy progression,  and an interactive case presentation.

Team Members Carrie & Jasmine

Conference-goers spent the entire day with our University’s presenters, arriving at the Knapp Center for Biomedical Research and Discovery at 8:30 AM and departing from the Center at 4:00 PM.

Kovler feels privileged to have been able to play a part in furthering education on the relationship between diabetes and kidney disease.

The “Wrong Call”: Mistaking Type 2 for Type 1

Many have asked me about this week about the recent article in the WSJ that was generated from a recent piece that pointed out how type 1 diabetes can sometimes be missed when an adult is thought to have type 2 diabetes. This is nothing new, sadly, but the rising incidence of type 1 as well as type 2 diabetes makes this a critical point to reconsider. Mistaking Type 2 for Type 1 is a potentially fatal error.

At Kovler, we know there in fact many kinds of diabetes and at least some of them can be seen at any age. As the WSJ article correctly points out, Type 1 diabetes use to be to thought of as occurring primarily in children, but this was always a misconception. While the peak ages for type 1 diabetes occur in the childhood to adolescent age group, I have had adult patients as old as 80 years of age receive a new diagnosis Type 1.

The first thing (but not the only thing!) to consider is the BMI (body mass index). Lean patients are much more likely to have type 1 diabetes or some other form of insulin-deficient diabetes (like monogenic, see below).  If the blood sugar is over 250 mg/dl it is very important to consider getting ketone levels. A positive test for acetone or other ketones is not definitive for type 1 but it should raise suspicions when the blood sugar is high.  Adults with type 1 often have a much slower time of progression of their disease, which can also be confusing. Children can appear to develop diabetes practically overnight requiring insulin right away, whereas adults with type 1 might take several years of progressive failure of one oral agent after another until insulin is finally started. This is also known as LADA – latent adult onset diabetes with autoimmunity. The autoimmunity part is really critical. Most but not all patients with type 1 will be positive for auto-antibodies against proteins of the beta cell. Typically we test for anti-GAD65, anti-IA2, anti-insulin, anti-ICA, and/or antiZnT8 antibodies. A positive test in any one of these is consistent with autoimmune type 1 diabetes, and insulin is the only appropriate therapy, although combinations that include insulin can often be helpful. The family history can also provide important  insights. Patients with type 2 diabetes actually have a positive family history of type 2 diabetes much often than patients with type 1 diabetes. Finally in some cases measuring the insulin levels can be helpful if they are high or very low. This is usually done by measuring the c-peptide level, a by-product of insulin secretion that was discovered at the University of Chicago. There are many caveats to this test so by itself it might be misleading in a non-research setting.

I should point out that there are other important forms of diabetes. Most primary care providers would be familiar with steroid-induced diabetes and gestational diabetes. While steroid-induced is a form of Type 2, gestational could be either type 1 or type 2 or monogenic and should be investigated further. Diabetes can also be associated with acromegaly, thyroid disease, and cystic fibrosis, for example.

Our team studies rare forms of diabetes that are strongly inherited – the monogenic forms. These are described on our website www.monogenicdiabetes.org, and several of them were also discovered here at the University of Chicago. These also have the hallmarks of young onset, are antibody negative, and usually positive for tests of insulin production such as the c-peptide test. They are important because they can have specific outcomes, specific treatments, and specific associated factors. They also tell us about genes that are important for normal metabolism. They occur in about 2% of everyone with diabetes, meaning about 3-500,000 people in the United States alone have one of these forms – a significant number that is largely missed.

The bottom line here is that Type 1 diabetes is increasing  in many populations, although perhaps not as dramatically as Type 2 diabetes associated with obesity. Missing type 1 diabetes can be a disaster, or at best a multiyear confusion. What I teach is that it is always important to ask oneself why a given patient has diabetes and what kind they have. Do not assume. If you have doubts, get another opinion, or get a referral to a see a specialist. Persistence can be life-saving.

Lou Philipson

Louis Philipson, M.D., Ph.D., FACP
Professor
Departments of Medicine and Pediatrics- Section of Endocrinology, Diabetes and Metabolism
Director, Kovler Diabetes Center

Introducing Emily: a Kovler Summer Intern

Hello, my name is Emily and I have been working here at Kovler for a little over a month and a half now.  Each day when I walk into work, I am astonished at how awesome this institution is and cannot believe I am able to work here.  Coming into this internship, I was very nervous about the types of things I would be doing and the people I was going to be working with.  Not having diabetes myself and with only a small amount of experience, I was nervous yet excited to begin.

Being a Nursing major my understanding of diabetes has mostly come from my textbooks, and the clinicals I have completed.  This pasted spring I worked on a Cardiac-Pulmonary floor and received the opportunity to care for numerous patients with diabetes.  I was able to assist them in managing their blood glucose levels within the hospital in addition to promoting healthy lifestyles once these patients were discharged.  With what felt like an abundance of knowledge I decided to take the opportunity to come work for Kovler.  But little did I know that I would become even more acquainted with diabetes.

Throughout my time here, I have found a deeper respect for patients with diabetes and the care that these patients need.  I also have so much admiration for the doctors working within Kovler, who have made ground-breaking discoveries through their research.  It’s so incredible and interesting!  Lastly, working with the members of Kovler has shed a new light on proving care.  The people here at the Kovler Diabetes Center are so passionate about what they do and it is incredible to see how they can make a difference for each individual they care for, educate, and support.  I hope to do the same in my own career.

While working close with these members, especially Peggy Hasenauer, I have helped to launch two substantial programs for Kovler this summer: Kovler Krew and the Diabetes All-Star Peer-to-Peer Program.  Both new projects have made great progress so far and we are excited to see where they are headed!

Kovler Krew, a volunteer program, provides members of the community a chance to offer their time, support, and knowledge to assist the Kovler Diabetes Center in expanding its community presence, and helping educate and support patients all throughout Chicago.  Volunteers play a large role in the Kovler team and we are very thankful for those that choose to do so.

The second program, Diabetes All-Star Peer-to-Peer Program is a peer-to-peer mentoring program for Kovler patients from the south side of Chicago who have type 2-diabetes. We believe that through this mentorship our patients, who have struggled in the past, will achieve confidence and stability in managing their diabetes and continue to live healthy lifestyles.

Working with these volunteers and patients, I hope to strengthen the Kovler Team and to build the Kovler connection throughout the Chicago-land area. It has been great seeing the progression of these programs so far, and I am eager to see what else the rest of the summer has to offer.