Meeting the Needs of All Children With Endocrine Disorders
Pediatric endocrine disorders such as diabetes and thyroid disease present physicians with unique challenges. Across the eight locations of the Division of Pediatric Endocrinology at Nicklaus Children’s Hospital, our specialists provide comprehensive, multidisciplinary care for a complete spectrum of endocrine disorders for children from infancy through adolescence.
When we think about pediatric endocrinology, the first thing that comes to mind is diabetes,” says Alejandro Diaz, MD, Director of the Division of Endocrinology at Nicklaus Children’s. “We offer complete diabetes care at our accredited Diabetes Treatment Center, but our services also extend to a wide array of other pediatric conditions, including thyroid problems, precocious puberty, short stature and many more.”
Personalized Care for Children with Diabetes
When a child is diagnosed with Type 1 or Type 2 diabetes, many factors must be considered, and finding the right treatment plan can prove challenging. At our accredited Pediatric Diabetes Treatment Center, we take every child’s unique needs into consideration and work together with the child and the child’s family to determine the best course of action. Care plans include not just medication, but also guidance for eating, learning, exercising and playing.
We have a multidisciplinary team, including endocrinologists, nurse practitioners, nutritionists, social workers, psychologists and diabetes educators,” Dr. Diaz says. “We also have experienced navigators who help patients with new-onset diabetes in the hospital from admission through discharge. Our team coordinates psychological, physical and social aspects of care for each patient. We give children and their families access to the programs and support they need.”
The team at Nicklaus Children’s also ensures that families have all the tools and education necessary to manage diabetes at home. Most patients start with insulin injections and then have the option of transitioning to continuous insulin infusion using insulin pumps.
Most patients make the transition to pumps, and we have a comprehensive training process,” Dr. Diaz says. “A continuous glucose monitor then gives us updates every five minutes, 24/7. This tool has changed the way diabetes is treated.”
When a patient approaches the age of adult care, the team helps the process go smoothly by preparing them for the transition.
We have a transition clinic in which we educate patients going into adult care,” says Adriana Carrillo Iregui, MD, Medical Director of the Diabetes Program at Nicklaus Children’s. “We also ensure that the patient has an adult endocrinologist before they leave pediatric care.”
The team has specialized clinics as well, including Type 1 diabetes clinics and another clinic, sponsored by the Miami Dolphins, tailored to the needs of Black patients.
Continuing Advancements
The team at Nicklaus Children’s is dedicated to advancing treatments for pediatric diabetes.
“Our center participates in innovative clinical trials and national research,” Dr. Carrillo Iregui says. “We specifically focus on new approaches to care for Type 1 diabetes, and we have had excellent results.”
Nicklaus Children’s is a member of TrialNet, an international network of prominent academic institutions, scientists, physicians and healthcare teams dedicated to the long-term goal of eliminating Type 1 diabetes.
Through this important research program, we offer access to Pathway for Prevention, in which all first relatives of children with Type 1 diabetes are screened for the antibodies that predispose them to having diabetes,” Dr. Diaz says. “There are now medications we can offer them to try to postpone the beginning of this condition.”
The program also gives researchers insight into how Type 1 diabetes develops, opening the door for new studies that could investigate preventive steps.
The team at Nicklaus Children’s also focuses on research targeting pediatric thyroid cancer.
We have access to molecular analysis of all patients with thyroid cancer, which is something novel,” Dr. Diaz says. “We have pioneered molecular studies that help us determine the outcome of procedures and the chances of a cancer metastasizing.”
Other Conditions and Specialty Programs
The scope of care at the Division of Pediatric Endocrinology goes beyond diabetes. Experienced specialists offer diagnostic, treatment and consulting services for a wide range of conditions, including adrenal, endocrine, growth, pituitary gland, sexual development and thyroid disorders.
Specific conditions treated include:
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Addison’s disease
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Ambiguous genitalia
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Congenital adrenal hyperplasia
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Delayed puberty/sexual development
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Endometriosis
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Fat atrophy
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Growth hormone deficiency
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Hypoglycemia
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Hypothyroidism/hyperthyroidism
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Mastalgia
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Precocious puberty
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Schwachman-Diamond syndrome
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Skeletal dysplasia
The team also has multidisciplinary clinics for patients with rare sex chromosome aneuploidy syndromes, including Turner syndrome and Klinefelter syndrome, as well as 22q11.2 deletion syndrome.
Treatments range from the latest drug therapies to advanced surgical procedures. At the Thyroid and Endocrine Surgery Center, our team manages thyroid and endocrine disorders requiring surgical intervention. We also provide radiation therapy and surgical treatment for patients with thyroid cancer.
“At Nicklaus Children’s, children with thyroid cancer benefit from highly experienced physicians and specialists working together to develop treatment plans,” Dr. Diaz says. “We have weekly meetings where everyone communicates with each other about complex cases. The beauty of our program is that everyone is involved. Our specialists are in constant contact with each other.”
Cases of thyroid cancer requiring surgery are handled by a high-volume surgeon with expertise in pediatric thyroid cancer.
To learn more about the Division of Pediatric Endocrinology at Nicklaus Children’s, email one of our physician liaisons.