Minnesota Chapter of the American Academy of Pediatrics

Member Profiles

Each year, the Minnesota Chapter of the American Academy of Pediatrics honors chapter members and individuals in the community for their dedication to the health and wellbeing of Minnesota’s children and adolescents with the Distinguished Service Award and the Eric Dick Child Advocacy Award. The Distinguished Service Award is presented to a pediatrician for dedicating their life to improving care for children in Minnesota. The newly named Eric Dick Child Advocacy award honors MNAAP’s late lobbyist and is presented to a person or organization from the community who goes above and beyond in their everyday routine to advocate for children, embodying the importance of advocacy that Eric strove to instill in our chapter.
Chapter President Eileen Crespo, MD, FAAP, announced the 2023 award recipients at the annual meeting on Sept. 21. We applaud these individuals for their commitment to advocacy and advancement on behalf of Minnesota’s youth.
<div id="attachment_4252" style="width: 160px" class="wp-caption alignleft"><a href="http://www.mnaap.org/chapter-honors-achievement-and-dedication-with-annual-awards-2/kaplan/" rel="attachment wp-att-4252"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-4252" class="size-thumbnail wp-image-4252" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2023/09/Kaplan-150x150.jpeg" alt="" width="150" height="150" srcset="https://wp.mnaap.org/wp-lib/wp-content/uploads/2023/09/Kaplan-150x150.jpeg 150w, https://wp.mnaap.org/wp-lib/wp-content/uploads/2023/09/Kaplan-300x300.jpeg 300w, https://wp.mnaap.org/wp-lib/wp-content/uploads/2023/09/Kaplan-1024x1024.jpeg 1024w, https://wp.mnaap.org/wp-lib/wp-content/uploads/2023/09/Kaplan-768x768.jpeg 768w, https://wp.mnaap.org/wp-lib/wp-content/uploads/2023/09/Kaplan.jpeg 1084w" sizes="(max-width: 150px) 100vw, 150px" /></a>Dr. Edward Kaplan</div>
<h3 class="p1">2023 Distinguished Service Award: Edward Kaplan, MD, FAAP (posthumously) </h3>
Dr. Ed Kaplan (Feb. 1936 &#8211; March 2023) left a legacy in pediatrics through his research and his mentorship of hundreds of young physicians. Dr. Kaplan was a pediatric cardiologist and infectious disease physician who pioneered critical research in Streptococcal infections. He served as head of the World Health Organization Collaborating Center on Streptococci. Many MNAAP members remember Dr. Kaplan as a professor at the University of Minnesota where he educated and encouraged young physicians.
Dr. Kaplan continued to contribute a breadth of research to pediatrics even after his retirement in 2013, with many articles for medical journals and chapters in medical books. He was awarded the Gold Headed Cane award in 2015, an honor given for excellence as a physician. MNAAP leaders recognize Dr. Kaplan’s impact on pediatrics both in Minnesota and worldwide.
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<div id="attachment_4253" style="width: 160px" class="wp-caption alignleft"><a href="http://www.mnaap.org/chapter-honors-achievement-and-dedication-with-annual-awards-2/goepferd-angela-1205971223/" rel="attachment wp-att-4253"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-4253" class="size-thumbnail wp-image-4253" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2023/09/goepferd-angela-1205971223-150x150.jpeg" alt="" width="150" height="150" /></a>Dr. Angela Kade Goepferd</div>
<h3 class="p1">2023 Eric Dick Child Advocacy Award: Angela Kade Goepferd, MD, FAAP</h3>
Angela Kade Goepferd, MD, FAAP, is a force for good in the corner of LGBTQIA+ youth in Minnesota. In addition to their roles as chief medical officer, chief of staff, and medical director of gender health at Children’s Minnesota, they are also a tireless advocate for gender-affirming care and equitable health care for children, teens, and their families. The chapter’s leadership recognized Dr. Goepferd with the 2023 Eric Dick Child Advocacy Award for their efforts to ban the dangerous and destructive practice of conversion therapy in Minnesota, and to establish the state as a trans refuge state during the 2022-23 legislative session.
Dr. Goepferd is a positive, encouraging presence for their patients and families. They represent the epitome of an advocate: a compassionate voice that continues to bring forward the needs and rights of their patients for representation and inclusion.

Chapter Honors Achievement and Dedication with Annual Awards

Board elections are held each year for open positions on the Board of Directors for the Minnesota Chapter of the American Academy of Pediatrics (MNAAP) and the Board of the Minnesota Academy of Pediatrics Foundation (MAPF).
Currently, the chapter is seeking to fill one board member opening for pediatricians or pediatrician specialists who want to help advance the chapter&#8217;s mission of improving the health of all Minnesota children.
Click <a href="https://www.surveymonkey.com/r/MPD2DGR" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.surveymonkey.com/r/MPD2DGR&amp;source=gmail&amp;ust=1694823335111000&amp;usg=AOvVaw0fAVgo1CVFbUlgrjcPPfHN">here</a> to vote. Ballots are due by Friday, Oct. 6, 2023.
To view a list of current board members, visit <a href="http://www.mnaap.org/board-members/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=http://www.mnaap.org/board-members/&amp;source=gmail&amp;ust=1694823335111000&amp;usg=AOvVaw0RQM1d7MDgI03bOUoW_wm5">http://www.mnaap.org/board-members</a>

Vote Today to Fill An Open MNAAP Board of Directors Seat

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<figure class="alignleft size-full is-resized"><img loading="lazy" decoding="async" src="https://wp.mnaap.org/wp-lib/wp-content/uploads/2023/07/langenfeld-adam-1265894463.jpeg" alt="Adam Langenfeld, MD, PhD, FAAP" class="wp-image-4373" width="250" height="313" srcset="https://wp.mnaap.org/wp-lib/wp-content/uploads/2023/07/langenfeld-adam-1265894463.jpeg 500w, https://wp.mnaap.org/wp-lib/wp-content/uploads/2023/07/langenfeld-adam-1265894463-240x300.jpeg 240w" sizes="(max-width: 250px) 100vw, 250px" /><figcaption class="wp-element-caption">Adam Langenfeld, MD, PhD, FAAP</figcaption></figure></div>


What does a typical workday look like for you as a developmental-behavioral pediatrician?&nbsp;



It can vary from day to day!&nbsp; At Children’s Developmental Pediatrics, we currently have a mix of in-person and virtual visits.&nbsp; I typically meet a few new patients each day and then spend the rest of my time seeing patients for follow-up visits.&nbsp;



For new patients, I will review their previous history and any information we have available (typically sometime prior to their visit).&nbsp; On the day of the visit, we discuss their developmental and medical histories in detail; we learn about behavioral concerns, developmental milestones, challenges with sleep or eating, and what kind of support they are already receiving.&nbsp; I usually perform a thorough physical exam as well, although sometimes the patients are not very interested! &nbsp;



We will then talk about next steps, which can include more developmental testing with me or one of our Neuropsychology colleagues, as well as referrals to appropriate therapies or other services.&nbsp; The rest of my day is spent following up with patients for medication management or behavioral concerns, along with answering messages, sending new prescriptions, and communicating with my colleagues about other patients.&nbsp; It can be very busy!



What do you especially like about your specialty?



I love working with our patients and their families.&nbsp; I chose this field of medicine in part for the opportunity to develop long-term relationships with patients and their families.&nbsp; The patients I see can be complex and have many challenges, but they are very resilient and usually do very well with the support of their families.&nbsp; Their parents work hard to provide appropriate support to help bolster their development and to be able to do the things that they want to do.&nbsp; Every patient I meet has a unique story and many positive interests! &nbsp;



Before completing your medical degree, you obtained a PhD in chemistry. Was it always your plan to be a pediatrician? How do you feel this educational path has helped you?



Yes, before being a full-time medical student I was enrolled in graduate school in chemistry.&nbsp; I had a strong interest in pediatrics but felt that I could also contribute to pediatric medicine through science and research.&nbsp; I was enrolled in the Medical Scholars Program at the University of Illinois, which was a unique MD-PhD program that allowed students to pursue graduate studies in fields outside of the “normal” fields offered by most programs.&nbsp; For example, one of my colleagues (now a Med-Peds hospitalist in Pittsburgh) obtained a PhD in History! &nbsp;



When I started, I anticipated being a “bench-to-bedside” researcher, working on genetic disorders in children.&nbsp; My PhD thesis focused on novel treatments for spinal muscular atrophy, a childhood neuromuscular disorder.&nbsp; After completing graduate school, I realized that bench research was not for me, but I retained my interest in pediatrics and neurodevelopmental disorders.&nbsp; My experiences in graduate school gave me a more scientific approach to asking questions, along with a willingness to persist on challenging problems, which has served me well as a Developmental Pediatrician.&nbsp;



Why did you join MNAAP?



When I returned to Minnesota in 2019 for fellowship, I had a strong desire to be more involved in advocacy work, especially for early childhood initiatives. &nbsp;



I had the opportunity to attend a few of the in-person Prenatal-to-3 policy forums before the pandemic started in 2020.&nbsp; The connections I made with Dr. Krish Subrahmanian and Dr. Nate Chomilo during those sessions, as well as Dr. Tom Scott (who was on my Scholarship Oversight Committee during my fellowship), further increased my interest in advocacy involvement and strengthened my interest in joining MNAAP.&nbsp; I knew that being involved in MNAAP would give me the chance to engage in this work.&nbsp; I have been able to participate in Advocacy Day activities and also joined the Early Childhood Work Group as part of MNAAP.&nbsp; I am glad to be part of this community!



Outside of medicine, what are some of your interests? How do you like to spend your free time?



Like many MNAAP members, I am a parent, and this occupies a lot of my time!&nbsp; Luckily, being a pediatrician helps me to feel very comfortable going places like the Minnesota Children’s Museum, Como Zoo (where I used to go as a child myself), and other child-friendly venues with my children.&nbsp; We love visiting farmers&#8217; markets in the summer and being outdoors all year round. &nbsp;



My biggest personal interest and activity for the past few decades (since age 12&#8230; I am turning 40 this year!) has been running, and I have completed 10 marathons since graduating college. I currently live near Elm Creek Reserve and you can find me on the trails most weekends.&nbsp;



Is there an advocacy issue you feel particularly drawn to support?&nbsp;



As stated earlier, I have a strong interest in early childhood initiatives and am a member of the Early Childhood Work Group.&nbsp; I am interested in investing time and financial support into initiatives that support children in the early stages, including access to high-quality childcare and educational support.&nbsp; Many of the patients I see rely upon these services and would definitely benefit from additional support.&nbsp; Early interventions can be extremely helpful in child development and I am excited to continue advocating for these services. &nbsp;



What’s something people might be surprised to learn about you?



I was a consultant for a television show.&nbsp; My brother (Alex M. Langenfeld, if you want to see his IMDB page) has been working in television production for some time and most recently was a production assistant and producer on the Netflix show Dead to Me; he reached out to ask me questions about how to display the EMR (electronic medical record) on a screen in the show!&nbsp; Let’s just say that my experience with charting served me well in this situation. 🙂

Member Spotlight: Adam Langenfeld, MD, PhD, FAAP

&#8220;Recognition is not a scarce resource. You can&#8217;t use it up or run out of it.&#8221; &#8211; Susan M. Heathfield



Every day, pediatricians and child health advocates are going above and beyond to ensure that Minnesota&#8217;s children and teens have a chance to live the healthiest, most promising lives they can. MNAAP wants to honor and celebrate these individuals through the chapter&#8217;s annual awards and needs your help to find the recipients who deserve to have their contributions celebrated.



The nomination process for the MNAAP annual awards is now open. Submissions will be accepted through Friday, July 7. The chapter has two awards: the Distinguished Service Award and the Eric Dick Child Advocacy Award. 



To see a list of previous honorees, visit the&nbsp;<a href="https://r20.rs6.net/tn.jsp?f=001sAsLAxy6spwAqbX5omOwbG5JgucPv2oS3iWJr5isE_exyaHAuxEb3NWNEFwWuPjsRpfEtS6-aSv77unkMnJ_-Qv4_IFEfaVTGaXdxxCeSZ_Y6XO40w6to_nQWkTOfJRW4KF0jL9Day6ifyrZojGBr54mOtNdBFglXT7SnoC_6j4=&amp;c=tRF8H2A379cJwim9Mf4Bb-dzqsa7uqOeli8N6s3fbbOQgNKV6x_r8g==&amp;ch=SRCGAZq9JAlF3uPMt1DlC8neFRWWkknq_3I6thKASwUW47cT40JEfQ==" target="_blank" rel="noreferrer noopener">Annual Awards page</a>.



Distinguished Service Award



Each year MNAAP recognizes a pediatrician for their outstanding efforts that contribute to the improvement of child health care. This is really the “Lifetime Achievement Award” for the pediatrician who has dedicated their life to improving care for children throughout the state of Minnesota.



<a href="https://r20.rs6.net/tn.jsp?f=001sAsLAxy6spwAqbX5omOwbG5JgucPv2oS3iWJr5isE_exyaHAuxEb3NWNEFwWuPjswLr14DGL60eikCB8IpgCMecpLGRRApvVpTXlFYJiqkFjXGGyd6gFmf21R3CGLCfeAmgZNkhna-O4i-LO5Av_W8iKrlGzmmdh5mtt_Nn8PTz39Qon2-T1kuDPD2JQE3-jPM_K_q-xA9SORArLuYYyx-zsUZU_JBtlEYlTJOkh3IHSJXBVLlFpYzuRNm-gNb9Z&amp;c=tRF8H2A379cJwim9Mf4Bb-dzqsa7uqOeli8N6s3fbbOQgNKV6x_r8g==&amp;ch=SRCGAZq9JAlF3uPMt1DlC8neFRWWkknq_3I6thKASwUW47cT40JEfQ==" target="_blank" rel="noreferrer noopener">Click here</a>&nbsp;to see more criteria&nbsp;for the Distinguished Service Award and to make a nomination.



Eric Dick Child Advocacy Award



MNAAP chooses an individual from the community who goes above and beyond their everyday routine to advocate for the health and welfare of children in Minnesota. This annual award was renamed in 2021 to honor the chapter’s late lobbyist, Eric Dick, who passed away in January of that year. Eric was a tireless advocate for Minnesota’s infants, children, and teens.



<a href="https://r20.rs6.net/tn.jsp?f=001sAsLAxy6spwAqbX5omOwbG5JgucPv2oS3iWJr5isE_exyaHAuxEb3NWNEFwWuPjsRpfEtS6-aSv77unkMnJ_-Qv4_IFEfaVTGaXdxxCeSZ_Y6XO40w6to_nQWkTOfJRW4KF0jL9Day6ifyrZojGBr54mOtNdBFglXT7SnoC_6j4=&amp;c=tRF8H2A379cJwim9Mf4Bb-dzqsa7uqOeli8N6s3fbbOQgNKV6x_r8g==&amp;ch=SRCGAZq9JAlF3uPMt1DlC8neFRWWkknq_3I6thKASwUW47cT40JEfQ==" target="_blank" rel="noreferrer noopener">Click here</a>&nbsp;to see more criteria&nbsp;for the Eric Dick Child Advocacy Award and to make a nomination.

MNAAP Annual Awards Nomination Process Now Open

<div class="wp-block-image"><figure class="alignleft is-resized"><img loading="lazy" decoding="async" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2023/03/MJ-Abuzzahab.png" alt="" class="wp-image-4106" width="102" height="183"/></figure></div>



Jennifer Abuzzahab is a pediatric endocrinologist at Children’s Minnesota and has been a MNAAP member since 2001. Dr. Abuzzahab answered these questions for Minnesota Pediatrician as this issue’s member spotlight.



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What made you choose pediatric endocrinology as your specialty? &nbsp;



I like the balance of hormone pathways, the ability to replace (most) deficits with bio-identical hormones, and the opportunity for patient continuity. I really like the Yin/Yang balance of it all. I chose pediatrics because kids are fun to work with and generally make me laugh every day.&nbsp;



What is a typical day like for you?&nbsp;



Every day is different! I have days where I am only in clinic (seeing outpatients), days/weeks where I am on call seeing inpatients, and days with blocked research time for our clinical studies. I love that there is not a “typical” day or week, although I did almost go to the wrong clinic once.&nbsp;



Prader-Willi syndrome (PWS) is a research area of interest for you. What drew you to study this genetic disorder?&nbsp;



It’s a fascinating condition and truly individuals with PWS can manifest many different ways across the spectrum of not only the genetic disorder but the stages of the disorder. I am proud to be part of the care team for several amazing kids (infants, school-age, teens, and young adults) with PWS and they have motivated me to look into ways to improve their lives. I also feel that there is some overlap between people with PWS and people with hypothalamic obesity following brain tumors. &nbsp;



Is there an area of advocacy work that you feel strongly about?&nbsp;



I am a strong advocate for preventive care and healthy lifestyles. I really believe that food is medicine. It is OK to eat candy or (my personal fav) Cheetos every now and then, but they are not every day foods. I promote more vegetables and fruits, or eating a rainbow every day.&nbsp;



What’s the funniest thing a patient has said to you recently? &nbsp;



There are so many to choose from. I think the best one was a 3 year old&nbsp; who was showing off their counting skills by counting their teeth. I am loosely quoting his proud and hysterical proclamation: “1, 2, 3, 4, 5…2, I have 2 teeth” &nbsp;

Member Spotlight: M. Jennifer Abuzzahab, MD, FAAP

<div class="wp-block-image"><figure class="alignleft is-resized"><img loading="lazy" decoding="async" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2023/01/Ashley-Bjorklund.jpeg" alt="" class="wp-image-4012" width="194" height="243"/><figcaption>Ashley Bjorklund, MD, FAAP</figcaption></figure></div>



What led you to choose pediatrics?



Who wouldn’t choose pediatrics?? Just kidding. My short answer is kids are just the best. Who wouldn’t want to care for them? I am actually med-peds trained though, and so I do love the full spectrum of ages and patient care, but I think people would say I have always been kind of a med-PEDS type. 



When I decided to do critical care, I was drawn more to pediatric critical care. I have always enjoyed working with kids (as a coach, counselor, etc.) and I am drawn to advocating for those whose voice is less heard. I also find joy in working with families in times of critical need and enjoy the responsibility of partnering with these families and supporting them in decisions and understanding about their child’s illness. This all combined to make pediatric critical care a good fit for me.



You’ve been published with several articles about medical device innovation for low-resource settings. What initially got you interested in this topic?



I have had a passion for working in resource-limited settings and trying to lessen gaps and disparities in care since a young age. While in residency, I had the opportunity to do some training in Nicaragua and Kenya as part of the Internal Medicine and Pediatrics “Global Health Tracks.” I knew by the time that I was headed for this training that I was interested in pursuing a career in critical care and had sought out mentorship from Dr. Tina Slusher, a global pediatric intensive care physician. She introduced me to the idea of low-cost devices and had me do a needs assessment for pediatric respiratory support while I was in Kenya.&nbsp;



My passion for device work grew from seeing the disparities in what was offered in a high-resource U.S. hospital, compared to what was available in different hospitals globally. In the ICU, a lot of the care we provide is now technology and device dependent. Whether it be monitoring devices or respiratory support devices, there have been huge advances in what we have available to care for patients. Some of the biggest differences in ICU care in a high-resource setting, versus that available in a low resource setting are the technology and devices that are available.&nbsp;



Most of these devices had a blueprint, a simple way of making them prior to commercialization. I love going back to that blueprint and thinking about how we can safely, and more cost effectively, make the technology. I don’t have a biomedical engineering background, so we have to partner with those experts. Low-cost device innovation seems to be a simple way to lessen gaps in what is available in high- and low-resource settings.



You are a veteran, having served in the Navy at both Camp Lejeune and Walter Reed. What lessons or experiences from this time do you carry with you in your current role at Hennepin Healthcare?



I learned a lot of life lessons as a medical officer in the Navy. The greatest lesson was the value and strength of mission driven teamwork (an all hands-on deck, in this together attitude). The Navy also taught me about leadership, attention to detail, and how to be resilient. Logistically, I learned about contingency planning and disaster management.



At Hennepin Healthcare, I am the medical director of the pediatric intensive care unit. I find that my goal is always to foster that same sense of mission driven teamwork and “in this together” attitude as I experienced in the Navy. The COVID pandemic has placed a great deal of strain on the medical system, but my training prepared me to think through contingency plans and to be flexible with resources.



What is one advocacy issue that you feel drawn to?&nbsp;



Right now, the issue that is highest on my list is gun safety. We need to find better ways to protect our children from gun violence and to support those who are survivors of gun violence. Gun violence has become the number one cause of death in children. It is a health equity issue when you look at the groups that are impacted the most. There are simple measures we can take as pediatricians to make sure our families know how to safety store firearms. However, advocacy efforts that work to stop the violence is a much greater issue that needs higher level support.



How do you enjoy spending your free time?



I enjoy being active and doing outdoor activities with my husband (Seth) and two children (Otto, age 10, and Camille, age 8). We enjoy running, often with the kids biking alongside. We have two big dogs, Chopper (American Bulldog) and Shady (Basset Hound) who bring us much joy, and two guinea pigs, Cinnamon and Milky Way, that bring us many laughs.

Member Spotlight: Ashley Bjorklund, MD, FAAP

Each year, the Minnesota Chapter of the American Academy of Pediatrics honors chapter members and individuals in the community for their dedication to the health and wellbeing of Minnesota’s children and adolescents with the Distinguished Service Award and the Eric Dick Child Advocacy Award. The Distinguished Service Award is presented to a pediatrician for dedicating their life to improving care for children in Minnesota. The newly named Eric Dick Child Advocacy award honors MNAAP’s late lobbyist and is presented to a person or organization from the community who goes above and beyond in their everyday routine to advocate for children, embodying the importance of advocacy that Eric strove to instill in our chapter. 



Chapter President Eileen Crespo, MD, FAAP, announced the 2022 award recipients at the annual meeting on Sept. 15. We applaud these individuals for their commitment to advocacy and advancement on behalf of Minnesota’s youngest residents.



2022 Distinguished Service Award



Lori DeFrance, MD, FAAP, dedicated more than a decade to the MNAAP Board of Directors, serving from 2010 to 2022, as the chapter president from 2018 to 2020, and as the foundation board president from 2020 to 2022.  Recently retired, Dr. DeFrance previously practiced medicine with Essentia Health in Duluth, and was a persistent voice which reminded the chapter to consider all of Minnesota’s children and teens in every part of the state. Her nominators recalled her “centering presence” which connected board members and allowed them to get to know one another outside of their roles as physicians. Others called her a calming, forward-thinking and a passionate pediatrician. Upon receiving her award at the chapter meeting, Dr. DeFrance said, “Pediatricians like you and me lay the foundation for our communities doing better by persistently and passionately advocating for the health and safety of children, adolescents and families. And this work continues through pandemics, gun violence, health care pressures and so on. So our work is needed now more than ever and I am so proud of you all.” 







2022 Eric Dick Child Advocacy Award



Kris Ehresmann, RN, MPH, is the former director of the Infectious Disease, Epidemiology, Prevention and Control Division at the Minnesota Department of Health (MDH). MNAAP President Eileen Crespo, MD, FAAP, called Ms. Ehresmann “fearless in her communication” during the early months and years of the COVID-19 pandemic. “Kris was the voice of calm and science. She interpreted the data and gave us a scientific basis for all the decisions being made,” said Dr. Crespo. “It’s really an honor to be recognized by the MNAAP,” Ms. Ehresmann said in her remarks. “I worked with Eric a lot in his role&#8230; To receive an award that honors Eric is especially meaningful to me.” She is recently retired from her role at MDH and is currently teaching epidemiology and public health at St. Olaf College.



Rep. Dave Pinto (DFL-64B)  is the chair for the Minnesota House Committee on Early Childhood Finance and Policy and has been a long-standing supporter of early childhood education and care. “He is a passionate advocate for the youngest Minnesotans,” wrote one nominator, “and seems to do everything with their future in mind.” When Rep. Pinto received his award, he reflected that his involvement in early childhood work came when he asked himself, “Where can I really make a difference?” He encouraged chapter members to “please lean in. We need you, the kids of Minnesota need you&#8230;having your elected officials hear from you, know about the work that you’re doing and understand the kind of things they need to know to make good decisions for kids and for all of us, that is so important to do.”

<div id="attachment_3843" style="width: 160px" class="wp-caption alignleft"><a href="http://www.mnaap.org/wp-lib/wp-content/uploads/2022/08/Bensignor_Photo-1.jpg"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-3843" class="size-thumbnail wp-image-3843" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2022/08/Bensignor_Photo-1-150x150.jpg" alt="" width="150" height="150" /></a>Meg Bensignor, MD, FAAP</div>
With a 95 percent increase in type 2 diabetes (T2DM) incidence in youth aged 10-19 years from 2001 to 2017, T2DM clearly is not just a disease of adulthood anymore. (1) It is also apparent that T2DM is not the same disease in adolescents as it is for adults. Firstly, T2DM in adolescents is a much more aggressive disease than in adults, characterized by rapid impairment of insulin secretion with up to 80 percent pancreatic β-cell function loss at the time of diagnosis. (2-6)  Additionally, medications that typically work well for adults are not as effective in adolescents. For example, despite treatment with metformin and lifestyle management, about half of adolescents with T2DM required insulin therapy in a median treatment time of 11.5 months, which is a much higher failure rate than adults. (7-11)  Two other medications commonly used in adults (dipeptidyl peptidase-4 inhibitors and sodium-glucose cotransporter-2 inhibitors) were recently found to not improve diabetes control in adolescents as they were with adults. (12, 13, 14)  On top of this, diabetes-related comorbidities occur early in youth with about a 60 percent cumulative incidence of any microvascular complication (retinopathy, diabetic kidney disease, hypertension, dyslipidemia, or nerve disease) in a mean of diagnosis length of 13 years. (15)
The <a href="https://diabetesjournals.org/care/article/45/Supplement_1/S208/138922/14-Children-and-Adolescents-Standards-of-Medical">American Diabetes Association (ADA) recommends</a> to start screening at age 10 years or the start of puberty, whichever is sooner. (16) Screening is typical done with a hemoglobin A1c (HbA1c), which can be quickly obtained in an office setting. Any patient should be screened annually if they have a BMI &gt; 85th percentile for age and sex and have a maternal history of diabetes or gestational diabetes, a first or second degree relative with T2DM, or signs of insulin resistance (acanthosis nigricans,  skin tags, hypertension, dyslipidemia, history of small-for-gestational-age status, and polycystic ovarian syndrome). (16) However, is important to note that diabetes type cannot be diagnosed by signs of insulin resistance or BMI alone as 35-50 percent of youth with type 1 diabetes can also have overweight or obesity. (17) Obtaining diabetes auto-antibodies to exclude type 1 diabetes is recommended for all suspected cases of youth with diabetes before labeling a patient as having T2DM. (16)
Once T2DM is diagnosed with an HbA1c &gt; 6.5 percent, a fasting glucose &gt; 126 mg/dL, or a random glucose &gt; 200 mg/dL with symptoms of polyuria, polydipsia, or unintentional weight loss, treatment with metformin should be started immediately along with lifestyle management. (16) A trial of lifestyle treatment alone without anti-diabetes pharmacotherapy is not recommend. Furthermore,  insulin therapy initiation and referral to a pediatric endocrinologists should be done if the HbA1c &gt; 8.5 percent.16 Although still limited, there are expanding treatment options for pediatric T2DM, including two injectable glucagon-like peptide-1 receptor agonists recently FDA approved for the use of patients &gt; 10 years (weekly exenatide extended-release and daily liraglutide 1.8mg). (18,19)
Staying vigilant of a T2DM diagnosis in youth is imperative as delayed diagnosis and treatment initiation can lead to diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome, and poor long-term glycemic control in an already remarkably aggressive disease. (20)
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About the Author
Meg Bensignor, MD, FAAP,  is an Assistant Professor in the Department of Pediatrics and in the Division of Endocrinology and Diabetes at the University of Minnesota as well as a Core Faculty in the University of Minnesota Center for Pediatric Obesity Medicine. She is a board-certified obesity medicine specialist and a pediatric endocrinologist, specializing in type 2 diabetes in youth. Dr. Bensignor&#8217;s area of research involves evaluating the effects of eating patterns on obesity risk and appetite, in addition to novel and effective treatments for youth with Type 2 Diabetes and obesity. She is part of the multidisciplinary team, which includes diabetes nurse educators, a dietician, and a social worker, that make up the Pediatric Type 2 Diabetes Clinic at the University of Minnesota/MHealth.
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References
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<li>Lawrence JM, Divers J, Isom S, et al. Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017. JAMA. 2021;326(8):717-727.</li>
<li>Elder DA, Woo JG, D&#8217;Alessio DA. Impaired beta-cell sensitivity to glucose and maximal insulin secretory capacity in adolescents with type 2 diabetes. Pediatr Diabetes. 2010;11(5):314-321.</li>
<li>Elder DA, Hornung LN, Herbers PM, Prigeon R, Woo JG, D&#8217;Alessio DA. Rapid deterioration of insulin secretion in obese adolescents preceding the onset of type 2 diabetes. J Pediatr. 2015;166(3):672-678.</li>
<li>Bacha F, Pyle L, Nadeau K, et al. Determinants of glycemic control in youth with type 2 diabetes at randomization in the TODAY study. Pediatr Diabetes. 2012;13(5):376-383.</li>
<li>Group TS. Effects of metformin, metformin plus rosiglitazone, and metformin plus lifestyle on insulin sensitivity and β-cell function in TODAY. Diabetes Care. 2013;36(6):1749-1757.</li>
<li>Michaliszyn SF, Mari A, Lee S, et al. β-cell function, incretin effect, and incretin hormones in obese youth along the span of glucose tolerance from normal to prediabetes to type 2 diabetes. Diabetes. 2014;63(11):3846-3855.</li>
<li>Brown JB, Conner C, Nichols GA. Secondary failure of metformin monotherapy in clinical practice. Diabetes Care. 2010;33(3):501-506.</li>
<li>Consortium R. Metabolic Contrasts Between Youth and Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes: II. Observations Using the Oral Glucose Tolerance Test. Diabetes Care. 2018;41(8):1707-1716.</li>
<li>Turner RC, Cull CA, Frighi V, Holman RR. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA. 1999;281(21):2005-2012.</li>
<li>Barnes NS, White PC, Hutchison MR. Time to failure of oral therapy in children with type 2 diabetes: a single center retrospective chart review. Pediatr Diabetes. 2012;13(7):578-582.</li>
<li>Zeitler P, Hirst K, Pyle L, et al. A clinical trial to maintain glycemic control in youth with type 2 diabetes. N Engl J Med. 2012;366(24):2247-2256.</li>
<li>Jalaludin MY, Deeb A, Zeitler P, et al. Efficacy and safety of the addition of sitagliptin to treatment of youth with type 2 diabetes and inadequate glycemic control on metformin without or with insulin. Pediatr Diabetes. 2022;23(2):183-193.</li>
<li>Shankar RR, Zeitler P, Deeb A, et al. A randomized clinical trial of the efficacy and safety of sitagliptin as initial oral therapy in youth with type 2 diabetes. Pediatr Diabetes. 2022;23(2):173-182.</li>
<li>Tamborlane WV, Laffel LM, Shehadeh N, et al. Efficacy and safety of dapagliflozin in children and young adults with type 2 diabetes: a prospective, multicentre, randomised, parallel group, phase 3 study. Lancet Diabetes Endocrinol. 2022;10(5):341-350.</li>
<li>Bjornstad P, Drews KL, Caprio S, et al. Long-Term Complications in Youth-Onset Type 2 Diabetes. N Engl J Med. 2021;385(5):416-426.</li>
<li>Draznin B, Aroda VR, Bakris G, et al. 14. Children and Adolescents: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Supplement_1):S208-S231.</li>
<li>Hamman RF, Bell RA, Dabelea D, et al. The SEARCH for Diabetes in Youth study: rationale, findings, and future directions. Diabetes Care. 2014;37(12):3336-3344.</li>
<li>AstraZeneca. Bydureon BCise (exenatide extended-release) approved in the US for the treatment of type 2 diabetes in pediatric patients ages 10 years and older. 2021; ttps://<a href="www.astrazeneca-us.com/media/press-releases/2021/bydureon-bcise-exenatide-extended-release-approved-in-the-us-for-the-treatment-of-type-2-diabetes.html">www.astrazeneca-us.com/media/press-releases/2021/bydureon-bcise-exenatide-extended-release-approved-in-the-us-for-the-treatment-of-type-2-diabetes.html</a>. Accessed November 24, 2021, 2021.</li>
<li>Bacha F. FDA approval of GLP-1 receptor agonist (liraglutide) for use in children. Lancet Child Adolesc Health. 2019;3(9):595-597.</li>
<li>Alemzadeh R, Ellis J, Calhoun M, Kichler J. Predictors of metabolic control at one year in a population of pediatric patients with type 2 diabetes mellitus: a retrospective study. J Pediatr Endocrinol Metab. 2006;19(9):1141-1149.</li>
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Pediatric Type 2 Diabetes: Not Your Grandfather’s Diabetes

<a href="http://www.mnaap.org/mnaap-remembers-dr-amos-deinard/show-image/" rel="attachment wp-att-3704"><img loading="lazy" decoding="async" class="size-thumbnail wp-image-3704 alignleft" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2022/03/show-image-150x150.jpeg" alt="" width="150" height="150" /></a>Amos S. Deinard, MD, MPH, FAAP, passed away at the age of 86 on March 9, 2022, from complications of Alzheimer’s disease. Dr. Deinard was a longtime member of MNAAP.
Dr. Deinard’s motto was, “Go forth and varnish&#8221; and he was an ardent supporter of pediatric oral health initiatives. In 2005, he helped found and direct the Minnesota Oral Health Project, an educational/research project, where the primary mission has been to increase public awareness of the caries crisis affecting high-risk children, improve access to early caries prevention services through training and support for medical and dental providers and to educate caregivers about healthy dental practices.
In 2015, Dr. Deinard received the American Public Health Association’s John W. Knutson Distinguished Service Award in Dental Public Health. He remains the only non-dentist or dental hygienist to have received that recognition in the 40 years that the award has been presented. In December 2020, the Minnesota Department of Health Oral Health Program and the Minnesota Oral Health Coalition jointly awarded Dr. Deinard with a lifetime achievement award for his unwavering commitment to the oral health of Minnesota’s children.
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(Biographical information taken from the Star Tribune obituary and the Minnesota Oral Health Coalition)

MNAAP Remembers Dr. Amos Deinard

<a href="http://www.mnaap.org/member-spotlight-ria-bardhan-mbbs-faap/bardhan_ria-5x7/" rel="attachment wp-att-3606"><img loading="lazy" decoding="async" class="size-medium wp-image-3606 alignleft" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2022/01/Bardhan_Ria-5x7.jpeg" alt="" width="143" height="200" /></a>Dr. Ria Bardhan is a member of the MNAAP Board of Directors and co-chairs a chapter work group. Minnesota Pediatrician asked Dr. Ria Bardhan to answer our questions as this issue’s Member Spotlight. Thank you, Dr. Bardhan!
What drew you to pediatrics?
This was an interesting journey as several experiences growing up in India shaped my journey to practice pediatrics. 
I grew up in the eastern part of India in a large city called Kolkata with parents who were both physicians. Volunteering in the orphanage of the Missionaries of Charity and working with Mother Teresa led me to see how children can be impacted by poverty and how love, compassion, and basic health care can transform their lives. I had a real-world lesson in economic and social disparities, and I made a decision from that point forward that I would advocate and provide care for children through the medical practice of pediatrics. All of this has shaped the person I have become.
What is a typical day like for you?
I work as a pediatrician in community practice at Allina Health in Inver Grove Heights. The day revolves around well-child checks, sick visits, and mental health concerns affecting our pediatric population which are increasing daily. 
What draws me in most is helping patients and families with complex medical conditions and seeing the children through illness and through health with continuity of care. I am blessed to be practicing in a community where I get to partner with so many brilliant specialists and a healthcare organization that can provide the resources necessary for our patient population. I feel joy when I’m with my patients who are also my best teachers.
I am humbled with the opportunity and platform the Minnesota Chapter of the American Academy of Pediatrics has given me through my roles as co-chair of the Mental Health and Behavioral Health Work Group, as an executive committee member, and through participation on the Executive Board. It is rewarding to work alongside many brilliant colleagues and partners who are all focused on delivering the best pediatric care for the children of Minnesota. 
I am also currently completing an Executive Masters in Healthcare Administration at my alma mater, the University of Minnesota. This education and experience give me a better understanding of improving healthcare delivery. My hope is to use this knowledge to improve access to healthcare and improve healthcare equity.
What is an advocacy issue (or issues) that you feel called to support? 
There are many issues at the forefront of our field that I am currently passionate about. Addressing mental and behavioral health in our pediatric and adolescent population was already a major issue, and the pandemic has only accelerated this need. We knew about the rise in mental health concerns prior to the COVID-19 pandemic, but to witness a “tsunami of this magnitude” affecting our kids was not something our system was not prepared to handle. It is heart-breaking to see the lives of children changed so dramatically, and crisis times make them more vulnerable despite their brave faces. 
Substance abuse, eating disorders, suicidal attempts, and witnessing violence are just some of the many impacts of this pandemic that have been on the rise too. The helplessness and uncertainty families are facing alongside these children are real too. Disparities and inequities tend to worsen the impact of the pandemic. Addressing social determinants of equity, childhood hunger, and poverty are additional areas I feel passionate about. 
Reducing preventable illness and taking care of complex medical conditions are areas I find myself making an impact on in order to improve the health of Minnesota’s pediatric population.
When you aren’t working, what do you enjoy doing? 
I enjoy traveling and seeing new places and meeting new people. I enjoy exposure to new cultures and trying to bring back positive elements to my daily life in Minnesota. I also realized in the pandemic that I can keep plants alive and have grown fond of gardening flowers and vegetables during the last two summers!
What is something people might be surprised to learn about you?
Hmm, this is a difficult question! I don’t think I’d call myself adventurous, but I have tried my hand at fly-fishing in Colorado and whale watching in the Atlantic. I found myself truly at one with nature and calmer during these events than I expected. I plan to see more whales in the Pacific Ocean, too, when traveling permits me to do so!

Member Profiles Updates

Chapter Honors Achievement and Dedication with Annual Awards

Vote Today to Fill An Open MNAAP Board of Directors Seat

Member Spotlight: Adam Langenfeld, MD, PhD, FAAP

MNAAP Annual Awards Nomination Process Now Open

Member Spotlight: M. Jennifer Abuzzahab, MD, FAAP

Member Spotlight: Ashley Bjorklund, MD, FAAP

Chapter Honors Achievement and Dedication with Annual Awards

Pediatric Type 2 Diabetes: Not Your Grandfather’s Diabetes

MNAAP Remembers Dr. Amos Deinard

Member Spotlight: Ria Bardhan, MBBS, FAAP