Endocrinologist at UBMD Pediatrics discusses career, her work as physician and how managing diabetes in children has improved
By Christopher Motola
Q: What does your patient base look like?
A: I’m the division chief of pediatrics and endocrinology. For our division, we take care of patients up to age 22. About 50% of our practice is diabetes, with the bulk of that being Type 1 diabetes. But we also do take care of a fair number of children with Type 2 diabetes. The other 50% of our business is taking care of all kinds of endocrine conditions. And that includes thyroid disease, growth, kiddos with early or delayed puberty, kids with vitamin D or calcium problems. We also do a fair amount of weight and obesity management.
Q: Is it easier to address endocrinological issues when they present at a young age?
A: It depends what you mean by “easier.” For each patient we need to have a workable diagnosis. Sometimes patients and parents just need some counseling and education. Sometimes they’re going to need medication. For instance, a child who is diagnosed with under-active thyroid will require thyroid hormone replacement. That involves taking a pill every day and frequent blood work to make sure the levels are normal and that the child continues to grow well. I guess that’s also fairly typical of what you’d see in the adult world, but it’s a little bit different. Children don’t generally enjoy getting frequent blood work and continuous physician visits.
Q: What kind of strides have we made recently in managing diabetes in children, particularly Type 1?
A: We’ve improved insulins to control blood sugars. We have better technology for measuring blood sugar in a real-time fashion. We also have better insulin pumps that can communicate with those monitoring devices, which can improve the overall glucose control.
Q: There have been some stories about some kind of connection between COVID-19 and diabetes in children. Have you observed any connection?
A: Well, what I will say is that, based on the early part of COVID-19, 2020 and into early 2021, we did see an increase in the number of diagnoses, particularly on the Type 2 diabetes side. It was not that much different than the past few years and going back, maybe, eight to 10 years in terms of absolute numbers. However, what we did notice is that the patients came in to hospital a little bit sicker. And probably because parents were nervous about coming to the hospital and weren’t necessarily recognizing the signs and symptoms because of everything else that was going on at home with kids home from school and watching other children — those kinds of things. In 2021, I think our numbers both in terms of Type 1 diabetes and Type 2 diabetes, are a little bit decreased from the previous year and are closer to being consistent with what we’ve seen in the past years. That’s in terms of the number of diagnoses in the Western New York community.
Q: What advice would you give parents now for keeping their kids healthy, especially with all the disruptions to normal life?
A: It’s usually a matter of making sure your children are eating a healthy diet and getting exercise. They can work with their general pediatrician to get a sense of what that means for their child. And also being really in tune with their child so they know when there are any changes in their sleep habits, in their moods, so that they can work with their general pediatrician to address problems before they get too large. And then to refer them to subspecialists when needed.
Q: Are there any tricks you’ve discovered over the years to getting children to eat more healthily?
A: I think most of it is listening to what they’re doing. Helping to guide them to healthier substitutions. That’s a major thing to do. And a lot of it is educating families on what qualifies as a healthy diet. We don’t ask parents to completely eliminate a food group or particular food, but we encourage them to incorporate it into their meals throughout the day so that they can maximize the enjoyability of the food without overdoing it. And, of course, we’re mainly talking about sweets and processed foods.
Q: What drew you toward administration?
A: I guess it was more a case of my falling into it. I’m a fairly organized person, so I was doing a lot of the organizational administrative aspects for the division. And so as I took on more of those roles, it started to seem like an easy fit for me to step into that role. So I was invited by the chair at the time to apply for the position here at UB.
Q: What kind of impact do you hope to have on the department, ultimately?
A: So my priorities right now are: number one, that my team does a really good job of serving the pediatric patients of Western New York with endocrine and diabetes disorders. And the second is to make sure my team is supported and receives as many resources as they need to do their jobs well. I will say that is always a challenge, to have those resources. And number three, it’d be really wonderful to continue to grow the division with respect to our teaching mission and research mission. That’s in addition to our clinical mission.
Q: What are some of the challenges you face in achieving those goals?
A: The challenge is that running a busy practice requires a lot of hands-on communication with parents and making sure that we can return all those phone calls and get back to people in a timely fashion so they feel like they’re being served. It’s always a challenge to have enough money in the bank to be able to pay people and support them and to recruit top talent to Buffalo so that we can provide quality care to our patients here.
Lifelines
Name: Lucy D. Mastrandrea, M.D.
Position: Division chief of pediatrics and endocrinology and University at Buffalo
Hometown: Columbia, Maryland
Education: University at Buffalo School of Medicine
Affiliations: John R. Oishei Children’s Hospital of Buffalo; Kaleida Health
Organizations: American Academy of Pediatrics; Pediatric Endocrine Society; American Diabetes Association
Family: Husband, three daughters
Hobbies: Running, reading, knitting