UF’s Champion for Kids with Diabetes

After 29 years at the University of Florida, Janet Silverstein keeps working…and fighting and running and even biking.

The chief of pediatric endocrinology in the College of Medicine works 12-hour days in UF clinics treating children with diabetes and other endocrine disorders. She repeatedly fights for more research to get to the root cause of the disease. She runs from committee to committee advocating for better policies, school training and standards of care for children with diabetes. And for fun, she bikes her way through the United States and Europe during vacations.

“Janet is a boundless source of energy — inspiring and influential to her colleagues, students and trainees,” said Dr. Desmond Schatz, professor and associate chairman of pediatrics and medical director of the UF Diabetes Center. “She is always charming, vivacious and full of enthusiasm.”

As one of the hardest-working physicians at UF, Silverstein’s expertise does not go unnoticed. She serves or has once served on dozens of key professional organizations and committees, including chairwoman of the executive committee of the Section of Endocrinology of the American Academy of Pediatrics and as chairperson of the Children’s Workgroup of the National Diabetes Education Program to develop manuals and training materials schools can use for addressing the needs of children with the disease. She serves on the editorial board of the Journal of Pediatrics, and is editor of Kids Corner, a monthly column in Diabetes Forecast, a magazine for people with diabetes. Silverstein also serves on the endocrinology sub-board at the American Board of Pediatrics, once chaired the Council of Youth of the American Diabetes Association (ADA) and is currently the pediatric representative on the Clinical Practice Committee of the American Diabetes Association. She spearheaded an ADA committee that developed standards of care for children who have diabetes.

“Janet is admired and respected by colleagues throughout the world for her dedication to children with diabetes and other endocrine disorders,” Schatz said. “No added task or responsibility is too much for her to undertake.”

Silverstein and her division colleagues recently were rewarded for their work with a private donation. The Silverstein Family Eminent Scholar Chair in Pediatric Endocrinology was established in February to support research, teaching and care of children with endocrine disorders, obesity, diabetes and other metabolic disorders and to further the involvement of the division of endocrinology in the mission of the Florida Diabetes Camp.

“With childhood obesity at epidemic numbers, we are overwhelmed in pediatric endocrinology,” said Silverstein, who joined the UF medical faculty in 1978. “Right now there are not enough of us.”
Silverstein explained that the $2 million gift will go far in helping the department build programs and provide for added salaries.

“We have a lot of people doing amazing work-very cutting-edge research,” she said. “And so much more needs to be done.”

The pediatric endocrinology division operates not only diabetes clinics, but also obesity and lipids clinics for children, adolescents and young adults. Some of the research crucial to their success includes studies to understand the cardiovascular risks for children. Another study is investigating the idea of converting stem cells to islets to treat type 1 diabetes.

Great strides also are being made in terms of treatment, Silverstein said.

“We’re able to get blood glucose levels much closer to normal because of better insulins, better glucose monitors and more advanced insulin delivery pumps,” she said.

But the hard work and the heavy toll on the children remain, even with the advances.

“The intensity of treatment has increased markedly over the past few years. We’re asking them to do more and we’re doing more,” said Silverstein, whose team must fill out school forms for each of her patients. “It’s such a hard disease for kids to live with. They can never take a break from managing their disease; they never can forget they have it.”

“They are frequently monitoring their blood sugar, constantly considering how much exercise they are getting, constantly counting their carbs. It’s very tough.”

That’s why Silverstein takes on one more very important task. Each summer, she travels to the sweltering Ocala National Forest for the Florida Camp for Children and Youth with Diabetes. Arlan Rosenbloom, MD, adjunct distinguished service professor emeritus of pediatrics at UF, with the help of his wife Edith, founded the camp nearly 40 years ago in an effort to help youngsters with diabetes learn to live with their disease.

“Camp makes a huge difference,” said Silverstein, the camp’s longtime medical director. “Each child thinks he or she is the only person in the world struggling with the disease. Then there’s a whole cabin full of kids who also have to take insulin injections and check their blood glucose levels and have to worry about low blood glucose with exercise.”

Silverstein once again was in attendance at this year’s camp. It came in July, shortly after her weeklong bike tour through Virginia, where she biked 60 miles a day with her husband, Dr. Burton Silverstein. The self-proclaimed non-athlete physically challenges her patients and insists on being a doer herself and not a spectator. She and her husband have run marathons in Boston, New York, Stockholm and biked up and down the mountains of Oregon and Italy.

“I’m slowing down a little these days,” she said. “I’ve cut back to half-marathons.”