Pediatric Endocrinology & Diabetes
We offer pediatric endocrinology and diabetes services at the following locations:
The Mount Sinai Hospital
Address: 1468 Madison Avenue, 4th Floor
New York, NY 10029
Mount Sinai-Union Square
Address: 10 Union Square East
New York, NY 10003
Mount Sinai Doctors Brooklyn Heights
Address: 300 Cadman Plaza West, 17th Floor
Brooklyn, NY 11201
Healthy Lifestyle Clinic (Pediatric Obesity Program)
The Healthy Lifestyle Clinic is a weight management program for children and teens with obesity and obesity-related health complications. Patients receive coordinated care all under one roof from a team of providers, including a dietitian, exercise physiologist, social worker, nurse practitioner, endocrinologist, cardiologist, hepatologist, and adolescent bariatric surgeon. We also have a dedicated psychologist, dentist, ophthalmologist, adolescent gynecologist, and sleep medicine pulmonologist on our team who work closely with us for direct referrals from our clinic. Our goal is to empower children and their families to lead healthier lifestyles through improved nutrition, physical activity, sleep quality, and emotional well-being. In addition to lifestyle modification, we offer weight loss medications, and for teens with the most severe obesity and comorbidities, bariatric surgery (laparoscopic vertical sleeve gastrectomy) is available.
Evaluation and Management of Obesity-Related Health Conditions
Because of our team of subspecialists, we are able to manage not only obesity but also its complications, including hypertension, dyslipidemia, type 2 diabetes, polycystic ovarian syndrome, fatty liver disease, steatohepatitis, and obstructive sleep apnea. We also provide comprehensive care for children with genetic obesity disorders such as Alström, Bardet-Biedl, Prader-Willi, ROHHAD, Smith-Magenis, and WAGR/11p deletion syndromes, and patients with leptin pathway disorders, including LEP, LEPR, POMC, PCSK1, MC4R, BDNF, and NTRK2 genetic variants.
Innovative Programs in the Healthy Lifestyle Clinic
We invite all our patients to participate in research if they are interested. We are building a biorepository of genetic and biochemical samples, and we are conducting clinical trials and studies in animal models to improve personalized therapy by targeting the genetic, behavioral, and environmental determinants of metabolic health unique to each person. In the community, we are planning group exercise programs and cooking classes - the COVID pandemic is presenting challenges, but we are working on technology-based strategies to offer these activities safely.
Bone Health Clinic
The Bone Health Clinic provides comprehensive care to infants, children, and adolescents with metabolic bone disorders. Childhood is a critical time for the attainment of bone mass, which impacts lifelong skeletal health. For children with rare bone diseases such as those with bone fragility or heritable forms of rickets, early diagnosis and treatment are necessary to ensure proper bone health. Children can also be at risk for developing low bone mass and osteoporosis due to an underlying chronic disease. Early identification of the risk factors and prevention of osteoporosis through modifications in nutrition, physical activity, calcium, and vitamin D intake are key to optimize bone health in children.
In the Bone Health Clinic, patients receive individualized assessment and care-plans, including:
- Clinical evaluation for screening and diagnosis of metabolic bone disorders
- Laboratory evaluation of bone minerals, such as calcium, phosphorus, and vitamin D metabolites
- Imaging studies including x-rays
- Dual-energy X-ray absorptiometry (DXA) scans to measure bone mineral density
- Genetic testing for rare metabolic bone disorders such as osteogenesis imperfecta, hypophosphatemic rickets and hypophosphatasia
- Treatment as indicated, including bisphosphonate infusions
Conditions Evaluated and Managed in the Bone Health Clinic
Many of the children seen in the Bone Health Clinic have a significant history of fragility fractures or rickets with bone deformities. In addition, patients are seen with other rare metabolic bone disorders such as osteogenesis imperfecta, fibrous dysplasia, McCune-Albright syndrome, hypophosphatasia, osteopetrosis, and X-linked hypophosphatemic rickets to list a few. An extensive list of the conditions for referral includes:
- Calcium disorders (hypocalcemia, hypercalcemia)
- Parathyroid disorders (hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism)
- Disorders of vitamin D metabolism
- Fibrous dysplasia/McCune-Albright Syndrome
- Low bone density
- Multiple or fragility fractures
- Osteogenesis Imperfecta
Innovative Therapeutic Approaches Offered in the Bone Health Clinic
Over the past decades, a multitude of therapies have become available for many of the metabolic bone disorders that affect children, including enzyme replacement therapy and monoclonal antibodies. These therapies are offered to our patients in the Bone Health Clinic when indicated. In addition, there are many indications for the off-label use of bisphosphonates in pediatric patients, including primary and secondary osteoporosis, osteogenesis imperfecta, bone pain, and hypercalcemia to name a few. IV bisphosphonate infusions can be quite effective in improving bone mineral density and reducing future fracture risk, yet they are not routinely available to patients except in specialized bone centers. In the Bone Health Clinic, we can treat children safely and effectively with these infusions based on our standard protocols.
Comprehensive Growth Center
Growth is an important window to the health of a child: it is an indicator of proper diet and nutrition, the functioning of the kidney, rheumatoid, gastrointestinal and cardiac systems; infection; inflammatory and genetic diseases; and levels of thyroid, growth, and pubertal hormones. Abnormal growth is a major concern for both pediatricians and families alike. Certain populations of children are at increased risk for growth failure and should be evaluated carefully. Others may appear to be short and possibly growing abnormally but may fall within the spectrum of what is normal for the family. For those that have true growth failure, non-hormonal causes must be considered. To aid diagnosis, this center comprises a testing center staffed by pediatric specialty trained phlebotomist and caregivers to safely provide a nurturing environment for the performance of prolonged stimulation tests that include growth hormone stimulation tests, tests of adrenal function, and tests hypothalamic pituitary gonadal function. If an endocrine etiology is the cause of growth failure, several treatment options are currently approved to aid in reversing the process. These therapies should be administered by an experienced pediatric endocrinology team to ensure correct diagnosis, appropriate treatment, and avoidance of potential side effects.
At the growth center, we diagnose and treat a variety of conditions such as growth hormone deficiency, idiopathic short stature; obesity; and Turner, Noonan, Russell-Silver, Prader-Willi, CHARGE, and overgrowth syndromes. We also specialize in treating children born small for gestational age. An integral part of the Growth Center is Genetics Core that will assist in evaluating anything from single gene to whole exome analyses for the diagnosis for growth disorders. Some of the genes assayed include: ACAN and NPR2, growth hormone deficiency (GHRHR, GH1, and GHSR), low IGF-1 (GH1, IGF1, GHR, STAT5B).
Our centralized team facilitates improved health outcomes by providing seamless continuity of care across sub-specialties involved in diagnosing and treating pediatric growth disorders. Growth disorders may reflect nutritional issues, systemic disorders, hormonal or genetic defects and our multidisciplinary team allows effortless coordination of care between these disciplines.
Why Choose Us
The Mount Sinai Children’s Comprehensive Growth Center provides comprehensive, integrated, and personalized care. Disorders related to growth often require a team of care, and patients at the growth center receive multidisciplinary care with our own team of physicians, nurse practitioners, nutritionists, and social workers. Our state-of-the-art stimulation testing center offers child-friendly entertainment during testing, and we additionally offer genetic testing, psychosocial support, and nutritionist assessment and recommendations. In addition, the Growth Center has practitioners to assist patients and their families with psycho-social challenges and the crucial transition to adulthood and the self-management of chronic conditions.
We also host both parent and patient support groups to foster connections within the community and aid with the psychological and social challenges associated with growth disorders. Our optional parent, patient, and professional advisory groups further support and improve the care of our patients and families.
Combined conferences with both genetics as well as neuroradiology assure that the latest in state-of-the-art developments for diagnosis and evaluation are available to the children and families being evaluated.
Our team is also at the forefront of clinical and scientific research, regularly contributing to peer-reviewed publications and national and international conferences. With an unrivalled research team of scientists and physician-scientists, we are working to advance scientific discovery for growth disorders which can be translated into new treatments and therapies.