Lori Laffel, M.D., M.P.H.
Dr. Laffel is Chief of the Pediatric, Adolescent and Young Adult Section at Joslin Clinic, an Investigator in the Section on Genetics and Epidemiology at Joslin Diabetes Center, and an Associate Professor of Pediatrics at Harvard Medical School. She is the Principal Investigator and the Program Director for Joslin’s NIH-funded Postdoctoral Fellowship and Early Career Development training grants for pediatric endocrinologists entering the field of diabetes research.
She is the co-director of the combined Pediatric Endocrine Training program at Joslin Diabetes Center and Children’s Hospital Boston. Dr. Laffel is also the principal investigator on two NIH-funded multicenter trials of youth with type 1 diabetes and type 2 diabetes. Dr. Laffel received her medical degree from the University of Miami School of Medicine and her master’s degree in Public Health from the Harvard School of Public Health. She did her pediatric training at Children’s Hospital and her fellowship training at Children’s Hospital and Joslin.
Dr. Laffel focuses her research and clinical interests on preventing the late complications of type 1 diabetes and preserving the health, normal growth, development and family functioning of children, adolescents and young adults with diabetes. Under her leadership, the Joslin Clinic Pediatric, Adolescent, and Young Adult Section has more than tripled in size, with a large pediatric research program complementing the clinical activities.
Dr. Laffel’s research concentrates on three areas: (1) optimizing glycemic control while preserving quality of life in pediatric patients with type 1 diabetes; (2) preventing complications and preserving health for pediatric patients with type 1 or type 2 diabetes, including outcomes and translational research activities; and (3) the use and assessment of innovative technologies, such as wireless devices, to improve adherence to blood glucose monitoring and diabetes management in young patients.
Working with her colleagues at Joslin, George King, M.D., and Andrzej Krolewski, M.D., Ph.D., Dr. Laffel continues to study the predictors of complications and early markers of microvascular and macrovascular disease in pediatric patients with type 1 diabetes. For example, Dr. Laffel was the lead author of a study that established the use of angiotensin-converting enzyme (ACE) inhibitors as the standard of care to preserve kidney function in certain patients with type 1 diabetes. Along with Christophe Benoist, M.D., Ph.D., and Diane Mathis, Ph.D., she is studying environmental and immunological factors that lead to islet cell autoimmunity and early age onset of type 1 diabetes in youth.
Dr. Laffel’s clinical research investigates the daily treatment for children with type 1 diabetes, studying which methods of family management predict healthy outcomes and do not compromise quality of life. These methods include parent-child teamwork with a multi-disciplinary healthcare team; the identification of predictors and strategies to avoid diabetes-specific family conflict; and the use of a “care ambassador”—a non-medically-trained staff person who serves as liaison to the family. This intervention aims to prevent the expected deterioration of glycemic control during the teenage years. In the study, the use of care ambassadors resulted in a 30 percent reduction in the need for hospitalization or emergency room visits and a 50 percent reduction in the occurrence of severe hypoglycemia in the intervention group.
In conjunction with four other centers, Dr. Laffel’s team is involved in a problem-solving intervention aimed at optimizing glycemic control in preadolescents and early adolescent patients with type 1 diabetes. This ongoing study, funded by the National Institute of Child Health and Human Development (NICHHD) of the National Institutes of Health (NIH), implements interventions and assesses how well they translate to other healthcare settings. Dr. Laffel is also a Principal Investigator in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study—funded by the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)—designed to address the epidemic of childhood obesity and type 2 diabetes in children and adolescents. This study compares three different treatment strategies of youth, ages 10 to 17 years, with type 2 diabetes. Additionally, Dr. Laffel continues to mentor many fellows and promote the career development of junior faculty in the pediatric section.
Laffel LMB, Wentzell K, Loughlin C, Tovar A, Molt K, Brink S. Sick day management using blood 3-hydroxybutyrate (3-OHB) compared with urine ketone monitoring reduces hospital visits in young people with T1DM: a randomized clinical trial. Diabet Med 23:278-284, 2006.
Moreland EC, Volkening LK, Lawlor MT, Chalmers KA, Anderson BJ, Laffel LMB. Use of a blood glucose monitoring manual to enhance monitoring adherence in adults with diabetes: a randomized controlled trial. Arch Intern Med 166:689-695, 2006.
Ahmed SB, Hovind P, Parving HH, Rossing P, Price DA, Laffel LM, Lansang MC, Stevanovic R, Fisher ND, Hollenberg NK. Oral contraceptives, angiotensin-dependent renal vasoconstriction, and risk of diabetic nephropathy. Diabetes Care 28:1988-1994, 2005.
Hood KK, Bennett Johnson S, Carmichael SK, Laffel LM, She JX, Schatz DA. Depressive symptoms in mothers of infants identified as genetically at risk for type 1 diabetes. Diabetes Care 28:1898-1903, 2005.
Lansang, MC, Stevanovic, R, Price DA, Laffel LMB, Hollenberg NK. ACE and non-ACE pathways in the renal vascular response to RAS interruption in type 1 diabetes mellitus. Kidney Int 67:1033-1037, 2005.
Kumar VS, Wentzell KJ, Mikkelsen T, Pentland A, Laffel LMB. The DAILY (Daily Automated Intensive Log for Youth) trial: a wireless, portable system to improve adherence and glycemic control in youth with diabetes. Diabetes Technol Ther 6:445-453, 2004.