Joslin Investigator Details

A Harvard Medical School Affiliate

Welcome to the Joslin Research Website


	Joslin Investigator:

Dr. Lori Laffel

Investigator Specifics:

Professional Details:

CV not available

Member of Section:

Current Fellows, Students, or Lab Members:

Cielo Alleyn

Debbie Butler, MSW, LICSW

Jessica T. Markowitz, Ph. D.

Sanjeev Mehta, MD, MPH

Lisa K. Volkening, MA

Katherine Wentzell

Jamie R Wood, M.D.

Past Fellows, etc.:

Justine Bode

Nicole Castronuovo, MA, CAGS

Kattia Corrales-Yauckoes, MS, RD, LDN

Ellen Goldberg

Julie Griffith

David Hanauer

Laura Hanson

Korey Hood

Christina Jacobsen

Vikrum Kumar

Anthont Lim

Allison Maher

Elaine Moreland

Laena Orkin

Erinn Rhodes

Ana Lilia Rodriguez Ventura

Elizabeth Rosolowsky, MD

Radomir Stevanovic

Nicole Sweatman

Sarah Wilczynski

Investigators

Adjunct Investigators

Fellows & Team Members

DERC Cores

Research Sections

Joslin Resources

Lori MB Laffel, MD, MPH

Investigator

Joslin Diabetes Center

Associate Professor

Harvard Medical School

1/1/2001 -

Reaching All Patients with Diabetes

Lori Laffel, M.D., M.P.H., 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 and Adolescent Section has doubled in size, with a large pediatric research program complementing the clinical activities.

Dr. Laffel’s research concentrates on three areas: (1) prevention and treatment of kidney disease; (2) optimizing glycemic control while preserving quality of life in pediatric patients with type 1 diabetes, work that includes outcomes and translational research; and (3) the use and assessment of innovative technologies, such as wireless devices, to improve adherence to blood-glucose monitoring in young patients.

Working with Norman Hollenberg, M.D., at Brigham and Women’s Hospital and other investigators, Dr. Laffel identified predictors of early kidney disease in young patients. In association with colleagues in Joslin’s Section on Genetics and Epidemiology, she found that risk for diabetic nephropathy increases in patients with infrequent medical follow-up and in those whose hemoglobin A1c values exceed a threshold value of 8 percent. These and other findings laid the foundation for prevention and treatment interventions. 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.

Dr. Laffel’s clinical research investigated 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 multidisciplinary health care 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 is designing new interventions for glycemic control. 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.

A new clinical research study entitled DAVY, is the study of diabetes in adolescents and the very young. This investigation involves a multi-disciplinary approach to untangling the genetic and environmental contributions to the development of pancreatic autoimmunity and type 1 diabetes in adolescents, ages 10 to 15, and very young children, under age 6 at diagnosis. Another aim of the investigation is to identify markers of early complications of diabetes in adolescents and in young adults. These investigations involve collaborations between the Sections on Genetics and Epidemiology, Immunology and Immunogenetics and Complications. Co-Investigators include Drs. Laffel, Benoist, Mathis, and King along with their research groups. These exciting studies will serve as pilot investigations to uncover genetic and environmental factors along with immunologic markers and markers of early complications and have been funded by through the generosity of the Charles H. Hood Foundation.

Selected References

Hood, K, Butler, D, Volkening, L, Anderson, B, Laffel, L. The blood glucose monitoring communication questionnaire. Diabetes Care 27:2610-2615, 2004.

Moreland, E, Tovar, A, Zuehlke, J, Butler, D, Milaszewski, K, Laffel, L. The impact of physiological, therapeutic and psychosocial variables on glycemic control in youth with type 1 diabetes. Journal of Pediatric Endocrinology & Metabolism 17, 1533-1544, 2004.

Laffel LMB, Connell A, Vangness L, Goebel-Fabbri A, Mansfield A, Anderson BJ. General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes Care 26:3067-3073, 2003.

Svoren BM, Butler D, Levine BS, Anderson BJ, Laffel LMB. Reducing acute adverse outcomes in youth with type 1 diabetes mellitus: A randomized controlled trial. Pediatrics 112:914-922, 2003.

Hollenberg NK, Price DA, Fisher NDL, Lansang C, Perkins B, Gordon MS, Williams GH, Laffel LMB. Glomerular hemodynamics and the renin-angiotensin system in patients with type 1 diabetes mellitus. Kidney Int 63:172-178, 2003.

Laffel LMB, Vangsness L, Connell A, Goebel-Fabbri A, Butler D, Anderson BJ. Impact of ambulatory, family focused teamwork intervention on glycemic control in youth with type 1 diabetes. J Pediatr 142:409-416, 2003.

Anderson BA, Vangsness L, Connel, A, Butler D, Goebel-Fabbri A, Laffel LMB. Family conflict, adherence, and glycemic control in youth with short duration type 1 diabetes. Diabet Med 19:635-642, 2002.

Biographical Sketch

Dr. Laffel is Chief of the Pediatric and Adolescent Section at Joslin Clinic and an Investigator in the Section on Genetics and Epidemiology at Joslin Diabetes Center, as well as an Associate Professor of Pediatrics at Harvard Medical School. She is the Program Director of Joslin’s NIH-funded postdoctoral fellowship and early career development training grants for pediatric endocrinologists entering the field of diabetes research. She also co-directs the combined pediatric endocrine training program at Joslin Diabetes Center and Children’s Hospital Boston. 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.