Sheela Magge, Seeing Endocrinology Patients as a Whole

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June 21, 2019

Sheela Magge, the new director of the Johns Hopkins Divi­sion of Pediatric Endocrinology, recently met with a fellow to discuss one of their type 2 diabetes patients. After the fellow went over the patient’s doses of insulin, her other medications and her glucose numbers, Magge urged him to dig deeper to better understand why this patient was having poor outcomes.

“I asked him, ‘Is she depressed? Does she have food security issues? Does she have reliable transportation, a safe place to exercise?’” Magge says. “How this patient ultimately does may have little to do with her diabetes and much more to do with a multitude of other underlying concerns.”

Looking at patients as a whole has long been part of her care philosophy, Magge says, even before she was officially a doc­tor. After completing her undergraduate degree from Harvard University, Magge spent a year before medical school on a community service project. Working in a domestic violence shelter in rural Appalachia, she started a tutoring program for abused children. Then, one weekend while taking a day trip, she suffered a traumatic accident that almost took her life and required months of intense recovery.

“I already knew that I wanted to be a pediatrician and that I would always try to see situations from my patient’s point of view, but it’s hard to do that until you’re a patient yourself,” she says. “That experience gave me a completely different out­look on how vulnerable and powerless you can feel and all the many factors that go into how well patients do.”

Magge went on to attend medical school at Yale University and a residency at Boston Children’s Hospital, where she ul­timately decided to specialize in endocrinology—a field that touches all organ systems and many intriguing biological path­ways, and allows her to work with children of all ages and maintain strong relationships as they grow.

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After a fellowship at Children’s Hospital of Philadelphia, Magge stayed there for 13 years, developing an expansive clini­cal research program along with her practice. In 2014, she took a position at Children’s National Health System in Washing­ton, D.C., where she served as the director of participant and clinical interactions at the Clinical and Translational Science Institute.

Now at Johns Hopkins Children’s Center, Magge has con­tinued a strong focus on research, with current projects focus­ing on areas including how body proportions of people with Down syndrome might affect cardio-metabolic risk, and racial differences in diabetes risk and cardiovascular disease. Many of her studies focus on type 2 diabetes, a disease that’s occurring at progressively younger ages due to an increasing incidence of obesity in children.

“A 60- or 70-year-old diabetic might develop complications toward the end of life, but what happens when a 10-year-old develops type 2 diabetes? We need to help protect this vulner­able population,” she says.

That’s why Magge and her colleagues are expanding their division’s diabetes footprint, offering a multidisciplinary clinic where nutritionists, psychologists, social workers, physical therapists and a multitude of other specialists improve pa­tients’ health as a whole. The team shares Magge’s approach of looking at all the factors that might affect patients’ well-being, rather than just their medical history and lab values.

“By addressing all their needs, not just those that endocri­nologists typically focus on,” she says, “we’re hoping to make a positive impact for the rest of their lives.”