 One of very few programs in the area as well as in the state of New Jersey, The Center for the Treatment of Insulin Disorders is a comprehensive, multidisciplinary, family-centered and culturally sensitive program to prevent and treat childhood obesity, type 1 and 2 Diabetes Mellitus, metabolic syndrome, hypertension, hypothyroidism, hyperthyroidism, short stature, failure to thrive and precocious, delayed puberty, dyslipidemia and polycystic ovarian syndrome. The Center also serves as a local contact for the Statewide Newborn Screening Program. The program uses a multidisciplinary approach including social support and nutritional counseling and involves the entire family to effectuate lasting change in the home environment. The Center has and continues to develop specialized methods to provide culturally and linguistically appropriate care, support, education and treatment.
Our Team
Individualized Treatment Plans
Significance and Scope of Childhood Obesity in Monmouth and Ocean County
Type 2 Diabetes and Obesity Program Goals and Activities
The program operates under the direction of Malcolm Schwartz, DO, Chief of Pediatric Endocrinology at Monmouth Medical Center. The team also includes 2 other pediatric endocrinologists, Frank Barrows, DO, and Kirk Kerensky MD. A psychologist, a nurse practitioner, a licensed practical nurse, a registered dietician and a social worker also are employed at the Center. The Center for the Treatment of Insulin Disorders treats approximately 700 children a year and has recently expanded to provide services in Lakewood (Ocean County), NJ.
Our physicians include:
Malcolm Schwartz, DO, FACOP
Chief of Pediatric Endocrinology
Frank Barrows, DO
Kirk Kerensky MD, FAAP
Lisa Ball-O'Brien, L.S.W. - Social Worker
Charles Katz, PhD Psychologist
Gaye Madigan, A.P.R.N., B.C. - Nurse Practitioner
Kelly Neumann, L.P.N. - Nurse
LuAnne Petrie, R.D., C.D.E. - Nutritionist
Malcolm Schwartz, D.O., the section chief of pediatric endocrinology at Monmouth Medical Center, is highly regarded throughout the state and the country for his significant accomplishments in endocrinology. He specializes in the treatment of diabetes, thyroid conditions and hormone deficiencies in infants, children and adolescents and offers comprehensive evaluation and treatment with a variety of therapies. His pediatric obesity program provides a blame-free, supportive environment to help obese children and their families adopt healthier lifestyles. He has also played a key role in the development of the Women’s & Children’s Specialty Center – a service that debuted in Lakewood, N.J. in 2005 to provide Ocean County residents with access to Monmouth’s renowned, experienced pediatric subspecialties and high-risk maternity care.
He earned his medical degree from the College of Osteopathic Medicine and Surgery in Des Moines, Iowa, and has since achieved such honors as becoming a member of the National Osteopathic Honor Fraternity, serving as the president of the North Jersey Pediatric Society, and receiving the Distinguished Service Award from the American College of Osteopathic Pediatricians. Dr. Schwartz, who holds board certifications in pediatrics and pediatric endocrinology, is an associate clinical professor of pediatrics at Drexel University College of Medicine in Philadelphia. He also served as chairman of the American Osteopathic Board of Pediatricians for nine years. He is an active member of the Lawson Wilkins Pediatric Endocrine Society, and his scientific studies have been presented before numerous professional organizations and published in peer-reviewed national journals. In 2006, he was named to the American Osteopathic Association (AOA) Mentor Hall of Fame in recognition of his “help in shaping the future of the osteopathic medical profession through his involvement as a mentor to students, interns, residents and young physicians.” Also in 2006, the American Osteopathic Foundation awarded him the Merck Excellence in Care Award in recognition of his work with the Center for the Treatment of Insulin Disorders at Monmouth Medical Center.
Dr. Barrows is board certified in general pediatrics and pediatric endocrinology and received his medical degree from the University of Medicine and Dentistry of New Jersey, School of Osteopathic Medicine in Stratford, New Jersey and a Bachelor of Arts in Public Health from Brown University in Providence, Rhode Island. Dr. Barrows completed his fellowship in Pediatric Endocrinology at University of North Carolina Children’s Hospital in Chapel Hill, NC. He completed his pediatric residency at K. Hovnanian Children's Hospital at JerseyShoreUniversityMedicalCenter in Neptune, New Jersey.
Dr. Barrows has published two articles: Continuous Subcutaneous Glucose Monitoring in Children with Type 1 Diabetes Mellitus: A Single-blind, Randomized, Controlled Trial Pediatric Diabetes, June, 2006 and Metastatic Medullary Thyroid Cancer in a Pediatric Patient with MEN 2B: Emphasis on the Need for Early Recognition of Extrathyroidal Clinical Findings Associated with MEN 2B. Journal of Clinical Pediatrics, June, 2006.
Dr. Barrows counsels his young patients on the importance of good nutrition and physical fitness. His interest in these areas is illustrated in athletic achievements, including earning a National Title in the American Ironman event at the United States Lifeguard Competition in Huntington Beach, CA.
Board certified in pediatrics and pediatric endocrinology, Dr. Kerensky received his medical degree from University of Pennsylvania School of Medicine in Philadelphia and his undergraduate degree in biological sciences from Rutgers University in New Brunswick, New Jersey. Dr. Kerensky completed his internship and residency in pediatrics as well as his fellowship in endocrinology, metabolism and diabetes mellitus at The Children’s Hospital of Pittsburgh. He is a fellow of the American Academy of Pediatrics and member of the American Diabetes Association, Lawson Wilkins Pediatric Endocrine Society, and the Endocrine Society.
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When patients first come to the Center, they are provided with a comprehensive medical evaluation in order to rule out other etiologies of their symtpoms. They are provided with the necessary prescriptions, as well as prescriptions for physical therapy, exercise, and nutrition evaluations as necessary. An individualized treatment plan developed within a family centered care framework guides their follow up care which may include teaching by the nursing staff, nutritional counseling, social work counseling sessions, and psychology appointments, as indicated.
The nursing staff provides up-to-date information on general diagnoses, diabetes management, diabetic supplies, and growth hormone topics. The nursing staff serves as your resource for questions regarding prescriptions and overall care.
The dietician provides nutritional counseling and supportive services to the patients and families. Individualized nutrition plans include an evaluation of the current intake of food as well as suggestions to improve overall nutritional status. The dietician not only teaches about proper nutrition, but also assesses traditional ethnic foods and cooking methods to provide healthy alternatives within the cultural framework. Meal plans are developed while stressing the importance of healthy eating patterns for the entire family while taking into account financial and family resources as well as lifestyle and cultural preferences. Children are educated on the consequences of overeating with regard to their health. Culturally appropriate teaching materials and methods, educational materials in Spanish, and translation services are provided when necessary.
The social worker helps patients and families access care and other related services. The social worker teaches coping skills to help children overcome their diagnosis, address issues around “emotional eating” if there is the need and also reinforces new behaviors and supports motivation for change. The social worker works closely with the families faced with Diabetes providing supportive services and monitoring the Diabetes Support Group.
Changing sedentary lifestyles is essential to weight loss and control of type 2 Diabetes Mellitus in children and as part of treatment, The Center for Treatment of Insulin Disorders provides several plans of physical exercise. We have contracted with a local athletic club, and two physical rehabilitation centers to provide a safe and effective program of physical training for each individual patient.
This Center fulfills the eligibility criteria for the Merck 2006 Excellence in Diabetes Care Award in that it provides assessment and diagnosis, treatment and management, education and the use of enhanced treatment modalities such as exercise, diet, lifestyle and pharmaceutical applications to effectively improve the quality of life for children with diabetes and conditions leading to diabetes. With more than 700 participants a year, The Center for the Treatment of Insulin Disorders is one of very few programs in the area offering this comprehensive and family-centered care and its reputation and blame free approach to management and treatment of obesity and related complications will continue to attract families from throughout the area. This is evident in the significant increase in the numbers of patients served since the program started.
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Both the Long Branch and Lakewood communities are home to a disproportionate share of the region’s indigent, minority and underserved populations. Located within Monmouth County, Long Branch stands in stark contrast to the county as a whole; it is the fifth wealthiest county in a state that has one of the highest per capita incomes in the nation. The Hispanic populations in these two cities comprise 20 percent and 15 percent of the total populations respectively. Approximately 20 percent in both cities live below the federal poverty level and more than 30 percent of children under the age of 18 live below the poverty level. Both Long Branch and Lakewood are home to a large undocumented population, consisting mainly of Mexican and other Central and South American people who are not represented in the above population figures. In Lakewood, the number of undocumented people working as day laborers has increased so much that the township is in the process of creating a government sanctioned muster zone. In Long Branch 33 percent of the population speak a language other than English in the home. Both the Long Branch and Lakewood minority populations face a multitude of barriers to care and rely on the clinics provided by federally qualified health centers and the emergency departments at Monmouth Medical Center in Long Branch and Kimball Medical Center in Lakewood as their only source of health care.
As the prevalence of childhood obesity has increased dramatically in the United States in recent years, the prevalence of overweight African American and Hispanic children has increased disproportionately. In addition, research has found that children of parents with less education have a higher incidence of overweight and obesity. The significant increase in overweight children and adolescents has been reported as the most significant risk factor for the rise in type 2 Diabetes Mellitus among children and adolescents. There is also a predominance of type 2 Diabetes Mellitus among Hispanic youngsters with a particularly high rate among those of Mexican descent.
The Center currently offers two support groups. The Healthy Living Support Group provides information and support to families who need an extra hand in promoting a healthy lifestyle for the whole family. The monthly sessions will provide an opportunity to discuss obstacles and successes. Topics such as exercise, nutrition and goal setting will be presented by the center's staff like the Nutritionist, Social Worker and Physical Therapist.
The Diabetes Support Group provides the opportunity to both our Diabetic Patients and their families to talk about living with Diabetes. In addition, various professionals and staff will come to talk about specific diabetes related information like carbohydrate counting, resources and new technologies.
The Support Groups are held monthly and rotate between the Long Branch and Lakewood sites. Contact Lisa Ball-O’Brien, Social Worker in the Lakewood office at 732-901-0211, in Long Branch at 732-923-6085 or via email at lball@sbhcs.com for more information.
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Very few programs addressing therapy and prevention of obesity and resultant type 2 Diabetes Mellitus in children and adolescents in Monmouth County and none addressing the problem in Ocean County, Monmouth Medical Center’s program has experienced continued growth in the numbers of patients served. Hispanic children and minority and medically underserved children constitute approximately half of the total number of patients and this number has steadily risen over the past few years. The program is challenged to provide culturally, linguistically and family-centered care to appropriately treat children and families and to educate them on necessary and realistic lifestyle changes while providing continued support to effectuate a permanent change. The goals of treatment are to control the condition in a way that helps minimize symptoms and prevent short and long term health consequences, while making sure the child has normal physical, mental, emotional and social growth and development. The following are the objectives of the program:
- To identify the cultural values that contribute to obesity and type 2 Diabetes Mellitus and devise specific interventional programs
- To assist children and families in maintaining a well balanced diet in coordination with a certified nutritionist
- To assist children and families in participating in routine physical activity to achieve and maintain and ideal body weight
- To provide continued medical treatment for diabetes, obesity and other related health problems
- To provide appropriate psychological support for children and families
To promote public awareness of childhood obesity and type 2 Diabetes Mellitus as a major public health problem and educate area pediatricians on the importance of timely referral of overweight children for specialized treatment.
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