• Panagiotopoulos, Constadina (Dina)

    Titles

    Investigator, BC Children's Hospital
    Pediatric Endocrinologist, BC Children's Hospital
    Clinical Professor, Division of Endocrinology, Department of Pediatrics, University of British Columbia

    Degrees / Designations
    MD, FRCPC
    Primary Area of Research
    Childhood Diseases
    Secondary Area(s) of Research
    Phone
    604-875-2345 ext. 5121
    Fax
    604-875-3231
    Lab Phone
    Assistant
    Lisa Wong
    Assistant Phone
    604-875-2624
    Mailing Address
    BC Children's Hospital
    Room K4-213
    4480 Oak Street
    Vancouver, BC V6H 3V4
    Affiliate Websites
    Research Areas
    Type 1 & 2 diabetes in children and youth
    Summary

    My research spans both type 1 and type 2 childhood diabetes.

    The first aspect of my research relates to the prevention of type 2 diabetes (T2D) and its associated co-morbidities in youth with mental health conditions treated with atypical antipsychotic (AAP) medications. Since 2006, we have performed foundational research on AAPs and their metabolic sequelae in children / youth, established key partnerships and a platform for ongoing research, and created and implemented Canada’s first (and so far only) pediatric Provincial Mental Health Meta-bolic Program.

    At the request of remote First Nations communities in BC, I have conducted diabetes screening and found high prevalence of pre-diabetes in youth residing in the region. This led to the program development of a modified, culturally appropriate Actions Schools! BC and Healthy Buddies program for implementation at three Tsimshian communities.

    Further, in collaboration with Drs. Jean-Pierre Chanoine and Louise Masse, I led the evaluation of the Shapedown program at BC Children’s Hospital. Shapdown is a multi-disciplinary, well-defined weight treatment/management program for children and adolescents with a family-focused intervention. I led the evaluation of this program’s effect on BMI, insulin resistance, metabolic syndrome, and examined its effect on changes in psychological outcomes, nutrition, and physical activity.

    In the realm of type 1 diabetes (T1D), I am the Clinical Core Leader within the CIHR New Emerging Team in Childhood Autoimmunity. Immune white cells, such as cytotoxic T lymphocytes (CTL) and natural killer (NK) cells protect us from infections by killing infected cells. Conversely, defects in their function or regulation lead to autoimmune diseases such as T1D. I collaborate with Dr. Rusung Tan in trying to understand the defects in these cells in order to develop new therapies and prevention strategies for this disease. In addition I am the regional site lead and Vancouver Affiliate PI for TrialNET, an international, multi-centre network dedicated to the study, prevention and treatment of T1D.

    Current Projects

    Metabolic Effects of Atypical Antipsychotics in Pediatric Population

    In BC, mental illness occurs in 15% of children and adolescents, many of whom are treated with atypical antipsychotics (AAPs). To evaluate the metabolic sequelae of AAP use in youth, we have since 2006 conducted a retrospective chart review at BC Children’s Hospital (BCCH), developed a draft Metabolic Assessment and Monitoring Tool, and undertaken various knowledge translation initiatives at BCCH, Vancouver Coastal Health and beyond. These include the development of Healthy Living Toolkit, implementation of Metabolic Monitoring Tool in community mental health teams and the first Pediatric Provincial Mental Health Metabolic Program. We seek to have an immediate impact to improve the health of AAP-treated youth by enhancing the knowledge base of healthcare providers and families. This work is funded by multiple stakeholders, including the Lawson Foundation and the BC Provincial Health Services Authority.

    Type 2 Diabetes Screening and Prevention in Remote First Nations Communities

    Through longstanding relationships with three Tsimshian communities in BC and at their request, we have conducted diabetes screening and determined a high prevalence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among youth residing in the region. This was the impetus behind the modification, implementation and evaluation of Action Schools! BC and Healthy Buddies programs for the communities’ specific settings. We are currently expanding this modified program to a community in Nunavut at their request.

    Autoimmunity in Type 1 Diabetes

    Type 1 diabetes mellitus arises from an autoimmune process directed against pancreatic beta cells in both humans and non-obese diabetic (NOD) mice. The destruction of beta cells is understood to be mediated by CD8+ cytotoxic T lymphocytes (CTL), though many other cell types are beginning to emerge as additional candidates in the disease progression. In collaboration with Dr. Rusung Tan, we are examining NK cells and subsets of proinflammatory T cells implicated in T1D. With Dr. Bruce Verchere, we are studying the mechanisms of beta cell failure in islet transplantation.

    Selected Publications

    Cote AT, Harris KC, Panagiotopoulos C, Sandor GGS, Devlin AM. State-of-the-art paper: Childhood Obesity and Cardiovascular Dysfunction. J Am Coll Cardiol. 2013 Oct 8;62(15):1309-19. doi: 10.1016/j.jacc.2013.07.042. Epub 2013 Aug 14. [link]

    Ronsley R, Lee AS, Kuzeljevic B, and Panagiotopoulos C. Healthy BuddiesTM reduces zBMI and waist circumference in Aboriginal children living in remote coastal communities. J Sch Health. 2013 Sep;83(9):605-13. doi: 10.1111/josh.12072. PMID: 23879779. [link]

    Ronsley R, Scott D, Warburton WP, Hamdi R, Louie DC, Davidson J, Panagiotopoulos C. A population-based study of antipsychotic prescription trends in children and adolescents in British Columbia, From 1996 to 2011. Can J Psychiatry 2013; 58(6): 361-369. PMID: 23768264. [link]

    Panagiotopoulos C, Riddell MC, Sellers EAC. Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Type 2 diabetes in Children and Adolescents. Can J Diabetes 2013; 37(suppl 1): S163-S167. [link]

    Xu Y, Nguyen D, Davidson J, Panagiotopoulos C. Health Information Preference among Youth and Caregivers related to Second-Generation Antipsychotic Treatment. J Can Acad Child Adolesc Psychiatry. 2012 Nov;21(4):302-9. [link]

    Ronsley R, Rayter M, Smith DH, Davidson J, Panagiotopoulos C. Metabolic monitoring training program implementation in a community setting is associated with improved monitoring in second-generation antipsychotic-treated children. Can J Psychiatry 2012; 57(5):292-9. PMID: 22546061. [link]

    Amed S, Hamilton J, Sellers E, Panagiotopoulos C, Hadjiyannakis S, Shah B, Booth G, Laubscher T, Dannenbaum D, Dean H. Differing clinical features in Aboriginal versus non-Aboriginal children presenting with type 2 diabetes. Pediatr Diabetes. 2012 Sep;13(6):470-5. doi: 10.1111/j.1399-5448.2012.00859.x. Epub 2012 Feb 27. [link]

    Devlin AM, Ngai YF, Ronsley R, Panagiotopoulos C. Cardiometabolic risk and the MTHFR C677T variant in children treated with second-generation antipsychotics. Translational Psychiatry. 2012 Jan. [link]

    Pringsheim T, Panagiotopoulos C, Davidson J, Ho J; Evidence-Based Recommendations for Monitoring Safety of Second Generation Antipsychotics in Children and Youth. J Can Acad Child Adolesc Psychiatry. 2011 Aug;20(3):218-233. [link]

    Ho J, Panagiotopoulos C, McCrindle B, Grisaru S, Pringsheim T; Management Recommendations for Metabolic Complications Associated with Second Generation Antipsychotic Use in Children and Youth. J Can Acad Child Adolesc Psychiatry. 2011 Aug;20(3):234-241. [link]

    Amed S, Dean H, Sellers EA, Panagiotopoulos C, Shah BR, Booth GL, Laubscher TA, Dannenbaum D, Hadjiyannakis S, Hamilton JK. Risk factors for medication-induced diabetes and type 2 diabetes. Journal of Pediatrics 2011 Feb 23 [published online ahead of print]. PMID 21353243 [link]

    Ronsley R, Raghuram K, Davidson J, Panagiotopoulos C.: Barriers and facilitators to implementation of a metabolic monitoring protocol in hospital and community settings for second-generation antipsychotic-treated youth. J Can Acad Child Adolesc Psychiatry. 2011 May;20(2):134-41. PMID: 21541103

    Qin H, Lee I-F, Panagiotopoulos C, Wang X, Chu AD, Utz PJ, Priatel JJ, Tan R. Natural killer cells from children with type 1 diabetes have defects in NKG2D-dependent function and signaling.Diabetes published online before print, January 26, 2011. [link]

    Trudel K, Sanatani S, Panagiotopoulos C. Severe amiodarone-induced hypothyroidism in an infant. Pediatric Critical Care Medicine 2011;12(1):e43–e45. [link]

    Chovil N, Panagiotopoulos C. Engaging families in research to determine health literacy needs related to the use of second-generation antipsychotics in children and adolescents. Journal of the Canadian Academy of Child and Adolescent Psychiatry 2010;19(3):201–208. PMID 20842275

    Marwaha AK, Crome SQ, Panagiotopoulos C, Berg KB, Qin H, Ouyang Q, Xu L, Priatel JJ, Levings. Cutting edge: increased IL-17-secreting T cells in children with new-onset type 1 diabetes. Journal of Immunology 2010;185(7):3814–3818. [link]

    Alghamdi MH, Steinraths M, Panagiotopoulos C, Potts JE, Sandor GG. Primary pulmonary arterial hypertension and autoimmune polyendocrine syndrome in a pediatric patient. Pediatric Cardiology 2010;31(6):872–874. [link]

    Mitchell MS, Gaul CA, Naylor PJ, Panagiotopoulos C. Habitual moderate-to-vigorous physical activity is inversely associated ith insulin resistance in Canadian First Nations youth. Pediatric Exercise Science 2010;22(2):254–265. PMID 20567046

    Naylor P, Scott J, Drummond J, Bridgewater L, McKay HA, Panagiotopoulos C. Implementing a whole school physical activity and healthy eating model in rural and remote First Nations schools: a process evaluation of Action Schools! BC. Rural and Remote Health 2010;10 (online):1296. [link]

    Panagiotopoulos C; Ronsley R, Elbe D, Davidson J, Smith DH. First do no harm: promoting an evidence-based approach to atypical antipsychotic use in children and adolescents. Journal of the Canadian Academy of Child and Adolescent Psychiatry 2010;19(2):124–137. [link]

    Amed S, Dean HJ, Panagiotopoulos C, Sellers EAC, Hadjiyanakis S, Laubscher TA, Dannenbaum D, Shah BR, Booth GL, Hamilton JK. Type 2 diabetes, medication-induced diabetes, and monogenic diabetes in Canadian children: a prospective national surveillance study. Diabetes Care 2010;33(4):786–791. [link]

    Panagiotopoulos C, Ronsley R, Davidson J. Increased prevalence of obesity and glucose intolerance in youth treated with second-generation antipsychotic medications. Canadian Journal of Psychiatry 2009;54(11):743–749. [link]

    Grants
    Honours & Awards
    • Abbott Nutrition Young Investigator Award in Research, Western Society for Pediatric Research – 2013
    • Leading Practice Award, Accreditation Canada – 2013
    • Speaking of Food and Healthy Living Award, Dietitians of Canada – 2012
    • Award of Excellence, BCMA Council on Health Promotion – 2012
    • Diabetes Champion, Canadian Diabetes Association – 2009
    • Regional Outstanding Health Professional Award, Canadian Diabetes Association – 2009
    • Clinician Scientist Awardee, Canadian Diabetes Association – 2008
    • Ivory Tower Award, BC Children's Hospital – 2007
    • Brian Dufton Memorial Manuscript Award, Canadian Diabetes Association – 2003
    Research Group Members
    • Duc Nguyen – Clinical Research Coordinator for the CDRU (604-875-2345, ext. 4696)
    • Sue Baynham – Clinical Research Coordinator (TrialNet) (604-875-2345, ext.4801)
    • Katie Robbins – Research Co-op student (604-875-2345, ext.4802)
    • Jemimah Membreve – Research Co-op student (604-875-2345, ext. 6658)
    • Anita Cote – Postdoctoral Fellow
    • Mikaela Barker – Graduate Student