Enhancing the lives of children

The late 1960s were a time of change and personal reflection. Neil H. White was a student at the State University of New York at Albany, pondering his own future and considering three professions: chemical engineer, ski bum or doctor.

Although he was a chemistry and physics major, White also was president of the Ski Club, and the allure of good powder on Vermont’s pristine slopes was strong.

To many patients’ benefit, he put the decision to rest during his junior year and chose medicine — a decision he’s never regretted.

“As soon as I started medical school, I knew I’d made the right choice,” says White, M.D., professor of pediatrics and of medicine and director of the Division of Pediatric Endocrinology and Metabolism.

Alan Schwartz, Ph.D., M.D., the Harriet B. Spoehrer Professor and chairman of the Department of Pediatrics, heralds White’s contributions.

“He has devoted his professional career to enhancing the lives of children with diabetes,” Schwartz says. “For more than two decades, Neil has been at the cutting edge of multicenter trials in pediatric diabetes, and his advice is sought worldwide.

“We are so very fortunate to have him leading those efforts here at Washington University.”

Devoted to diabetes

White, the son of an optometrist and elementary-school teacher, grew up with a brother and sister on Long Island in the town of Great Neck. Weekends were spent boating the cool waters of Long Island Sound. White also spent a lot of time on the tennis court.

He attended medical school at Albert Einstein College of Medicine in the Bronx, where he became interested in pediatrics while training at Lincoln Hospital, a hospital in the South Bronx that serves an indigent population.

But it wasn’t until his residency at St. Louis Children’s Hospital in 1975 that White discovered endocrinology. He was fascinated by the interaction of physiology with the management of diabetes in the day-to-day life of children.

Morey Haymond, M.D., and Anthony Pagliara, M.D., immediately made an impact on the young doctor.

“Not only were these physicians interesting people who were incredibly devoted to their patients, but they also were dedicated to me understanding this fascinating disease,” White says.

Although Haymond and Pagliara left the School of Medicine around the time White began a pediatric endocrinology and metabolism fellowship, he soon met two other University endocrinologists, Julio Santiago, M.D., and Phil Cryer, M.D., the Irene E. and Michael M. Karl Professor of Endocrinology and Metabolism.

White joined the faculty as an instructor and began working with Santiago and Cryer on a number of key diabetes studies.

After a four-year stint on the University of Michigan faculty, White returned to Washington University in 1991. He was involved in the national Diabetes Control and Complications Trial (DCCT) both here and at the University of Michigan.

Considered one of the most important studies in diabetes research, in 1993 the DCCT determined that strictly controlling blood sugars can prevent or delay the ravaging complications of the disease, such as limb amputation, kidney failure and blindness.

“That was a very exciting year,” White says. “It made us all feel that the research we had conducted for 10 years had really paid off.”

He was also involved in the Diabetes Prevention Program (DPP), a large national study that found that people at high risk for type 2 diabetes can sharply lower their chances of getting the disease with diet and exercise.

Additionally, White has conducted studies with psychologist Michael A. Harris, Ph.D., instructor of pediatrics, who specializes in psychosocial interventions in teenagers with diabetes and other chronic diseases.

In 1997, White’s career took an unexpected turn when Santiago, director of the Division of Pediatric Endocrinology and Metabolism, died of a heart attack on a flight to Germany.

“It was very shocking,” White says. “At that point and time, I took over a number of his studies and became interim division director.”

White became the permanent division director in 1999. Bess Marshall, M.D., assistant professor of pediatric endocrinology and metabolism, describes White as a great boss who likes to have consensus. “He’s easy to work with, and he’s very agreeable,” Marshall says.

Paul Hruz, M.D., also an assistant professor of pediatric endocrinology and metabolism, says White genuinely cares about his faculty members and staff. “He’s been very helpful in getting my career up and running,” Hruz says.

In addition to being division director, White carries a large patient-care load as well as the teaching responsibilities that accompany it. He also directs a patient-oriented research unit for the Department of Pediatrics and is associate director of the General Clinical Research Center for pediatrics.

“I am committed to academic medicine, and at this point I see my role in academic medicine as developing clinical care at the highest levels and passing that along to future physicians and health-care professionals,” White says. “I also want to develop a culture of high-level clinical investigation in pediatrics, particularly in diabetes.”

White is motivated by the positive comments he receives from his patients and their families and by the important breakthroughs in the field of diabetes over the past 20 years.

“I feel strongly that this is a worthwhile endeavor,” he says. “And I take a great deal of pride in knowing that I helped this division survive a very difficult tragedy that could have destroyed us.”

In his research and care of patients, White has learned that children with diabetes respond best to positive reinforcement — focusing on what they’ve achieved instead of on what they need to do. He has also discovered that each family is different and he must assess a family’s physical, financial and emotional resources before developing a plan to help them manage diabetes.

White’s next big study is Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY), which is the first clinical trial to focus on type 2 diabetes in children and teens. To slow the rate at which children are being diagnosed with type 2 diabetes, White believes society needs to first address the alarming number of obese children.

“I think the wake-up call is getting to this population of at-risk patients before they develop diabetes,” he says.

Passionate about patients

In his free time, White attends many Cardinals games and plays “a very bad game” of golf with his children, Michael, 26, and Justin, 23. Michael is a nuclear engineer in upstate New York, and Justin will begin graduate school to study trumpet in the fall.

His wife, Ann, is a busy volunteer for St. Louis Children’s Hospital and occasionally works with him on special projects.

Over the years, White has stayed committed to helping children with diabetes while maintaining his enthusiasm for the outdoors. For the past 21 years, he’s been involved with the American Diabetes Association (ADA) camps in Missouri and Michigan, many of those years as medical director.

He has served as president of the local ADA and on many of the association’s national committees. He’s also encouraged many families to become involved with the ADA and empowered them in managing the disease.

“He’s a superhero,” says Ed Clay, executive director of the local ADA. “We should get him a cape. He has a passion for what he does, and I think it comes across in what he accomplishes.”