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Biography
Dr Pooja Sachdev is an Associate Professor in Paediatric Endocrinology at the University of Nottingham. She is also an Honorary Consultant in Paediatric Diabetes and Endocrinology at Nottingham Children's Hospital based at Queen's Medical Centre in Nottingham. Her research interests include childhood obesity, Type 2 diabetes in Children and Young People and adrenal insufficiency with an emphasis on iatrogenic induced adrenal suppression. She leads the regional East Midlands Complications of Excess Weight (CEW) service for Children and Young People for Nottingham. Dr Sachdev completed her undergraduate degree in Medicine in Aligarh, India and undertook further paediatric training in Delhi, India and the West Midlands and South Yorkshire deaneries in the UK. She completed her PhD at the University of Sheffield in the area of childhood obesity. Dr Sachdev has given over 50 presentations at international, national and regional meetings and written several papers.
She is a committee member of the Association of Children's Diabetes Clinicians (ACDC), the Clinical Standards Officer for the British Society of Paediatric Diabetes and Endocrinology (BSPED) and Chair of the National Type 2 Diabetes Working Group for Children and Young People.
She was the Training Advisor on the College Speciality Advisory Committee (CSAC) of the Royal College of Paediatrics and Child Health (RCPCH) for Paediatric Diabetes and Endocrinology from 2016-2022. She was the Return to Training (RTT) Champion for the School of Paediatrics in the East Midlands to facilitate a safe and supervised return to training for doctors who had been out of programme (2018-2021). She founded and chaired the East Midlands Endocrine Group (EMEG) from 2019 to 2022 to facilitate education and peer support within the region.
She was the RCPCH College Tutor for Notingham Children's Hospital from 2016-2022 and the Clinical Audit Lead from 2015-2018.
Expertise Summary
Dr Sachdev has a keen interest in severe childhood obesity. Her PhD was the first feasibility study in the UK of the use of intragastric balloons in young people and the metabolic and skeletal effects of this. Her research interests also include Type 2 Diabetes in children and young people and she has received a grant from Diabetes UK for the LEGEND study on low energy diets using total meal replacements in young people aged 12-17 years. Recruitment will start in early summer 2024.
She is also an investigator on the BPSU study exploring the incidence of Glucocorticoid induved adrenal suppression in children under 16. Surveillance completed in September 2022.
Teaching Summary
Keen interest in teaching at both undergraduate and post graduate level as well as allied health professionals. I have initiated, organized and run regional endocrine teaching for Paediatric… read more
Research Summary
Type 2 Diabetes in children and young people has increased exponentially in the last 10 years. Early onset Type 2 Diabetes is an aggressive condition with a prognosis that is worse than Type 1… read more
Keen interest in teaching at both undergraduate and post graduate level as well as allied health professionals. I have initiated, organized and run regional endocrine teaching for Paediatric Endocrine trainees, organized Return to Train Days for trainees coming back into training, taught on MRCPCH clinical teaching programmes as well as helped trainees prepare for START.
Current Research
Type 2 Diabetes in children and young people has increased exponentially in the last 10 years. Early onset Type 2 Diabetes is an aggressive condition with a prognosis that is worse than Type 1 diagnosed the same age or T2DM that develops later in life. Adult T2DM has seen a paradigm shift in approach with the Direct study showing remission in T2DM can be achieved and sustained with weight loss.
Dr Sachdev's current research includes studying the feasibility of low energy diets using total meal replacements to induce rapid and significant weight loss in young people to understand the acceptability of this approach in this population. The study will also explore the qualitative aspects of this work through semi-structured interviews with a subset of the participants, health care professionals delivering the study and those that declined to take part in the study.
Dr Sachdev is also a co-investigator in the 'Diabetes in Diversity' Programme grant which aims to improve glycemic outcomes in socially and economically disadvantaged young people with Type 1 Diabetes. NPDA data year on year has shown that there is a significant gapShe will be leading on the feasibility study in year 3 at Nottingham.
She is also a co-investigator in the 'Glucocorticoid induced adrenal suppression' surveillance study conducted through the British Paediatric Surveillance Unit from September 2020 to September 2022 (25 months. This study will estimate how many people are presenting to healthcare providers with adrenal suppression causing symptoms because of them currently or previously taking glucocorticoid medication; describe the characteristics of these patients; find out whether healthcare management differs from established guidelines; and see if there are identifiable factors in health professional or family practice that might prevent these patients from becoming unwell or reduce the severity of their illness in future.
Past Research
Past research includes a feasibility study of the use of intragastric balloons in children and young people living with severe obesity and the metabolic and skeletal impact of this.
Intragastric Balloons are a temporary, reversible and safer option compared to bariatric surgery to promote significant weight loss, leading to improved metabolic outcomes. However, due to subsequent weight regain, alternative procedures are now preferred in adults. In adolescents, more amenable to lifestyle change, balloons may be an alternative to less reversible procedures. Our aim was to assess the tolerability and efficacy of the intragastric balloon in severely obese adolescents and the impact of associated weight loss on biomedical outcomes (glucose metabolism, blood pressure, lipid profiles) and bone density. A 2-year cohort study of 12 adolescents (BMI >3.5 s.d., Tanner stage >4) following 6 months intragastric balloon placement was carried out. Subjects underwent anthropometry, oral glucose tolerance test, and DEXA scans at 0, 6 and 24 months. The results showed clinically relevant improvements in blood pressure, insulin: glucose metabolism, liver function and sleep apnoea at 6 months. Changes were not sustained at 2 years though some parameters (Diastolic BP, HBA1c, insulin AUC) demonstrated longer-term improvement despite weight regain. Despite weight loss, bone mass accrual showed age appropriate increases. In conclusion, the intragastric balloon was safe, well tolerated and effective in supporting short-term weight loss and clinically relevant improvement in obesity-related complications, which resolved in some individuals. Benefits were not sustained in the majority at 2 years.
Future Research
Dr Sachdev would aim to use the feasibility work and learning from through the Legend Study to inform a national definitive randomized control trial in children and young people with Type 2 Diabetes. Other areas include use of continuous glucose monitoring in early onset non insulin treated Type 2 Diabetes and planning a priority setting partnership in management of complex pediatric obesity.