Sheela Natesh Magge
VerifiedUniversity of Pennsylvania · Rehabilitation Medicine
Active 1992–2025
About
Sheela Natesh Magge, MD, MSCE, is an Adjunct Associate Professor of Pediatrics specializing in Endocrinology and Diabetes at the University of Pennsylvania's Perelman School of Medicine. She serves as the Director of the Division of Endocrinology and Diabetes. Dr. Magge's research expertise focuses on type 2 diabetes mellitus and pre-diabetes in children, childhood obesity, childhood insulin resistance, and metabolic syndrome, as well as glucose tolerance. Her clinical expertise includes childhood obesity, pediatric insulin resistance and metabolic syndrome, type 2 diabetes mellitus and pre-diabetes in children, type 1 diabetes, and syndromes of extreme insulin resistance. She completed her education at the Massachusetts Institute of Technology with a BA in Biochemical Sciences, Harvard University with an MD, Yale University School of Medicine with an MSCE in Clinical Epidemiology and Biostatistics, and the University of Pennsylvania School of Medicine Center for Clinical Epidemiology and Biostatistics. Dr. Magge's work is dedicated to advancing understanding and treatment of pediatric metabolic disorders.
Research topics
- Medicine
- Internal medicine
- Endocrinology
- Pediatrics
- Gerontology
Selected publications
American Journal of Hypertension · 2025-07-18 · 1 citations
articleOpen accessSenior authorBACKGROUND: Compared to individuals of European or African ancestry, individuals of South Asian (SA) ancestry have greater cardiovascular disease (CVD) risk. We aimed to compare arterial stiffness and central hemodynamics, surrogates of CVD, in adolescents and young adults (AYA) of SA, White, and African American (AA) ancestry with overweight or obesity. METHODS: Pulse wave velocity (PWV) and pulse wave analysis (PWA metrics: Pulse Pressure Amplification [PPA]; Augmentation Index adjusted to heart rate of 75 [Aix75]) were performed in a cross-sectional study of 40 (18M/22F) SA, 45 (16M/29F) AA, and 44 (21M/24F) White AYA (age 12-21 years) of comparable age, sex, and BMI. Between-group comparisons of PWV, PPA, and AIx-75 were tested using linear regression models adjusted for covariates (BMI, mean arterial pressure, sex, age), as appropriate. RESULTS: As expected, BMI (kg/m2) did not differ (SA: 27.1, AA: 28.4, White: 27.4). Mean PWV (m/s) did not differ in SA (5.5), AA (5.1), and White (5.5). The typical relationship of BMI with PWV was absent in SA. PPA was lower in SA (1.45, P = 0.001) and AA (1.48, P = 0.014) vs. White (1.56). Aix75 was higher in SA (108, P = 0.004) but not in AA (105, P = 0.12) vs. White (101). CONCLUSIONS: Although their PWV did not differ, SA AYA had lower PPA and higher Aix75 compared to White counterparts. As lower PPA associates with higher likelihood of future CV events, these findings could reflect an early CVD predisposition in SA and underscore the potential value of pulse waveform analysis in studies of emerging adults, a life stage in which interventions may mitigate CVD risk.
Cardiovascular Diabetology · 2025-10-24
articleOpen accessBACKGROUND: Despite the growing burden of youth-onset type 2 diabetes (Y-T2D), the long-term risk for fatal/non-fatal cardiovascular disease (CVD) in Y-T2D compared to peers is unknown. The International Childhood Cardiovascular Cohort (i3C) combined-risk z-score is a novel tool for predicting 35-year risk of adult CVD events. In Y-T2D compared to peers (Lean and overweight/obesity [OW/OB]), we estimated predicted CVD events and evaluated the relationship of the i3C z-score with risk-enhancing factors. METHODS: In a pooled cohort cross-sectional analysis of 1547 adolescents and young adults (AYA) aged 10-25 years [627 Lean, 803 OW/OB, 117 Y-T2D], i3C combined-risk z-scores and estimated hazard ratios (HR) were obtained from the published i3C equation using risk z-scores of systolic blood pressure, body mass index (BMI), smoking history, total cholesterol, and triglycerides. ANCOVA regression models were used: 1) to compare i3C z-scores and HR in AYA with Y-T2D, OW/OB and Lean peers, and 2) to measure associations between i3C estimated HR and risk-enhancing factors including apolipoprotein B (ApoB), total low density lipoprotein particle number (LDL-P), and high sensitivity C reactive protein (hsCRP). Models were adjusted for diagnosis group, race, study center and multiple comparisons with Bonferroni. RESULTS: Y-T2D had the highest i3C z-score (Y-T2D: 1.23 [1.10, 1.36] vs. OW/OB: 0.84 [0.80, 0.88] vs. Lean: -0.11 [-0.15, -0.06], mean[95%CI]) and estimated HR for predicted CVD events (Y-T2D: 4.25 [3.65-4.86] vs. OW/OB: 3.04 [2.85-3.22] vs. Lean: 0.95 [0.74-1.17], HR [95% CI]). Risk-enhancing factors increased the HR for predicted CVD risk by 0.3 for each 10 mg/dL increase in ApoB, 0.1 for each 100 nmol/L increase in LDL-P, and 0.16 for each 2 mg/L increase in hsCRP, all P < 0.001. CONCLUSIONS: Y-T2D had an estimated 4.5- and 1.4-times higher risk for predicted CVD events compared to Lean and OW/OB peers, respectively. Lipoprotein and inflammatory risk-enhancing factors may help stratify and guide primary prevention strategies in high-risk AYA.
Journal of Pediatric Endocrinology and Metabolism · 2025-11-23
articleAbstract Objectives Nutrition education is important for managing type 2 diabetes (T2D), and how much knowledge is retained after nutrition education for new onset diabetes is challenging to assess. We hypothesize that deployment of a nutrition assessment will reinforce nutrition knowledge in newly diagnosed youth with T2D. Methods An exploratory quality improvement project was conducted to evaluate nutrition knowledge retained following new diagnosis of T2D. We implemented an 18-item nutrition assessment (at the first or second outpatient visit) evaluating nutrition label reading, hypoglycemia/hyperglycemia management, insulin management, and physical activity. Data was collected from the medical record, and descriptive and summary statistics were performed. Results Quizzes were administered to 19 patients and their caregivers, mean patient age 14.9 ± 2.1 years, 68 % female, 68 % NH Black, 79 % publicly insured, with mean HbA 1c 11.3 % at diagnosis, and 8.2 % at time of assessment. Mean overall nutrition assessment score was 14/18 (76 %). Patients scored well on questions about insulin (87 % correct) and physical activity (90 % correct) but needed additional reinforcement on questions about general nutrition (61 % correct) and acute and chronic complications of diabetes (64 % correct). Patients who had a lower HbA 1c at follow-up scored higher on the quiz (p=0.037). Dietitians commented that the assessments allowed them to gain “quick insight” into patients’ baseline knowledge, which enabled more tailored nutrition education with each patient. Conclusions Implementation of nutrition assessments during comprehensive diabetes visits is feasible and facilitates nutrition education with the patient and/or caregiver in an engaging manner. Reinforcement of nutrition education is critical for type 2 diabetes management and outcomes.
American Heart Journal · 2025-12-15
articleCirculation · 2024-03-19
articleBackground: Combined dyslipidemia of obesity (CDO) is prevalent in ~20% of youth and characterized by high numbers of atherogenic small LDL (sLDL) particles associated with stiffer arteries. The safety and impact of statin therapy is not known. Methods: A 2-year masked trial of pitavastatin calcium 4 mg/day versus placebo for participants ages 10-19 years with body mass index (BMI) ≥85 th %ile and CDO defined as non-HDL-C ≥120 mg/dL and either low HDL-C or high triglyceride (TG):HDL-C ratio. The primary outcome was change in carotid-femoral pulse wave velocity (PWV) and carotid measures assessed at baseline, 6, 12, 18, and 24 months. Secondary outcomes included safety and lipid measures. Results: Across 18 sites, 59 participants were randomized to pitavastatin and 60 to placebo. Demographic (mean age 13.5±1.2 yrs; 55% males), anthropomorphic (BMI %ile 98±3; waist/height ratio 0.66±0.08), lipid (non-HDL-C 167±29 mg/dL, LDL-C 127±25 mg/dL, HDL-C 37±7 mg/dL, TG/HDL ratio 6.4±4.7, sLDL number 866±419 nmol/L), vascular (PWV 5.0±0.7 m/sec) and safety measures were similar at baseline between groups. There were 28 early terminations (11 pitavastatin, 17 placebo). Significant reductions with pitavastatin versus placebo were noted in non-HDL-C (median -25% vs +3% at 6 months, p<0.001), LDL-C (-29% vs +7%, p<0.001), and apolipoprotein B (-26% vs 0%, p<0.001). An early reduction relative to placebo in sLDL particle number was not sustained (FIGURE A), and there were no significant changes or trends for PWV (FIGURE B) or carotid measures in either group. There was one serious adverse event (placebo), and no significant differences in liver enzymes, muscle toxicity, glucose homeostasis, or somatic growth, including adiposity. Conclusions: Over 2 years, treatment of CDO in adolescents with pitavastatin calcium resulted in significant improvement in dyslipidemia with no safety concerns. No change in PWV in either group may be due to lower-than-expected baseline PWV, insufficient magnitude of impact on CDO, or lack of change in adiposity.
Childhood Obesity and Cardiovascular Disease Risk
Current Atherosclerosis Reports · 2023-05-31 · 129 citations
reviewOpen accessSenior authorCorrespondingCardiometabolic risk in young adults with <scp>Down</scp> syndrome
American Journal of Medical Genetics Part A · 2023-03-31 · 10 citations
articleOpen accessSenior authorStudies regarding cardiometabolic risk (CMR) for individuals with Down syndrome (DS) conflict. Our previous research in youth with DS, aged 10-20 years, found increased prevalence of dyslipidemia and prediabetes compared to matched peers without DS. Herein, we compare CMR in young adults with DS, aged 18-35 years, to a similar population-based sample from the 2001-2018 National Health and Nutrition Examination Survey (NHANES). The group with DS had higher NonHDL-C (mean DS 131.9 mg/dL; NHANES 126.1 p < 0.001), lower HDL-C (DS 47.5 mg/dL; NHANES 52.2 p < 0.001), higher LDL-C (DS 109.3 mg/dL; NHANES 105.4 p < 0.001), higher triglycerides (DS 102.9 mg/dL; NHANES 86.9 p < 0.001), but lower fasting glucose (DS 85.8 mg/dL; NHANES 95.2 p < 0.0001), lower HOMA-IR (DS 2.17; NHANES 2.24 p = 0.0006), lower systolic (DS 109.7 mmHg; NHANES 114.6 p < 0.0001) and lower diastolic (DS 60.9 mmHg; NHANES 67.8 p < 0.0001) blood pressures. There was relationship of higher HDL-C, triglycerides, glucose, systolic, and diastolic blood pressure with increasing BMI in the NHANES cohort which was dampened in the group with DS. These results indicate that more information is needed to guide clinicians in screening for CMR in individuals with DS.
The Journal of Clinical Endocrinology & Metabolism · 2023-05-16 · 20 citations
articleOpen accessEndocrine care of pediatric and adult patients continues to be plagued by health and health care disparities that are perpetuated by the basic structures of our health systems and research modalities, as well as policies that impact access to care and social determinants of health. This scientific statement expands the Society's 2012 statement by focusing on endocrine disease disparities in the pediatric population and sexual and gender minority populations. These include pediatric and adult lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) persons. The writing group focused on highly prevalent conditions-growth disorders, puberty, metabolic bone disease, type 1 (T1D) and type 2 (T2D) diabetes mellitus, prediabetes, and obesity. Several important findings emerged. Compared with females and non-White children, non-Hispanic White males are more likely to come to medical attention for short stature. Racially and ethnically diverse populations and males are underrepresented in studies of pubertal development and attainment of peak bone mass, with current norms based on European populations. Like adults, racial and ethnic minority youth suffer a higher burden of disease from obesity, T1D and T2D, and have less access to diabetes treatment technologies and bariatric surgery. LGBTQIA youth and adults also face discrimination and multiple barriers to endocrine care due to pathologizing sexual orientation and gender identity, lack of culturally competent care providers, and policies. Multilevel interventions to address these disparities are required. Inclusion of racial, ethnic, and LGBTQIA populations in longitudinal life course studies is needed to assess growth, puberty, and attainment of peak bone mass. Growth and development charts may need to be adapted to non-European populations. In addition, extension of these studies will be required to understand the clinical and physiologic consequences of interventions to address abnormal development in these populations. Health policies should be recrafted to remove barriers in care for children with obesity and/or diabetes and for LGBTQIA children and adults to facilitate comprehensive access to care, therapeutics, and technological advances. Public health interventions encompassing collection of accurate demographic and social needs data, including the intersection of social determinants of health with health outcomes, and enactment of population health level interventions will be essential tools.
Prevention and Treatment of Obesity in Children
2023-01-01 · 1 citations
book-chapterSenior authorPhysical Activity in Youth with Down Syndrome and Its Relationship with Adiposity
Journal of Developmental & Behavioral Pediatrics · 2023-05-19 · 12 citations
articleOpen accessSenior authorPURPOSE: The aims of this study are to (1) compare physical activity (PA) and sedentary activity (SA) in youth with and without Down syndrome (DS and non-DS) and examine the relationships of PA and SA with their traditional risk factors (age, sex, race, and body mass index Z score [BMI-Z]) and (2) explore the relationship of PA with visceral fat (VFAT) in both groups. METHODS: SenseWear accelerometry data from at least 2 weekdays and 1 weekend day were collected from youth with DS (N = 77) and non-DS (N = 57) youth. VFAT was measured by dual x-ray absorptiometry. RESULTS: In age-, sex-, race-, and BMI-Z-adjusted models, those with DS engaged in more minutes of light PA (LPA) ( p < 0.0001) and less SA ( p = 0.003) and trended toward fewer minutes of moderate-to-vigorous PA (MVPA) ( p = 0.08) than non-DS youth. No race or sex differences in MVPA were detected in those with DS, unlike non-DS. After additional adjustment for pubertal status, the relationship between MVPA and VFAT approached significance ( p = 0.06), whereas the relationships of LPA and SA with VFAT were maintained ( p ≤ 0.0001 for both). CONCLUSION: Youth with DS engage in more LPA compared with non-DS, which, in typically developing populations, can confer a more favorable weight status. Increasing the opportunity for youth with DS to engage in LPA as part of their activities of daily living may offer a viable strategy for achieving healthy weight when barriers restrict pursuit of more vigorous PA.
Recent grants
NIH · $6.4M · 2006
NIH · $630k · 2012
Cardiometabolic Risk Factors and Obesity in Adolescents with Down Syndrome
NIH · $2.8M · 2012–2019
Frequent coauthors
- 37 shared
Andrea Kelly
Children's Hospital of Philadelphia
- 36 shared
Babette S. Zemel
University of Pennsylvania
- 36 shared
Risa M. Wolf
- 35 shared
Nicolas Stettler
Children's Hospital of Philadelphia
- 34 shared
Lorraine E. Levitt Katz
Children's Hospital of Philadelphia
- 28 shared
Mary Pipan
University of Pennsylvania
- 25 shared
Stephanie T. Chung
National Institute of Diabetes and Digestive and Kidney Diseases
- 20 shared
Sarah D. de Ferranti
Harvard University
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