The Regional Metabolic Program is a multidisciplinary program designed to address the needs of Kaiser Permanente members with metabolic disorders. The program team includes metabolic geneticists, genetic counselors, nutritionists, a pediatric neurologist, a nurse, a social worker, and a psychologist. We follow approximately 250 patients of all ages and offer 20 to 25 clinics every year at different Kaiser Permanente facilities: Oakland, Santa Teresa, Sacramento, and Vallejo.
The goal of the Regional Metabolic Program is to optimize the physical, social, and psychological well-being of our patients by coordinating their care.
The Regional Metabolic Program is run by program coordinators who provide case management. In addition to organizing clinic days, the coordinators follow patient care between visits and ensure that clinic recommendations are acted upon in a timely manner. The coordinators are also available throughout the year to help patients and their families with any needs, questions, or concerns that arise between clinics as well as to provide emotional support.
Regional Metabolic Program phone: (510) 752-7703
Regional Metabolic Program fax: (510) 752-6367
Regional Metabolic Program Coordinators:
Shana Maloney, MS, RD (510) 752-1540
Cheryl Weigel, RN, MSN (510) 752-6920
Joyce Wong, MS, RD (510) 752-7474
Andrea Curran, MS, RD (510) 752-1388
Secretary: Sirita Bowden (510) 752-7703
Case Management services include:
1) working with patient and family to create individualized treatment plans
2) coordinating medical testing and appointments
3) addressing psychosocial issues related to the condition, such as barriers to compliance with treatment recommendations.
After receiving a referral, one of the program coordinators will contact the Kaiser member to arrange Regional Metabolic services, assess the individual or family needs, and set up an appointment.
Types of Clinics
The Regional Metabolic Program offers two types of clinics: Regional Clinics and Satellite Clinics
Regional Clinics: These clinics are only offered 3-4 times a year at Kaiser Permanente at the Oakland Medical Center facility. Appointments are typically reserved for patients with more complicated conditions. Geneticists from the entire Region attend this clinic to provide their expertise in the diagnoses and treatment of metabolic clinic patients. After each clinic, the team meets together in a post-clinic conference to discuss their findings and make recommendations.
Satellite Clinics: Satellite clinics are offered at four different Kaiser facilities: Oakland, San Jose, Sacramento, and Vallejo. throughout the year. These clinics offer an opportunity for clients to be seen closer to home and more frequently than Regional Clinics would allow. The team meets after each clinic for a post-clinic conference to discuss their findings and make recommendations.
Many patients are referred to the Regional Metabolic Program after being identified by the California State Newborn Screening (NBS) Program. The NBS program has been expanded to include many metabolic disorders. For more detailed information about the California NBS Program, please see the California Department of Health Services Newborn Screening Program website.
Below is a list of specific metabolic conditions followed by the Metabolic Clinic:
Amino Acid Disorders
Maple Syrup Urine Disease (MSUD)
Glycogen Storage Disease
Hereditary Fructose Intolerance (HFI)
Fatty Acid Oxidation Disorders (FODs)
Medium Chain Acyl-CoA Dehydrogenase Deficiency (MCAD)
Long Chain Acyl-CoA Dehydrogenase Deficiency (LCAD)
Very Long Chain Acyl-CoA Dehydrogenase Deficiency (VLCAD)
Lipid Storage Disorders
Respiratory Chain Deficiency
Methylmalonic Acidemia (MMA)
Multiple Carboxylase Deificiency
Propionic Acidemia (PPA)
Urea Cycle Disorders
Lysinuric Protein Intolerance
Ornithine Transcarbamylase Deficiency
How do metabolic disorders happen
Most metabolic conditions are inherited as an autosomal recessive condition. In order for a child to be born with an autosomal recessive condition, both parents must carry a non-working copy of the involved gene. Although each parent carries one non-working copy of the gene, they do not have the disorder themselves. This is because they each also carry one "working" gene. The working copy of the gene is able to keep their metabolism functioning normally. People with one working and one non-working gene are called "carriers" for a recessive condition.
Most carriers of metabolic disorders are perfectly healthy and normal. There is no easy way to predict who is a carrier of one of these disorders. For most children with a metabolic disorder, there is no previous history of the condition in the family.
Most metabolic conditions occur unexpectedly with no history of the disorder in the family. In this situation, routine prenatal tests cannot identify these disorders. Prenatal diagnosis may be possible for families who meet both of the following conditions:
There is a known family history of a metabolic disorder.
The genetic mutations that caused the disorder in the family have been identified.
Genetic mutations can sometimes be identified by genetic testing techniques, usually this means a blood test. The family member who has the known metabolic disorder is tested first. If the mutations can be identified, prenatal testing can sometimes be provided. If the mutations cannot be identified, prenatal testing usually cannot be offered. This is true even when the family member definitely has the metabolic condition in question. Metabolic conditions may be caused by more than one mutation. There are times when the mutations that caused the disorder in that particular person has not yet been discovered, and in such cases prenatal diagnosis may not be possible.