Division of Endocrinology Annual Progress Report 2010

Beth Israel Division of Endocrinology Annual Progress Report 2010

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Table of Contents

Division of Endocrinology Activities Friedman Diabetes Institute Activities New Staff and 2010 Goals

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Copies of manuscripts and publications are available upon request.

Beth Israel Division of Endocrinology Annual Progress Report 2010

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Divisional Activities
Clinical Educational Research

Educational Activities
Patients Gerald J. Friedman Diabetes Institute Physicians 2 conferences per week Medical Students Clinical and research rotations Fellowship Program From warning status in 2000 to full accreditation for the last two cycles; site visit 2/23/2010 Presentations at national meetings by the fellows (12 in 2010) Boards passing rate increased from 33% in 2000 to 100% for the last 10 years House Staff Research rotation Clinical rotation Co-author abstracts and presentations Journal club

Clinical Activities
Inpatient and outpatient consultations and ongoing patient care within the Faculty Practice Plan (FPP) Diabetes Clinic Endocrine Clinic Insulin Pump Program Diabetes in Cardiac Surgery Program Thyroid Clinic - New York Eye and Ear Infirmary Gerald J. Friedman Diabetes Institute

Clinical Encounters
35,000 2007-2010 30,000 25,000 20,000 15,000 10,000 FPP Total

31511

32395

31171 25744

GJ Friedman (3082); Clinics (1614); Off site (731); FPP (25744)

24684 22109

26611

15704 12504

16802 17060 17347

18267

Research Programs
Administration of Vitamin D analog to new onset type 1 diabetes mellitus patients to restore pancreatic beta cell function. PI Dr. Agustin Busta Vitamin D supplementation in patients with type 2 diabetes and vitamin D deficiency. PI Dr. Emilia P. Liao Paracalcitol in patients with type 2 diabetes, chronic kidney disease, and vitamin D deficiency. PI Dr. Emilia P. Liao A pilot randomized controlled trial to evaluate the effects of an interactive website on clinical outcomes in patients with diabetes. PI Dr. Leonid Poretsky Interaction among perixisome proliferator activated receptor-y, insulin signaling pathways, steroidogenic acute regulatory protein, and aromatase activity in the human ovary. PIs Dr. Donna Seto-Young and Dr. Leonid Poretsky Global hypopituitary control and complication study (HYPOCS). PI Dr. Alina Gouller A pilot nonrandomized study on the effects of diabetes self management education on HBA1C in deaf patients. PIs Dr. Leonid Poretsky and Marina Krymskaya, NP, CDE Gerald J. Friedman Diabetes Institute database-retrospective and prospective data analysis. PIs Dr. Leonid Poretsky and Marina Krymskaya, NP, CDE

6014
5000 0

2976
00 01 02 03 04 05 06 07 08 09 10

Year
Years 2000-06 are FPP encounters only.

2010 FPP volume decrease is due to our busiest physician being on leave of absence (LOA) for 3 months.

FPP Collections ($)

$2,000,000 $1,800,000 $1,600,000 $1,400,000 $1,200,000 $1,000,000 $800,000 $600,000 $400,000 $200,000 $0 $342,672 $208,656 2000 01 02 03 04 05 06 07 08 09 10 $722,376 $801,773 $926,562 $994,758 $1,591,444 $1,308,642 $1,167,828 $1,967,014 $1,951,075

Year

Beth Israel Division of Endocrinology Annual Progress Report 2010

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Research Programs continued

A pilot randomized controlled trial to assess the Social Emotional Intelligence (ESI) levels and Confidence in Diabetes Self-Care (CIDS) scores of insulin-dependent subjects with diabetes to determine whether higher ESI measures predict better self-efficacy outcomes and improved glycemic control. PIs Dr. Leonid Poretsky, Marina Krymskaya, NP, CDE and DArcy Yeager A randomized trial comparing the effects of exenatide or placebo in patients with type 2 diabetes on therapy with insulin glargine, with or without oral antihyperglycemic medications. PI Dr. Jerome Tolbert Effects of exenatide in overweight patients with policystic ovary syndrome (PCOS) and role of exenatide in human ovarian regulation. PI Dr. Leonid Poretsky Receptor mechanisms of insulin and insulin-like growth factors (IGF) action in human ovary. PIs Dr. Leonid Poretsky and Dr. Donna Seto-Young Role of thiazolidinediones in the human ovary. PIs Dr. Leonid Poretsky and Dr. Donna Seto-Young Role of vitamin D in the human ovary. PI Dr. Donna Seto-Young Queens/South Asian Action For Diabetes Education Programs and Treatment: funded by the New York State Health Foundation. PI Dr. Leonid Poretsky Comparison of the therapeutic effects of oral medications in women with polycystic ovary syndrome. PI Dr. Alina Gouller Role of pramlintide in patients with polycystic ovary syndrome. PI Dr. Leonid Poretsky Genetic markers for increased risk of gestational diabetes in Chinese-Americans. PIs - Dr. Donna SetoYoung and Dr. Leonid Poretsky The role of Thiazolidinediones (TZDs) in bone metabolism. PIs - Dr. Donna Seto-Young and Dr. Leonid Poretsky

Research Funding continued

Sources of Funding Gerald J. Friedman Foundation Aventis Pharmaceutical Sanofi-Aventis U.S. Inc. Chinese American Medical Association Glaxo SmithKline, Inc. Novo-Nordisk, Inc. Generex Biotech Corp. Eli Lilly and Company Pfizer BIASP Novolog Genzyme Corporation New York State Health Foundation New York State Department of Health National Institute of Health

2010 Original Peer-Reviewed Publications

Grunberger G, Alfonso B. Syndromes of Extreme Insulin Resistance. In Principles of Diabetes Mellitus, 2nd Ed. Poretsky L., Editor. Springer, New York, 2010. Feng Y, Fleckman A. Acute hyperglycemic syndromes: diabetic ketoacidosis and the hyperosmolar state. In Principles of Diabetes Mellitus, 2nd Ed. Poretsky L., Editor. Springer, New York, 2010. Garger Y, Joshi P, Pareek A, Romero C, Seth A, Fleckman A. Secondary causes of diabetes mellitus. In Principles of Diabetes Mellitus, 2nd Ed., Poretsky L., Editor. Springer, New York, 2010. Schneider A, Rayfield E, Busta A, Gurevich Y. Diabetes in Pregnancy. In Principles of Diabetes Mellitus, 2nd Ed. Poretsky L., Editor. Springer, New York, 2010. Zweig SB, Tolentino MC, Strizhevsky M, Poretsky L. Polycystic ovary syndrome. In Principles of Diabetes Mellitus, 2nd Ed. Poretsky L., Editor. Springer, New York, 2010. Zajac J, Shrestha A, Patel P, Poretsky L. The main events in the history of diabetes mellitus. In Principles of Diabetes Mellitus, 2nd Ed. Poretsky L., Editor. Springer, New York, 2010. Brass BJ, Abelev Z, Liao EP, Poretsky L. Endocrine Pancreas. In: Principles of Diabetes Mellitus, 2nd edition, L. Poretsky, Ed. Springer, New York, 2010. Poretsky L. Preface II. In: Principles of Diabetes Mellitus, 2nd edition, L. Poretsky, Ed. Springer, New York, 2010. Principles of Diabetes Mellitus, 2nd edition L. Poretsky, editor. Springer, New York, 2010.

Research Funding
Note: Philanthropic Gifts from the Gerald J. and Dorothy Friedman Foundation support endowed chair and research in the Division of Endocrinology Research Laboratory.
$3,000,000 $2,580,514 $2,500,000 $2,000,000 $1,500,000 $1,000,000 $500,000 $0 $24,201 $522,000 $623,000 $2,705,144

$2,208,393 $1,775,340 $1,790,529 $1,258,355 $1,005,627 $557,677

2000 01

02

03

04

05

06

07

08

09

10

Continued on next page

Year

Beth Israel Division of Endocrinology Annual Progress Report 2010

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Publications continued
Via M, Chandra H, Araki T, Potenza MV, Skamagas M. Bromocriptine approved as the first medication to target dopamine activity to improve glycemic control in patients with type 2 diabetes. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 3:43-48, 2010. Kahn SE, Haffner SM, Viberty G, Herman WH, Lachin JM, Kravitz BG, Yu D, Paul, G, Holman RR, Zinman B, ADOPT Study Group (L. Poretsky, M. Krymskaya). Rosiglitazone decreases C-Reactive protein to a greater extent relative to glyburide and metformin over 4 years despite greater weight gain. Diabetes Care 33:177-183, 2010. Zinman B, Haffner SM, Herman WH, Holman RR, Lachin JM, Kravitz, BG, Paul G, Jones NP, Aftring RP, Viberti G, Kahn SE, ADOPT Study Group (L. Poretsky, M. Krymskaya). Effect of rosiglitazone, metformin, and glyburide on bone biomarkers in patients with type 2 diabetes. J Clin Endocrinol Metab 95:134-142, 2010. Patel P, Poretsky L, Liao E. Lack of effect of subtherapeutic vitamin D treatment on glycemic and lipid parameters in Type 2 diabetes: A pilot prospective randomized trial. J Diabetes 2:36-40, 2010. Parikh G, Varadinova M, Suwandhi P, Araki T, Rosenwaks Z, Poretsky L, Seto-Young D. Vitamin D regulates steroidogenesis and insulin-like growth factor binding protein-1 (IGFBP-1) production in human ovarian cells. Horm Metab Res 42:754-757, 2010.

Presentations continued
Araki T, Joshi PM, Gouller A. Carcinoid heart disease due to a primary ovarian carcinoid tumor (P3-102); The Endocrine Society 92nd Annual Meeting, San Diego, CA, June 2010. Araki T, Alfonso B, Charlap E, Rizk D, Holick M, Newman L. Vitamin D Intoxication due to Manufacturing and Labeling Errors of a Dietary Supplement: A case Report; 8th Annual Research Fair, Beth Israel Medical Center, New York, May 6, 2010. Araki T, Joshi PM, Fleckman A. Adrenal Catastrophe: A case report of bilateral adrenal hemorrhage in a patient with antiphospholipid syndrome ( No.71032, P15-8-1 ), 14th International Congress of Endocrinology , Kyoto, Japan March 2010. Araki T, Alfonso B, Busta A. Non-insulinoma pancreatogenous hypoglycemic syndrome after gastric bypass surgery (No.71146, P2-12-5), 14th International Congress of Endocrinology, Kyoto, Japan, March 2010. Araki T, Alfonso B, Holick M, Newman L. Vitamin D intoxication due to manufacturing and labeling errors of a dietary supplement: A case report (P2-203); The Endocrine Society 92nd Annual Meeting, San Diego June 2010. Cadag S, Patel R, Kahan J, Liao EP, Poretsky L. Latent autoimmune diabetes in adults (LADA) with high titers of GAD 65 antibodies but lack of long-term insulin dependence. 92nd Annual Meeting of the Endocrine Society, Abstract P3-560, San Diego, CA, June 19-22, 2010. DeJesus J, Krymskaya M, Towe M, Poretsky L. Diabetes self-management education for the deaf population. 70th Scientific Sessions of the American Diabetes Association, Abstract 1039-P, Orlando, FL, June 25-29, 2010. Seth AK, Gajzer DC, Suwandhi P, Feng Y, Kato S, Romero C, Patel R, Rosenwaks Z, Poretsky L, SetoYoung D. Thiazolidinediones (TZDs) inhibit bone turnover. 92nd Annual Meeting of the Endocrine Society, Abstract P2-184, San Diego, CA, June 19-22, 2010. Parikh G, Mantha-Thaler K, Ayinikal A, Pandya S, Joshi P, Homel P, Poretsky L. Action for Diabetes Education Program and Treatment (ADEPT): An outreach program for South Asian patients with diabetes. 70th Scientific Sessions of the American Diabetes Association, Abstract 1032-P, Orlando, FL, June 25-29, 2010.

2010 Presentations at National Meetings

Alfonso B, Via M. Prior gastric bypass surgery complicating total thyroidectomy. 19th Annual Meeting and Clinical Congress of the American Association of Clinical Endocrinology, Abstract #604, Boston, MA, April 21-25, 2010. Alfonso B, Reddy P, Saliby A. Methimazole-induced hepatic steatosis: Case report and literature review. 14th International Thyroid Congress, Abstract P-0543, Paris, 2010. Araki T, Ruminjo A, Gouller A. Electroconvulsive therapy-induced thyroiditis? (P1-610); The Endocrine Society 92nd Annual Meeting, San Diego, CA, June 2010.

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Gerald J. Friedman Diabetes Institute

Insulin Pump Program
Resources for people with diabetes interested in insulin pump therapy Weekly sessions on advanced pump features with the pump trainers (MiniMed) 3082 office visits in 2010 3rd Anniversary - Celebrated on November 13, 2010 3rd Annual Friedman Fellows Symposium: http://www.friedmandiabetesinstitute.com/fellows Friedman Fellows Website: http://www.friedmandiabetesinstitute.com/fellows http://www.friedmandiabetesinstitute.com/fellows/ elibrary FDI Certified Diabetes Educators (CDEs) became certified pump trainers (Omni-Pod, Animas)

Pediatric Program
352 office visits in 2010 Series of lectures for FDI providers by Dr. Gabrielle Grinstein Presentations by CDEs specialized in pediatrics. Topics include: Medications and insulin usage in pediatrics. Meters and insulin administration in pediatrics. Growth and development issues with school age and adolescents. Psychosocial support for parents and kids. BS goals and A1C goals in pediatrics. Complications associated with diabetes in pediatrics. DKA/Sick day guidelines. Nutrition and exercise. Insulin pump-Minimed, Animas. Luxura pen or other pens and devices used in pediatrics. Events for Kids: Halloween celebration Christmas holiday celebration Cooking demonstration

Adult Program
Provides diabetes education to adults with diabetes. Working in collaboration with the patients primary care physician. Daily individual sessions Weekly classes Monthly support groups for people with type 1 and type 2 diabetes Cooking demonstrations Outreach program Program for the deaf Exercise program Achilles Group Consultations with an exercise physiologist twice a week Insulin pump program Yoga classes

Deaf Community Program

Individual and group diabetes education for the deaf (on-going) Developed culturally sensitive educational and didactic materials Grant from NYEEI Meeting with the deaf artist to develop educational booklets (on-going project) Collaborating with the Gallaudet University - the world leader in liberal education and career development for deaf and hard-of-hearing undergraduate students http://www.friedmandiabetesinstitute.com/exercises/ deaf_hard_of_hearing/diabetes_anims/diabetes_animations.html

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Community & Outreach Programs

Date Event Presentor(s)

January

Events coordinated and run by Claire, in collaboration with the College of Mount Saint Vincent. Started in 2010, 8-10 nursing students represent FDI at various community centers. They come Nell Hanks to our Institute at the beginning of their 4-week rotation, and get the necessary information/education/orientation for the outreach activities. Diabetes Alert Day - Petrie/PACC Karpas Spring Day Tune Up at PACC Community Outreach Conference at PACC related to stroke Nursing week Podell In-service for BIMC providers at 6 Karpas Tolulope Ojeyemi, Randi Levine, Kamala Mantha, Natalie Morrow, Karina Ziskovich, Sandy Farrell Jenny De Jesus, Jennifer Regester Dr. Agustin Busta, Dorothy Perry Marina Krymskaya, Tolulope Ojeyemi Dr. Agustin Busta, Marina Krymskaya Tolulope Ojeyemi Dr. Agustin Busta Jenny De Jesus

March April

May

Annual Cymbrowitz (Assemblyman) Community Health Fair Emmons Ave, Brooklyn DSME for HIV+diabetes Housing Works Health Center National Senior Health and Fitness Day at the Council Senior Center, 241 West 72nd Street.

June July August

Health Fair for Seniors The Encore Community Center 239 West 49th Street, in the basement of St. Malachys Church Health fair at The Pentecostal Church in Brooklyn Health fair at The Pentecostal Church in Brooklyn HOWL festival The Caring Community at The Independence Plaza (Senior Citizen Center) 310 Greenwich Street, Tribeca

Jennifer Regester Sandy Farrell Marina Krymskaya Sandy Farrell, Pamela Flores Marina Krymskaya Jenny De Jesus Jenny De Jesus Jenny De Jesus

September

Latino Event Karpus Lecture FOOD BANK: Diabetes and Diabetes Prevention 252 West 116th Street (8 Sessions program, the last Friday of the month) Pediatric Diabetes Walk

October

Adult Diabetes Walk FOOD BANK: ABCs of Diabetes Tolulope Ojeyemi

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Achilles Fitness Program

Running Your Life Keeping fit, focused and moving forward: Running Your Life is a program for people with diabetes that combines a motivational informational workshop with physical training. The program was designed in collaboration with the Achilles Track Club. Each week a different topic is presented in the workshop that will help individuals reach their goals. There are also two physical fitness classes every week at 6pm on Mondays and Wednesdays. Participants train for a predetermined walk/run, from walking a mile to running a marathon.

Interactive Diabetes Education Website in Development

2010 Marathon Runners Helen Ceck ING NY half marathon David Isaacson Columbus marathon Juan Carlos Gonzalez ING NY marathon Ricardo Gonzalez ING NY marathon Steven Rosenberg ING NY marathon

2010 FDI Media Appearances

The Wall Street Journal The Journal of the American Medical Association AOL Health Renal and Neurology News New York Daily News New York Post Long Island Press Web MD New York State Diabetes Campaign Webinar CNBC-TV (D-Life) Liberty Health Matters Magazine Fitness Magazine The Huffington Post EverydayHealth.com QualityHealth.com

New Staff and 2011 Goals

New Staff in 2010
Helena Aminov, RN Assistant Manager Phillip Bukberg, MD Director, Lipid Center Veronica Cordero Administrative Assistant Megan Fendt, RD Nutritionist Erika Pemberton Administrative Assistant Lynn Polmanteer, RD Nutritionist

Friedman Diabetes Institute Website www.friedmandiabetesinstitute.com

At the website you will find diabetes related information for: Families/Caregivers Kids/Teens Deaf/Hard of Hearing People with Diabetes Professionals Clinical Study Participants Friedman Fellows virtual symposium Friedman Fellows e-library

Directions for 2011

Continued growth of Gerald J. Friedman Diabetes Institute Continued growth of clinical activities Increase funding for research programs Maintain full accreditation of fellowship program Maintain full accreditation from the American Diabetes Association for the diabetes education program Continue planning for the interdisciplinary diabetes unit.

To contact the Endocrinology Division:

Leonid Poretsky, MD, Chief - 212 420-4666 or Pamela Flores, Business/Practice Manager - 212 420-2491