Division of Endocrinology Annual Progress Report 2009

Beth Israel Division of Endocrinology Annual Progress Report 2009

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Table of Contents

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

page 3 page 6 page 9

Copies of manuscripts and publications are available upon request.

Beth Israel Division of Endocrinology Annual Progress Report 2009

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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 to full accreditation; site visit 2/23/2010 Presentations at national meetings by the fellows (9 in 2009) Boards passing rate increased from 33% in 2000 to 100% for the last 9 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 Diabetes in Pregnancy Program Diabetes Clinic - New York Downtown Hospital Thyroid Clinic - New York Eye and Ear Infirmary Gerald J. Friedman Diabetes Institute

Clinical Encounters
35,000 30,000 25,000 20,000 15,000 10,000 2007-2009 FPP Total
2007: GJ Friedman (1247); Clinics (1863); Off site (732); FPP (18267) 2008: GJ Friedman (4488); Clinics (1520); Off site (816); FPP (24684) 2009: GJ Friedman (4929); Clinics (1538); Off site (855); FPP (26611)

31511

32395

24684 22109 18267

26611

Visits

15704 12504

16802 17060 17347

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
$1,967,014 $1,591,444

6014
5000 0

2976
2000 01 02 03 04 05 06 07 08 09

Year
Years 2000-06 are FPP encounters only.

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 $722,376 $801,773 $926,562 $994,758 $1,308,642 $1,167,828

A pilot randomized controlled trial to evaluate the effects of an interactive website on clinical outcomes in patients with diabetes. PI Dr. Leonid Poretsky 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 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

Year

Beth Israel Division of Endocrinology Annual Progress Report 2009

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Research Programs continued

Research Funding continued

Generex Biotech Corp. Eli Lilly and Company Pfizer BIASP Novolog Genzyme Corporation New York State Health Foundation New York State Department of Health

A 26-week, open-label, randomized, active compara- Sources of Funding tor study of Generex Oral-lyn spray and injected Gerald J. Friedman human insulin in subjects with type-1 diabetes mellitus. Foundation PIs Dr. Alina Gouller and Dr. Leonid Poretsky Empire Clinical Research Gerald J. Friedman Diabetes Institute database retroAventis Pharmaceutical spective and prospective data analysis. PIs Dr. Leonid Sanofi-Aventis U.S. Inc. Poretsky and Marina Krymskaya, NP, CDE Chinese American Medical Association A Randomized trial comparing exenatide with placebo in patients with type 2 diabetes on insulin glargine with Glaxo SmithKline, Inc. or without oral antihyperglycemic medications. PI Dr. Novo-Nordisk, Inc. Jerome Tolbert Receptor mechanisms of insulin and insulin-like growth factors (IGF) action in human ovary. PIs Dr. Leonid Poretsky & 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

2009 Original Peer-Reviewed Publications

Alfonso B, Liao EP, Busta A, Poretsky L. The role of vitamin D in diabetes mellitusa new field of knowledge poised for D-velopment. Diabetes/Metabolism Research and Reviews 25:417-419, 2009. Poretsky L, Song L, Brillon DJ, Ferrando S, Chiu J, McElhiney M, Ferenczi A, Sison C, Haller I, Rabkin J. Metabolic and hormonal effects of oral DHEA in premenopausal women with HIV infection. Hormone Metab Res 41:244-249, 2009. Potenza M, Via MA, Yanagisawa RT. Excess thyroid hormone and carbohydrate metabolism. Endocrine Practice 15: 254-62, 2009. Seres DS. Safe care after surgery. In Questions patients need to ask. Xlibris. D Shulkin, Ed, 2009. Seres DS. Evidence-based nutrition support: Is a recession a good thing? Nutrition in Clinical Practice 24:541-542, 2009. Seres DS. Overview of nutrition support in critical illness. In Up-To-Date www.uptodate.com, 2009. Seres DS. Enteral nutrition in critical illness. In UpTo-Date, www.uptodate.com, 2009.

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

Seres DS. Parenteral nutrition in critical illness. In Up-To-Date, www.uptpdate.com, 2009. Via MA, Mechanick JI. Endocrinology. In Medical management of the adult with a neurological disability. Demos Medical Publishing, New York, 2009. Via MA, Mechanick JI. Skeletal complications. Cancer Medicine, 8th Edition. James F. Holland, editor. PMPH USA, 2009.

2000

01

02

03

04

05

06

07

08

Year

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2009 Presentations at National Meetings

Abelev Z, Gouller A. Chylocele in a patient with papillary thyroid carcinoma. American Association of Clinical Endocrinologists, 18th Annual Meeting and Clinical Congress, Houston, TX, May 13-17, 2009. Abelev Z, Seth A, Patel R, Goldstein S, Bogun M, Homel P, Busta A, Poretsky L. Intravenous insulin infusion (III), 24 hr postoperative capillary blood glucose (CBG) and patient age affect post-surgical length of stay (LOS) and complications in patients with diabetes mellitus (DM undergoing coronary artery bypass graft (CABG). 69th Scientific Sessions of the American Diabetes Association, Abstract 692-P, New Orleans, LA, June 5-9, 2009. Abelev Z, Gouller A. Fibrotic transformation of invasive Nelsons adenoma as the result of treatment with octreotide and cabergoline. The Endocrine Society 91st Annual Meeting, Abstract # P1-685, Washington, DC, June 10-13, 2009. Araki T, Goldman M, Varadinova M, Joshi P, Chaanine A, Seth A, Feng Y,Rosenwaks Z, Poretsky L, SetoYoung D. The effects of thiazolidinediones (TZD) on aromatase enzyme kinetics in human granulosa cells. 91st Annual Meeting of the Endocrine Society, Abstract P3-268, Washington, DC, June 10-13, 2009. Cadag S, Liu D, Gonzales M, fleckman A. Antepartum pituitary infarction in diabetes mellitus. 18th Annual Meeting & clinical congress, American Association of Clinical Endocrinologists (AACE), Houston, TX, May 2009. Cadag S, Krymskaya M, DeJesus J, Srivastava A, Craig W, Regester J, Levine R, Morrow N, Poretsky L. The effects of a diabetes education program on clinical outcomes in patients with diabetes. 69th Scientific Sessions of the American Diabetes Association, Abstract 911-P, New Orleans, LA, June 5-9, 2009 Cadag S, Krymskaya M, DeJesus J, Srivastava A, Craig W, Regester J, Levine R, Morrow N, Poretsky L. The effects of a diabetes education program on clinical outcomes in patients with diabetes. 36th Annual Meeting of the American Association of Diabetes Educators, Abstract # 153019, Atlanta Georgia, August 5-8, 2009. Gupta R, Gupta V, Rothsein B, Seres D. Reduced cost and incidence of tube clogging without increasing volume by using dilute high-protein feed vs. concentrated feed plus protein powder in ICU. American Society of Parenteral and Enteral Nutrition, New York, NY, February, 2009. Gupta R, Wyman R, Juhng S, Gupta V, Seres D. Effect of product choice on cost per calorie for enteral nutrition support. American Society of Parenteral and Enteral Nutrition, February, 2009. Kothari H, Jammula A, Huang A, Busta A. Antiphospholipid antibody syndrome (APS) presenting as bilateral adrenal hemorrhage. New York American College of Physician NYACP, New York City, May 30, 2009. Krymskaya M, Cadag S. DeJesus J, Srivastava A, Craig W, Regester J, Levine R, Morrow N, Poretsky L. The effects of a diabetes education program on clinical outcomes in patients with diabetes. 69th Scientific Sessions of the American Diabetes Association, Abstract # 911-P, New Orleans, LA, June 5-9, 2009. Parikh G, Patel R, Fleckman A. 2009 Technetium Scan for the diagnosis of Graves disease following intravenous iodine contrast. The Endocrine Societys 91th Annual Meeting, Washington DC Abstract # P1535, 2009 June 9-13, 2009. Patel R, Shah S, Smith B, Fleckman A. Hypersensitivity vasculitis in a patient on glipizide. Endocrine Society 91st Annual Meeting. Washington, D.C., June 9-13, 2009. Romero C, Busta A. Severe Vitamin D deficiency in a patient with carcinoid syndrome. 91st Annual Meeting of the Endocrine Society, Abstract P1-142, Washington, DC, June 10-13, 2009. Strizhevsky M. Gouller A. Rapidly progressive papillary thyroid carcinoma. 91st Annual Meeting of Endocrine society Abstract # P1-522, Washington, DC, June 10-13, 2009. Strizhevsky M, Parikh G, Soto-Barreto D, Wenig B, Busta A. Nesidioblastosis after gastric bypass surgery in patients with panhypppituitarism. 91st Annual Meeting of the Endocrine Society, Abstract P1-140, Washington, DC, June 10-13, 2009. Yen YH, Tsai TT, Busta A, Huarachi L. Thyrotoxic hypokalemic periodic paralysis in a young AsianAmerican presenting with chronic lower leg ulcer. 91st Annual Meeting of the Endocrine Society, Abstract P1-532, Washington, DC, June 10-13, 2009.

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Gerald J. Friedman Diabetes Institute

Pediatric Program
322 office visits in 2009 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

4929 office visits in 2009 2nd Anniversary - Celebrated on November 13, 2009 2nd Annual Friedman Fellows Symposium: http://www.friedmandiabetesinstitute.com/fellows Friedman Fellows Website: http://www.friedmandiabetesinstitute.com/fellows http://www.friedmandiabetesinstitute.com/fellows/ elibrary

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 South Asian Outreach Program Exercise Program Achilles Group Insulin pump program High risk OB/Gyn program

Karpas Community Program

Community outreach program in collaboration with the Karpas Health Information Center. Series of lectures: Treating Pre-Diabetes Agustin Busta, MD Deaf Fair Collaboration with Karpas Diabetes Taking Care From Head to Toe Jenny DeJesus, RN Taking Charge of your Type 2 Diabetes Marina Krymskaya, NP, CDE Eating and Exercising for People with Diabetes Rosalia Doyle, RD, CDE BI Cares for You! Wellness programs for BIMC employees - Monique Welbeck, NP, William Craig, RD Howl Festival FDI Staff

High Risk OB/GYN Program

Provides diabetes education to pregnant women with diabetes Precept OB/GYN residents (Diabetes Education)

Insulin Pump Program

Resources for people with diabetes interested in insulin pump therapy Weekly sessions on advanced pump features with the pump trainers (MiniMed) FDI Certified Diabetes Educators (CDEs) became certified pump trainers (Omni-Pod, Animas)

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Community & Outreach Programs

Date Year-round January February March Event Mondays and Wednesday: Achilles Track Club SAHI Health Fair Queens, NY Adult Cooking Demo Children Cooking Class Adult Cooking Demo Kids Cooking Demo Achilles Club Parkinsons Unity 2 Mile Walk Central Park Achilles Club Colon Cancer Walk 5K Presentor(s) Nell Hanks Anto Ayinikal, RN/CDE William Craig, RD Randi Levine, RD/CDE Randi Levine, RD/CDE Randi Levine, RD/CDE

April

Randi Levine, RD/CDE, Jennifer Regester, RD/CDE, Karina Ziskovich, Sandy Farrell

May

Diabetes forum in two public elementary schools in Brooklyn Randi Levine, RD/CDE At the request of Assemblyman Steve Cymbrowitz An outdoor health fair - Spring Creek, a NORC program Jena Costanzo Karpas) Starrett City, Brooklyn Jenny De Jesus, RN/CDE, Health fair for the Deaf at PACC Jennifer Regester, RD/CDE, Marina Krymskaya, ANP Diabetes Nutrition Workshop for people of Chinese and Italian heritage Randi Brook, RD/CDE Knickerbocker Senior Services, Chinatown DSME for HIV+diabetes Agustin Busta, MD Housing Works Health Center Food Bank Community Kitchen and Food Pantry Harlem Health Fair Isabella Senior Resource Center Washington Heights Leonid Poretsky, MD Alina Gouller, MD Jenny De Jesus, RN/CDE

June

Health Fair Full Gospel Tabernacle Inc., Bronx, NY Food Bank Community Kitchen and Food Pantry Harlem Natalie Morrow, LCSW-R Gabrielle Grinstein, MD Jerome Tolbert, MD Jesse Taylor 212 566-7855 ex. 8213 Karina Ziskovich Jerome Tolbert, MD, Karina Ziskovich, Sandy Farrell, Tolulope Oyejemi, FNP, Stephanie Welbeck Gabrielle Grinstein, MD, Randi Brook, RD/CDE, Karina Ziskovich, Marina Krymskaya, ANP Jenny De Jesus, RN/CDE Randi Brook, RD/CDE Randi Brook, RD/CDE Jennifer Regester, RD/CDE

July

Food Bank Community kitchen and food pantry Harlem HOWL festival

September

Diabetes Expo

JDRF Walk October Bronx District Attorneys Health Fair Henry Street Settlement SMART a program for women living with HIV/AIDS Greenwich House

November

Beth Israel Division of Endocrinology Annual Progress Report 2009

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Deaf Community Program

Individual and group diabetes education for the deaf (on-going) Developing 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

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. 2009 marathon team members: Anthony J. DiCarlo, Lisa Galynker, PhD, Juan Carlos Gonzalez, David Isaacson, Marina Krymskaya, ANP, Leonid Poretsky, MD

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

Interactive Diabetes Education Website in Development New York Health Foundation South Asian Program
The Asian outreach program specifically targets the Asian community within NYC in an effort to understand their unique needs and to provide educational opportunities for them to lead healthier lives while living with diabetes. We provide diabetes education to the various Asian communities while building bridges between the Asian communities and the Friedman Diabetes Institute.

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2007-2008 FDI Media Appearances

AARP Bulletin Boston.com BusinessWeek.com Caribbean New Yorker ChicagoBears.com China News Diabetes Health DiabetesMythsand Truths. com DiabetesStories.com Diabetic Living D-Life/CNBC EverydayHealth.com Fox News Channel Health Matters Housecalls Magazine India Abroad India Express India Post India West JDRF.org LiveStrong.com Many newspapers all over mainland China Medical Diabetes.org Ming Pao Newspaper NDTV New York Post New York Times Newsweek International NFL Radio NFL.com Our Town Pharmawire Quality Health Sinovision StepOutDiabetes.org Telemundo TheInsider.Com TuDiabetes.org TV Asia TV.Com USA Today Womens-Healthcare. info

New Staff and 2010 Goals

New Staff in 2009
David C Gajzer, MD Friedman Diabetes Fellow, Visiting Research Scholar AECOM Raul Grannum - Admin. Assistant Tolulope Oyejemi Family Nurse Practitioner FDI, Pediatric Program

Directions for 2010

Recruitment of new endocrinology physician staff 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