John Wysolmerski, MD, section chief
Silvio Inzucchi, MD, clinical chief
Yale Bone Center Celebrates 35 Years of Progress
For 35 years, Karl Insogna, MD, built the Yale Bone Center into a thriving clinical practice that accounts for one-third of the section’s outpatient encounters. In addition to clinical care, the Yale Bone Center is an important provider for bone density services and routine clinical measurements of calciotropic hormones for Yale New Haven Hospital. The center has also been a site of important clinical research into the pathophysiology of hypercalcemia of malignancy, hyperparathyroidism, rickets, and rare genetic disorders of phosphate and calcium metabolism.
Yale endocrinologists are at the center of the expanding field of obesity medicine, including the development of a new class of drugs that target the brain’s system for regulating food intake. Ania Jastreboff, MD, PhD, an internationally recognized researcher and educator in obesity medicine, was the on-site principal investigator at Yale and lead author of SURMOUNT-1, a study that demonstrated that people with obesity treated with tirzepatide, a novel GIP/GLP-1 receptor agonist, lost on average 52 pounds with the highest dose of the medication. Jastreboff also leads an R01 study looking at the impact of the GLP-1 receptor agonist semaglutide on the desire to eat highly palatable foods.
Yale Diabetes Center’s Tradition of Excellence
Led by Clinical Chief Silvio Inzucchi, MD, the internationally recognized Yale Diabetes Center has helped to establish standards of care for outpatient and inpatient care of diabetic patients. The robust nature of the clinical practice has allowed clinical and basic research in both type 1 and type 2 diabetes to flourish within the section. Inzucchi presented new data from the DELIVER trial at the European Association for the Study of Diabetes in September 2022. The data examined the effectiveness of the SGLT2 inhibitor dapagliflozin on clinical outcomes in over 6,000 patients with heart failure and mildly reduced or preserved ejection fraction. Dapagliflozin, originally developed as a glucose-lowering agent for type 2 diabetes, appears to be equally effective in reducing the composite outcome of worsening heart failure and cardiovascular death in those with diabetes, prediabetes, and normoglycemia.
Kasia Lipska, MD, MHS, looked at catastrophic spending on insulin in a national U.S. sample in a paper in the journal Health Affairs. Lipska and colleagues provided data on people who use insulin, whether and how they are insured, and who is at highest risk of extreme financial burden. According to the team’s findings, 14 percent of people who use insulin in the United States face catastrophic levels of spending on the drug.
In people with type 1 diabetes, the immune system attacks the cells that make insulin, which the body needs to process sugar. The drug teplizumab, a monoclonal antibody, is intended to prevent or delay diabetes by moderating the body’s immune response. In a clinical trial led by Kevan Herold, MD, teplizumab prevented or extended the time preceding clinical diagnosis. Any delay in developing type 1 diabetes is significant; such a reprieve could mean, for example, attending primary school disease-free.
The section welcomed Priyadarshini Balasubramanian, MBBS, MD, and Brian Wojeck, MD, MPH, as assistant professors in July 2022. Both are former Yale endocrinology fellows.
Honors and Awards
Gerald I. Shulman, MD, PhD, won the 2021 Manpei Suzuki International Prize for Diabetes Research in recognition of his extensive pioneering contributions over many years, leading to several paradigm shifts in the understanding of physiologic regulation of liver and muscle carbohydrate and fat metabolism in humans, and its dysregulation in type 2 diabetes. Shulman is co-director of the Yale Diabetes Research Center.
Elizabeth Jonas, MD, professor of medicine, was elected to the Association of American Physicians during the organization’s annual meeting in April 2022. She is currently investigating a novel hypothesis for the way in which changes in mitochondrial ion channels occur during ischemic brain disease and developmental disease.
Inzucchi, the section’s fellowship program director, received a Rosemarie L. Fisher, MD, Excellence in Graduate Medical Education Award for 2022.
Clinical case conferences and endocrine grand rounds, both CME-accredited, bring the section together to learn from one another and from experts from around the world. The section’s educational programs benefit from a fund established upon the retirement of Arthur Broadus, MD, PhD, which now serves as a tribute to his memory. If you would like to contribute to the Broadus Fund, please email John Wysolmerski, MD, (email@example.com) for details.