Diabetes, Endocrinology and Metabolism Treatment Programs

Treatment options and approaches for diabetes and endocrinology are more plentiful than ever.  Treatment is tailored to the individual, with the type of diabetes and its severity determining the optimal course of treatment.
 
Insulin Therapy
Insulin therapy is the mainstay of type 1 diabetes treatment, and is also used in some cases of type 2 diabetes.  Not so long ago, diabetics had to inject porcine insulin (derived from pigs), which sometimes caused allergic reactions. Now, recombinant human insulin is the standard treatment, and may be administered in several ways:
  • Daily injections
    Patients inject themselves with insulin several times daily, timing the injections to coincide with meals and measurements of blood glucose levels. This is the time-honored way to take insulin, and many patients are used to the routine.
  • Insulin infusion
    In a hospital setting, intravenous infusion of insulin is sometimes used to manage severe hypoglycemia. This is not usually a practical option for self-care.
  • Insulin pump
    The insulin pump has revolutionized insulin therapy for many patients.  It provides a continuous infusion of insulin subcutaneously (under the skin) via a small, unobtrusive, wearable pump. The pump is combined with a glucose monitor, which constantly measures blood glucose levels. The pump can therefore adjust insulin delivery to ensure optimal blood glucose levels sustained over time, and eliminate the sharp spikes and downswings in blood glucose that can occur with other treatment methods.
 
Non-endocrine Cancers
  • Investigation of endocrine complications as a result of chemotherapy, radiation therapy and bone marrow transplant in cancer patients.
  • Management of immunosuppressive therapy-related endocrine complications.
  • Development of clinical practice guidelines for the management of hypothalamic-pituitary endocrine complications after bone marrow transplant.
  • Aggressive prevention and treatment of bone marrow transplant osteoporosis in both men and women.
 
Thyroid Cancer
After thyroid cancer surgery, standard treatment consists of radioiodine to ablate residual tumor cells. However, we have been exploring methods of augmenting or supplanting this therapy. Initiatives include:
  • Continued clinical research in thyroid cancer exploring new diagnostic and therapeutic alternatives to radioactive iodine therapy
  • Providing compassionate use of recombinant human thyroid stimulating hormone (Thyrogen) for thyroid cancer therapy
    
Neuroendocrine Tumors (carcinoids, pancreatic endocrine tumors, etc.)
These tumors present a significant challenge both at diagnosis and in treatment. Research efforts include:
  • Advancing the management of neuroendocrine tumors with the use of radioactive iodine MIBG
 
Male and Female Sexual Dysfunction (primary and secondary)
  • Management of male and female sexual dysfunction in premature gonadal/ovarian failure patients
  • Clinical research in male sexual dysfunction in patients with cancer and diabetes