Advancing Treatment and Improving Patient Care
Our physicians and scientists are committed to advancing the treatment of diseases and improving the care of patients through clinical research studies. These studies include investigations of new treatments for diabetes and other endocrine disorders, newer surgical approaches to parathyroid and thyroid conditions, and surgical and medical management of obesity.
Type-2 Diabetes Mellitus Study
The Division is conducting an NIH multi-center study investigating the best treatment option for newly diagnosed patients with type-2 diabetes mellitus. The 5-year study, led by Dr. Faramarz Ismail-Beigi, is now near completion as the data is analyzed.
Thyroid Function in Patients with Cancer
Studies on the impact of gonadal steroids on thyroid function, especially in patients with thyroid cancer, were published in prestigious journals, including the New England Journal of Medicine and the Annals of Internal Medicine, and had a major impact on disease management.
Long-Term Follow up of Patients with Thyroid Cancer
We have been following a large cohort of patients with thyroid cancer for many years to try and identify the clinical, biochemical and imaging characteristics that can predict long term of these patients.
Pituitary and Adrenal
Studies on pituitary hormone secretion were initiated in the early 1980s by Dr. Baha Arafah, the last fellow trained by Dr. Olaf Pearson. Over the years, many studies have been conducted on patients with pituitary hormone abnormalities, including those with primary or metastatic pituitary tumors, hypothalamic tumors, and others with mass lesions around the pituitary area. These studies provided mechanisms for the development of the loss of pituitary hormone function (hypopituitarism) and the potential for its reversibility. Before these studies were published, the common view among leading endocrinologists was that loss of pituitary function is always permanent. Therefore, patients with loss of function were destined to be on permanent hormone replacement therapy. Our studies demonstrated that was not often the case, provided specific mechanisms for its development, and offered clues for potential recovery.
We have a large database of patients with pituitary tumors that have grown over the past 40 years and led to multiple sub-studies.
Current Studies on Adrenal Function
Adrenal function during critical illness has been a major focus of our investigations. Studies conducted over the past few years have significantly impacted the management of critically ill patients with adrenal dysfunction. Our studies addressed important issues in the current understanding of adrenal function during critical illness, the role of adrenal hormones, and the serious limitations of biochemical testing of adrenal steroid secretion.
Another study examines the best method to provide glucocorticoid replacement for those with deficiencies during a critical illness such as surgery.
The impact of liver disease on adrenal steroid metabolism is also under investigation. The liver is the primary organ that metabolizes glucocorticoids, and any alterations in liver function are highly likely to slow down steroid metabolism and alter the doses needed to replace or treat conditions requiring glucocorticoid therapy.
Studies on Patients with Adrenal Tumors
Benign adrenal tumors are often discovered incidentally in patients, and the incidences increase with age. While most of these tumors do not function, some have a variable degree of hormone secretion leading to various clinical manifestations. The current recommendation is to have all functional tumors surgically removed. The current practice is to treat all patients who are having surgery to remove these tumors is to treat them with large doses of hydrocortisone for a while. We are conducting a study to identify through some hormonal testing those who would and others who would not need to be treated with glucocorticoids before, during, and after that surgery.