EndocrinologyOur nationally and internationally recognized physicians are experts in diagnosing and treating diseases related to the body’s endocrine system, which regulates hormones. They also specialize in treating metabolic disease, or any of the diseases or disorders that disrupt normal metabolism, the process of converting food to energy. We are a national referral center for 3,000 patients with type 1 and type 2 diabetes, as well as other metabolic conditions. We help patients transition seamlessly from pediatric to adult care. We emphasize a personalized approach to care, tailoring the treatment program to each patient’s needs. Our 24/7 consult service provides expert consultations to patients with complex conditions, spanning the full spectrum from disorders of the thyroid to electrolyte abnormalities and hormonal conditions. Specialized care is offered in the following areas: Bone Center Diabetes Center Endocrine Neoplasia Program (thyroid/adrenal) Pituitary Program A major referral center for 3,000 patients with type 1 and type 2 diabetes, as well as other metabolic conditions, including obesity and lipid disorders. Services include insulin pumps, continuous glucose monitoring, and access to clinical trials. An inpatient diabetes management service that is available 24/7 to assist clinicians in achieving optimal glucose control in hospitalized patients in both ICU and non-ICU settings A national referral site for patients with thyroid diseases, including hyperthyroidism, thyroiditis, thyroid nodules, and thyroid cancer; and adrenal diseases, including adrenal masses, Cushing syndrome, hyperaldosteronism, and pheochromocytoma Multidisciplinary care provided to patients with pituitary diseases, including tumors, prolactinomas, Cushing syndrome, acromegaly, hypopituitarism, and hypophysitis. Special services include intraoperative MRI and intraoperative hormonal testing to ensure complete removal of tumor. National and international experts on metabolic bone disease, including osteoporosis, hyperparathyroidism, Paget disease, vitamin D disorders, and genetic conditions involving the skeleton. Challenging cases are reviewed at a monthly multidisciplinary bone conference. Bone density measurements by the Yale Densitometry Service that are taken on a new Hologenic DXA scanner
Pediatric Endocrinology & DiabetesConsidered one of the nation’s most respected sections in endocrinology and diabetes, our team includes nationally recognized physicians, certified nurse practitioners, nurse educators, dietitians, social workers, and other caregivers. We help children and their families with the many problems that may accompany defects in the endocrine system, including diabetes, growth problems, and obesity. Yale Pediatric Endocrinology faculty are expert in the clinical management of endocrine and metabolic disorders, including: Type 1 diabetes Type 2 diabetes Obesity & weight management in children Interdisciplinary bariatric surgery clinic Lipid disorders, including hyperlipidemia and lipodystrophy General endocrine disorders Thyroid disease Parathyroid Adrenal, including congenital adrenal hyperplasia Pituitary Neuroendocrine Growth & puberty Polycystic ovarian syndrome Metabolic bone disease, including nutritional rickets & osteomalacia Interdisciplinary differences in sexual differentiation Interdisciplinary transgender program Hormonal complications of cancer and cancer treatment
Diabetes CenterOur goal at the Diabetes Center is to give patients the tools necessary to successfully manage the day-to-day challenges of living with diabetes and prevent long-term diabetes complications. We provide comprehensive management and education for adults with type 1 and type 2 diabetes. We focus on lifestyle interventions and use the latest medications and technologies to improve our patients’ health. We also treat patients with: Pre-diabetes and metabolic syndrome Obesity Polycystic ovarian syndrome Lipid or cholesterol abnormalities Our nationally recognized doctors and nurse practitioners work as a team to address our patients’ needs in managing diabetes and other conditions. We understand that living with diabetes presents challenges. We focus on education and making patients their own advocates. Through the most current and state-of-the-art treatments, we will help them better manage their care. Oral Medications There are several classes of oral diabetes medications that we may prescribe if patients have type 2 diabetes. These medications differ in the way they work to reduce blood glucose levels. Frequently, oral medications from different classes are used in combination. Sulfonylureas: These drugs increase the amount of insulin produced by the pancreas. Meglitinides: These drugs rapidly increase the amount of insulin produced by the pancreas. Biguanides: Metformin is the only biguanide on the market. It is thought to work by reducing the production of glucose in the liver. Alpha-Glucosidase Inhibitors: These medications reduce the amount of glucose absorbed in the intestines. Thiazolidinediones: This agent makes the body more sensitive to insulin. Dipeptidyl Peptidase 4 inhibitors (DPP-4 inhibitors): These drugs increase the amount of insulin produced by the pancreas after a meal and reduce the amount of glucose produced by the liver. Injection Therapies There are several classes of injection therapies for diabetes. These treatments are given by an injection under the skin. The most common injection therapy is insulin, which comes in many different formulations that differ in how fast they work and how long they last. Below is a list of the different types of insulins. Technologies and Experimental Treatments Insulin Pumps: Insulin pumps were first pioneered at Yale in the 1970s. An insulin pump is an electronic, pager-sized, battery-powered device that delivers insulin continuously through a small plastic catheter under the skin. Insulin is delivered in different amounts (“basal” or “bolus” levels) during the day and controlled by the patient. While fasting, patients will administer a low level of continuous “basal” insulin to keep their blood glucose in the normal range. Prior to meals, they will determine a “bolus” of insulin based on the amount of carbohydrates in the meal. Continuous Glucose Monitoring systems (CGM): A CGM is a device that measures glucose under the skin (also known as “interstitial” glucose) every five minutes thr
Pediatric Diabetes ProgramWe specialize in the treatment of children with type 1 diabetes, offering comprehensive care and support for patients and their families. Ourteam of physicians, nurse practitioners/certified diabetes educators, nurses, social workers, psychologists,and nutritionists is dedicated to educating and supporting children, adolescents, and parents as they cope with this disease. We place a special emphasis on technological tools, as well as clinical research that can help our patients manage their diabetes. For our teen and young adult patients who are preparing to transition to adult diabetes care and are learning to manage their diabetes on their own, we offer the Yale FORGE Ahead Bridge Diabetes Program. FORGE stands for: Form new relationships Orient to the future Reach out for support Gain new knowledge Embrace life … Ahead and Bridge We recognize that teens and young adults need a different kind of support as they prepare to manage diabetes on their own. We aim to: Better address the unique needs of teens with type 1 diabetes who are transitioning into adulthood Support efforts for patients to assume full responsibility for their own diabetes management and exercise healthy behavior. At the Bridge Clinic, patients will have a team visit with a nurse practitioner trained in both pediatric and adult diabetes, along with our clinical nutritionist and social worker. The team will help guide patients through the transition to adult care.