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Medical School Engagement Program

We are excited to announce that the Division of Endocrinology, Diabetes and Metabolism was selected as a 2024 MSEP Award Recipient. The program will be led by Dr. Aleona Zuzek as she joins our faculty as an Assistant Professor of Clinical Medicine

Endocrine Society

We are delighted to announce the outcome of a highly competitive application process for our inaugural year of the Endocrine Society's Medical School Engagement Program(MSEP). With participation from 25 medical schools vying for just ten available spots, our chosen recipients stood out with exceptional leadership in education, innovative approaches, and unwavering commitment to advancing pathways to careers in endocrinology.

Please join us in congratulating our 2024 MSEP Award Recipients:

  • Eric Epstein, MD: Albert Einstein College of Medicine
  • Alex Tuttle, MD and Erika Zevin, MD: Indiana University School of Medicine
  • Dimpi Desai, MD: Stanford University School of Medicine
  • Teodor Duro, MD: University of New Mexico School of Medicine
  • Aleona Zuzek, MD: University of Cincinnati College of Medicine
  • Brian T O’Neill, MD and Amal Shibli-Rahal, MD: University of Iowa, Carver College of Medicine
  • Megan Kristan, MD: University of Minnesota Medical School
  • Susan E Kirk, MD: University of Virginia School of Medicine
  • Andrea Utz, MD and Jennifer Kelley, MD: Vanderbilt University Medical Center
  • Adnin Zaman, MD: University of Rochester School of Medicine and Dentistry

As you know, the endocrinology pipeline is facing unprecedented challenges. In 2010, endocrinology was one of internal medicine’s most competitive specialties. In 2024 it’s one of the least. While the number of endocrine fellowship positions and US medical students continue to rise, the number of US medical school graduates applying for endocrinology fellowships has been declining. In 2023, fewer than one-third of endocrine fellows were from US based medical schools, and only 38 fellows (11%) chose a three-year research fellowship.

Together, we can meet this challenge: timely, ongoing, and engaging mentorship with medical students - starting early, and continuing through their educational careers - can play a significant role in increasing the number of students choosing a specialty. Our goal is to increase medical students’ interest and enthusiasm for endocrinology as their career choice.

Our Medical School Engagement Program plays a pivotal role in this mission, offering invaluable opportunities for our medical students to learn, grow, and excel in their journey toward becoming our colleagues

The 2024 Thirteenth Annual DOIM Research Symposium was held on March 27, 2024 and we would like to recognize the efforts of our fellows and their mentors in presenting excellent research posters. 

Name: Ehab Abdelgyed, MD
Mentor: Dima Diab, MD
Poster Title: "Melorheostosis: A Rare Osteosclerotic Disease"

Name: Junting Liu, MD
Mentor: Dima Diab, MD
Poster Title: "Catatonia Induced by Lithium Associated Hyperparathyroidism: A Case Report"

Name: Aleona Zuzek, MD, and Aviva Atri-Schuller, DO
Mentor: Abid Yaqub, MD
Poster Title: “Debunking the Bimodal Theory of Autoimmunity: Grave’s Disease (GD) Hyperthyroidism and Hashimoto’s Disease (HD) Hypothyroidism can Coexist on a Spectrum, A Case Series”

We would also like to congratulate Aleona Zuzek, MD (2nd year fellow), and Aviva Atri-Schuller, DO (PG-Y2), for their 1st place award in the clinical case report poster category. 

Image of Zuzek and Atri-Schuller winning poster

Grade Study Investigators Publish Expanded Results of Major NIH-Sponsored Comparative Study of Glucose Lowering Medications in Type 2 Diabetes
MAR/25/2024

Gentleman with beard and glasses dressed in white medical coat

The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study was conducted at 36 US centers and nine subsites between 2013 and 2021.

It was designed to compare four major medications approved by the FDA to treat diabetes in combination with metformin, the usual first-line drug. Major results focusing on the relative differences in blood glucose (sugar) levels and the occurrence of cardiovascular outcomes, like heart attacks and stroke, were published in two papers in The New England Journal of Medicine in September, 2022.

Ten scientific papers published in the April issue of Diabetes Care report other important differences between the four medications which are commonly used to treat type 2 diabetes. The GRADE study included more than 5,000 volunteer participants with type 2 diabetes from diverse racial and ethnic groups. They were studied over five years during which insulin glargine, liraglutide, glimepiride and sitagliptin were compared. The trial was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health.

Diabetes affects more than 1 in 10 — or more than 38 million — Americans. People with diabetes who keep their blood sugar levels in the near-normal range generally have a much lower risk of developing diabetes complications such as heart, kidney, and eye diseases. The challenge is that most people with diabetes require more than one medication to control blood sugar levels over time.

Beyond the differences in blood sugar control between the four diabetes medications shown in the previous publications, the current findings examined individual characteristics that were associated with the achievement of lower and higher average blood sugar levels over time. For example, the inability to maintain good blood sugar control was largely driven by younger age and higher blood sugar levels at baseline.

Understanding these factors can help to identify people who would benefit from more aggressive diabetes management. Another set of analyses revealed that adding liraglutide to metformin improved quality of life after the first year of treatment, but this benefit was subsequently lost. The improvement with liraglutide was related to the degree of weight loss, particularly in those who had the highest weight at baseline.

Of note, assignment to insulin therapy was well-accepted by the participants, with even better compliance than for the other medications, and there were no adverse effects of insulin therapy on the participants' distress related to diabetes. In fact, treatment with insulin and the other injectable medication, liraglutide, lowered distress related to diabetes. These findings largely debunk the myth that patients are intolerant of insulin therapy or that once started it diminishes quality of life.

The sensitivity to insulin action and insulin secretion from the pancreas' beta-cells are known to be important contributors to type 2 diabetes. Their respective roles were reported in separate papers. The loss of insulin secretion was critically related to the progressive worsening of blood sugar control with all four medications, with reduced insulin sensitivity contributing to the outcomes of treatment.

The two most common causes of death during the study were cardiovascular disease and cancer, with no differences among the four treatment groups.

“GRADE has previously shown which medications worked best at achieving and maintaining blood glucose targets over time. The current findings provide additional information regarding the relative benefits and risks of the medications which should help patients and their health care providers choose the best medication to treat their diabetes" said GRADE Study Chair Dr. David M. Nathan, director of the Massachusetts General Hospital Diabetes Center.

Dr. Robert M. Cohen served as the Principal Investigator of GRADE at the University of Cincinnati and Jacqueline Craig was the lead study coordinator. "We are indebted to our 148 volunteers who diligently participated in this important study" noted Dr. Cohen.

The GRADE Study was supported by a grant from NIDDK (U01DK098246). Additional support was provided by NIH’s National Heart, Lung, and Blood Institute, National Institute of General Medical Sciences, and National Center for Advancing Translational Sciences; the Centers for Disease Control and Prevention; and the American Diabetes Association. The Department of Veterans Affairs provided resources and facilities. Material support in the form of donated medications and supplies has been provided by Becton, Dickinson and Company, Bristol-Myers Squibb, Merck & Co., Inc., Novo Nordisk, Roche Diagnostics, and Sanofi. ClinicalTrials.gov number: NCT01794143.

Clinical Care Information:
If you have questions about clinical care, please visit the UC Health Endocrinology, Diabetes & Metabolism site or call 513-475-7400.

 

Division Director:
Mercedes Falciglia, MD

Business Manager:
Connie Adkins
Phone:513-558-3811
Email: connie.adkins@uc.edu

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University of Cincinnati
Department of Internal Medicine

Division of Endocrinology, Diabetes & Metabolism
231 Albert Sabin Way, ML 0547
Cincinnati, OH 45267-0547

Phone: 513-558-4444
Fax: 513-558-8581
Email: ucintmed@uc.edu