From the Division Chief: Peter Arvan, M.D., Ph.D.
Welcome! This division of the U of M has a long and illustrious history in academic endocrinology, of which we are very proud. Nevertheless, one of my first official acts was to change the name of our division to MEND (Metabolism, Endocrinology & Diabetes). This acronym reflects our field, our aspirations, our plans, and our goal.
This web page provides a short tour of who we are, what we do, and why we're here. We're a division of the Department of Internal Medicine, with 35 active primary faculty members, 10 secondary appointees, and 8 emeritus or adjunct faculty. I invite you into the world of Metabolism, Endocrinology & Diabetes at the University of Michigan.
I. SCIENTIFIC DISCOVERY — The MEND Division serves a primary academic mission. We pursue scientific inquiry in several general areas.
Diabetes and obesity research is a field of ever-expanding aspects, and consumes much of the energies of Drs. Arvan, Asao, Bernal-Mizrachi, Burant, Gianchandani, Herman, Hodish, Koenig, Kraftson, Kumagai, Myers, Oral, Pietropaolo, Pop-Busui, Rothberg, Tan, and Wrobel. Current studies range broadly from pancreatic beta cell biology, pancreatic endocrine progenitor (stem) cell differentiation, selenoproteins and oxidative stress, lipid storage and lipid metabolism, insulin resistance in aging, outcomes of for critically ill hyperglycemic patients, cost and efficacy analyses in the treatments of diabetes, insulin-stimulated glucose transport into tissues, and diabetic complications such as neuropathy. These diabetes-related investigations are further described not only in individual faculty listings, but in great detail under the Michigan Diabetes Research and Training Center.
Studies of endocrine hypertension include efforts from Drs. Auchus, Grekin, Esfandiari, and Mortensen. These studies range from patient-based analyses of relationships between adiposity and hypertension, roles of fat in steroid hormone metabolism, as well as animal model studies to analyze the roles of G-protein mediated signaling and PPAR nuclear receptor activation in lipid and glucose metabolism.
The adrenal research program includes the efforts of Drs. Hammer and Schteingart. Ongoing studies include analysis of the steroidogenic factor-1 transcription factor, the homozygous acd mutant gene causing adrenal dysgenesis, conditionally-dependent adrenal carcinoma that develops in mice lacking inhibin , the behavior of a variety of human adrenocortical carcinoma cell lines and the susceptibility of such cells to novel anti-tumor agents, as well as clinical studies of syndromes of steroid excess.
The pituitary research program involves active pursuit by Drs. Barkan and Jaffe. Studies in this area include analyses of pulsatility of growth hormone secretion, sex steroid regulation of growth hormone secretion, and optimizing treatments of acromegaly.
The thyroid research program involves the efforts of Drs. Arvan, Haymart, and Koenig. Work in this area includes studies on thyroid cancer, thyroid hormone biosynthesis defects, thyroid hormone receptors and their actions on target tissues, and the role of retinoids in development and cellular differentiation.
II. CLINICAL CARE — MEND Division clinic programs include management of Diabetes types 1 and 2, thyroid, osteoporosis, parathyroid, pituitary, and adrenal dysfunction, as well as endocrine tumors and endocrine hypertension. The Division also services ongoing clinical programs for obesity and gestational diabetes. This care is provided both at the main campus and at outpatient satellite facilities, including our MEND-Podiatry Clinic at Domino's Farms and UMHS Health Centers in Brighton and Chelsea. A number of dedicated full-time clinical faculty, including Drs. Choksi, Dimaraki, Douyon, Esfandiari, Franzese, Holmes, Munson, and Wyckoff, contribute great effort to provide the finest subspecialty care possible to our patients. The clinical effort is assisted both by our clinical-educator, physician-scientist, clinician-scholar, and part-time faculty, as well as the dependable effort of emeritus and adjunct faculty members.
One Division initiative is our pilot program to control hyperglycemia in patients hospitalized in the intensive care unit setting. Headed by Dr. Gianchandani, the pilot program began in the Thoracic Surgery and Cornonary Care Units. The program is predicated on the evidence that improved glucose control limits hospital-acquired infections, improves wound healing, and shortens patients length of stay. It also includes a training component for hospital staff. These efforts interface with the Diabetes Management Program headed by Dr. Lash and intensive insulin (pump) outpatient program run by Dr. Kumagai.
All of our clinical activities are overseen by the director of the Adult Endocrinology Clinical Program, Dr. Craig Jaffe.
III. EDUCATION — The MEND Division is committed to its educational mission to prepare physicians and scientists of tomorrrow.
Drs. Lash, Kumagai, and Grekin have all played important roles in the development and implementation of the new curriculum for second-year medical students. Dr. Schteingart oversees our NIH-funded training programs in clinical research. Drs. Burant and Hammer have participated as directors in the "Organogenesis of Complex Tissues" course run through the Cell and Developmental Biology department. Drs. Bernal-Mizrachi, Oral, and Pop-Busui organize the MEND research conference series. Drs. Choksi, Lash, and Tan organize the MEND clinical conference series. Dr. Koenig serves as the director of the M.D.- Ph.D. program at the U of M.
In closing, let me welcome you again to our site; take your time to explore, and let us know what you think. Involvement from the community, the state of Michigan, and the nation are all key elements of dialogue that will keep us strong and on target. There's a lot of work to be done — come and join forces with us!