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Yale has a new battle station for fighting diabetes

The Yale Diabetes Center has a dedicated space for the treatment and education of adults with Type 1 and Type 2 diabetes

[January 2009] When the Yale Diabetes Center was founded, in 1994, it was a “center without walls,” meaning that it shared space and resources with other specialty practices in the central area for outpatient activity at the Yale School of Medicine. Today, with the financial support of Yale-New Haven Hospital, the center has its own dedicated space, complete with a reception area and five rooms for patient care and education.

But it’s not the new space that pleases Center Director Silvio Inzucchi, MD, a board-certified endocrinologist, as much as it’s the expanded clinical services that can now be offered to patients.

“People realized that diabetes is a very important disease and that it was time to enhance our program with additional resources,” said Inzucchi. “With our new space, we can treat more patients than we could before and offer them new tools for managing their disease.”

Geralyn Spollett, a nurse practitioner in internal medicine, endocrinology, and the center’s associate director, said patients’ interaction with their health care providers has been enriched by the new space. “With diabetes, the patient is a partner in his or her own care, and there’s a lot of equipment that goes along with that,” Spollett said. “In our new space we can give patients the hands-on training they need.”

The center is staffed with four faculty physicians, four nurse practitioners, and two medical assistants. Plans are underway to hire an additional full-time diabetologist. Inzucchi hopes to have that position filled by July 1.

The Yale Diabetes Center is a joint program between the Yale Medical Group and Yale-New Haven Hospital. It offers comprehensive diagnosis, management and education for adults with Type 1 and Type 2 diabetes, focusing on lifestyle interventions and using the latest medications and technologies. The goal is to give patients the tools to self-manage their diabetes.

Three important features of the new center are:

The center is opening its doors at a time when diabetes management is undergoing major changes. “Managing diabetes patients in 2008 is much different than it was even in 1998,” Inzucchi said, noting there’s been a significant jump in the number of drugs that are used to treat the disease, and new instruments have made glucose monitoring and insulin injection much easier.

“Some of these new technologies really can’t be adequately taken advantage of in a busy primary care practice. It’s best done in a custom-designed facility with specialty trained physicians and nurses. ” Inzucchi said.

But perhaps what excites him most about the new center is the opportunity it affords to treat patients earlier in the disease course. “Classically, the diabetologist became involved in patient care when there may have been little benefit to improving care. The horse was already out of the barn. Whatever you did should have been done 15 or 20 years ago,” he said. “With the new center, we’ll be able to see the full span of patients, from those who don’t even have diabetes yet but are at risk and want to learn how to prevent it, to patients with very early diabetes to others with a later stage of the disease who are having a hard time getting it under control.”

Wherever a patient falls on the disease spectrum, Inzucchi said the goal of the center is the same: to maximize the capacity of each patient to self-manage the disease. That means understanding what diabetes is, how food affects it, how to monitor blood glucose, what triggers make it high and low and the importance of diet and exercise.

“It’s important for us to transfer the knowledge we have to our patients so they can live healthy lives,” Inzucchi said. He is also helping to educate physicians about diabetes management through a pocket guide he annually updates and distributes nationwide, called Diabetes Facts and Guidelines. It is available at the center or by calling 203-737-1932.

For more information about diabetes, click here.

The Yale Diabetes Center is located in the Dana Building, second floor, 789 Howard Ave., New Haven, CT. Hours are 8:30 a.m. to 4:30 p.m. Monday through Friday. Phone: 203-737-1YDC. The building is handicap accessible.

Photos of Dr. Inzucchi and the Diabetes Center: Robert Lisak.
Photo of Kevan Herold: Terri DaGradi.

Clinical trials offer patients a chance to be a part of cutting-edge diabetes research

 Kevan Herold, MD

Kevan
Herold, MD

An important component of diabetes interest at Yale is the range of clinical trials researchers are conducting to test new treatments for at-risk patients and those who already have the disease.

This effort will be supported and enhanced by the new diabetes center, said Director Silvio Inzucchi, MD. He foresees a two-way street in which center patients participate in clinical research which could lead to new therapies for patients who come to the center for diabetes care.

Kevan Herold, MD, a professor of immunobiology and internal medicine, is the principal investigator on a number of clinical trials related to Type 1 diabetes. The trials are testing new drugs to prevent the disease or to halt its progression. Patients newly diagnosed with Type1 diabetes, those who have been diagnosed for an extended period and relatives of people who have the disease are all encouraged to participate.

Researchers are exploring ways to regenerate beta cells (insulin-producing cells in the pancreas that are destroyed by the disease) as well working to develop new immune and cellular therapies to prevent the disease in people at risk, or to stop its progression in patients who already have the disease. 

Some of the clinical trials that are underway or are being planned at Yale include:

  • Teplizumab. Scientists want to test whether this drug protects and preserves the beta cells of the pancreas, thereby preventing the progression of diabetes. Teplizumab testing began in 1999 with promising results. Herold and his team are now enrolling patients in another clinical trial.
  • GAD immunization molecule. Within the year, Herold hopes to launch a clinical trial in which newly diagnosed patients would be immunized with GAD to see if the drug stops the disease’s progression.
  • Anti-CD3 prevention. This trial will look at whether the drug CD3 protects people who are at risk for getting diabetes.
  • Oral insulin prevention. Already underway, this trial is testing whether insulin taken in pill form prevents the onset of diabetes in at-risk patients.

Yale researchers also want to screen relatives of people with Type 1 diabetes to see if they are at risk for getting the disease. This involves collecting a blood sample so researchers can measure autoantibodies and look for biomarkers that will help them identify who is at risk and who isn’t.

If you or somebody you know is interested in participating in a Type 1 diabetes clinical trial, call the Yale Diabetes Center at (203) 737-1932 or email one of the two study coordinators, Linda Rink, at Linda.rink@yale.edu, or Laurie Feldman, at laurie.feldman@yale.edu

More diabetes trials can be found at www.yaletrials.org.



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