UAB Synopsis, Vol. 27, No. 16, April 28, 2008

The Division of Endocrinology, Diabetes, and Metabolism will open a Multidisciplinary Comprehensive Diabetes Clinic (MCDC) this summer with a goal of improving treatment for people with diabetes mellitus. The clinic will offer patients 1-day multispecialty evaluations, lifestyle education, and a recommendation to guide care for the next year.

“The new clinic will provide a unique service to the community and to referring physicians,” Division Director Stuart J. Frank, MD, says. “It also will serve as the strong clinical arm for UAB’s Comprehensive Diabetes Center, a complement to the Diabetes Research and Training Center, and as a means to care for people with type 1 diabetes as they outgrow the pediatric endocrinology clinic at Children’s Hospital.”

The clinic, to be located on the first floor of The Kirklin Clinic^® (TKC) in the area previously occupied by the Pain Clinic, will be unique in Alabama and matched by only a few places in the country, diabetologist Fernando Ovalle, MD, says. One week before their appointment, patients will stop by the clinic to be fitted with a subcutaneous sensor and device that continuously monitors blood glucose levels. When patients arrive for their all-day appointment, those data will be downloaded for evaluation. Patients will undergo a comprehensive set of fasting laboratory tests, both in the clinic and in TKC Lab Services. Patients then meet with nutrition and diabetes educators to explore appropriate diets and lifestyle options. Patients and family members will be treated to a diabetes-appropriate lunch that puts into practice the morning discussions.

In the afternoon, patients will rotate through in-depth evaluations by endocrinology, ophthalmology, orthopaedic surgery, and other specialties as needed. Social workers and nutritionists also will provide consults. At the end of the day a clinic coordinator will develop a comprehensive clinic note to give the patient and send to the referring physician that provides evaluations from each specialist and recommendations for future care.

Dr. Ovalle says patients will save time by seeing several specialists in one location in a single day. “Typically they would have at least 3 or 4 half-day appointments to accomplish what we are going to do during one visit.”

Initially Dr. Ovalle plans to operate weekly subspecialty clinics for patients on insulin pumps, adolescents transitioning to adult care, and people with type 1 and 2 diabetes. Less frequent clinics are planned for less common situations, such as cystic fibrosis-related diabetes, maturity-onset diabetes of the young, pancreatic diabetes, transplant-related diabetes, and others. He envisions eventually adding a hospital discharge clinic for patients newly diagnosed with diabetes and for those placed on insulin pumps while in the hospital for the first time.

Dr. Ovalle calls the MCDC “UAB’s face of diabetes” to the community. “This clinic would not be possible without community and institutional support,” he says.

“The clinic will devote more time and resources to patients than possible in a general endocrinology practice, but the payoff will come with improved glycemic control, increased patient follow up, higher patient satisfaction, lower risk for micro- and macrovascular complications, improved quality of life, and decreased health costs in the long run.” An added benefit of the clinic will be its ability to serve as a ready source for translational research.

The division will continue to see patients for routine visits in its general endocrinology/diabetes clinic on TKC’s fourth floor.

MCDC Faculty
Endocrinology: Carlos R. Arguello, MD, Stuart J. Frank, MD, Fernando Ovalle, MD, Richard S. Rosenthal, MD, and Amy H. Warriner, MD.
Pediatrics/Endocrinology: Kenneth L. McCormick, MD, Joycelyn A. Atchison, MD, and Brooks Vaughan III, MD.
Ophthalmology: R. Jeffrey Crain, MD.
Orthopaedic Surgery: John S. Gould, MD.
Nephrology: Ruth C. Campbell, MD.
TKC Nutrition & Diabetes Education: Cathy E. Crawford, RD, CDE.
TKC Social Work: Jessica E. Gifford, MSW.

The University of Alabama System Board of Trustees has named Stuart J. Frank, MD, as the second holder of the endowed Ruth Lawson Hanson Chair of Medicine in Diabetes and Metabolism. Dr. Frank is the Director of the Division of Endocrinology, Diabetes and Metabolism, and is a professor in the Departments of Medicine, Cell Biology, and Physiology and Biophysics.

An internationally known endocrinologist and distinguished leader in the field of growth hormone (GH) biology, Dr. Frank has authored numerous peer reviewed manuscripts and serves on the editorial board of Molecular Endocrinology. Dr. Frank’s professional memberships include the American Association for the Advancement of Science (AAAS), the Massachusetts Medical Society, the Endocrine Society, the American Federation for Medical Research, the Southern Society for Clinical Investigation and the American Association of Clinical Endocrinologists.

The previous holder of the endowed chair was Dr. Jeffrey Kudlow, former division director of Endocrinology, Diabetes and Metabolism.

Dr. Edward Abraham, Chair of the Department of Medicine, has appointed interim director Dr. Stuart Frank to serve as Director of Endocrinology, Diabetes and Metabolism beginning October 1. Dr. Frank is a Professor in the Departments of Medicine, Cell Biology, and Physiology and Biophysics at UAB. He serves as Director of the Basic Science Section of the Division of Gerontology, Geriatrics and Palliative Care, and as Chief of the Endocrinology Section in the Medical Service at the Birmingham Veterans Affairs Medical Center. In addition, Dr. Frank serves as Chair of the School of Medicine Faculty Council.

Dr. Frank is an outstanding educator, clinician and researcher. “I have every confidence that Dr. Frank has the leadership abilities, research skills, creativity, and energy level required to build on the existing strengths of this division and to develop productive programs in new directions,” said Dr. Abraham.

Dr. Frank received his medical degree from Harvard Medical School and completed his internship and residency in Internal Medicine at Washington University School of Medicine in St. Louis. He completed a fellowship in Endocrinology and Metabolism at the National Institute of Child Health and Human Development at NIH and was a medical staff fellow/senior staff fellow in the Cell Biology and Metabolism Branch, NICHD, NIH. He was appointed to the faculty at UAB in 1991. His research, aimed at understanding growth hormone (GH) receptor signal transduction and structure/function relationships and mechanisms of generation of the GH binding protein, is supported by grants from NIH and the Department of Veterans Affairs.

Dr. Frank sees an exciting future for the Division. “The emphasis on diabetes and metabolism in the research and clinical strategic plans, the tremendous philanthropic support for the new Comprehensive Diabetes Center and related activities, and the recent NIDDK decision to fund UAB’s NIH-sponsored Diabetes Research and Training Center are all important developments that directly impact therole of our Division. I foresee recruitment of world-class research faculty in diabetes and endocrinology to compliment our existing excellent basic and clinical research programs, and I envision that our planned Multidisciplinary Comprehensive Diabetes Clinic will similarly enhance our already robust clinical efforts. I look forward to collaborating closely with Dr. Corbett at the Diabetes Center, Dr. Garvey of Nutrition Sciences, Dr. McCormick in Pediatric Endocrinology, and other leaders in the Department of Medicine to develop new clinical, research, and training programs.”

A proposal to establish a new Diabetes Research and Training Center (DRTC) at UAB has been funded by NIH/NIDDK. The goal of the 5 year, $9 million project will be to promote excellence in diabetes research, to decrease morbidity/mortality and increase quality of life for diabetes patients, and to provide an outstanding environment for student training and for faculty career development in diabetes research.

The DRTC will be led by Director Timothy Garvey, MD, assisted by Stuart Frank, MD, Associate Director for biomedical research, and Catarina Kiefe, MD, PhD, Associate Director for prevention and control. The Director and Associate Directors will join other key DRTC faculty, Drs. David Allison, John Corbett, and  Victor Darley-Usmar, in comprising the DRTC Leadership Committee.

Investigators in the project are grouped into eight research areas of excellence: (1) molecular signaling, (2) metabolism, (3) vascular biology/inflammation, (4) lipids/ kopoproteins/atherosclerosis, (5) microvascular disbetes complications, (6) epidemiology/genetics, (7) interventions, trials, and community-based research, and (8) health services research.

Other Department of Medicine faculty who are involved in the project are Drs. Mona Fouad, Cora Lewis, David Calhoun, John Chatham, Louis Dell’Italia, Michelle Martin, and Monika Safford.

John A. Corbett, PhD, will join the faculty at UAB as professor of Medicine in the Division of Endocrinology, Diabetes & Metabolism and will assume his duties as the director of the Comprehensive Diabetes Center at UAB on June 1.

Dr. Corbett comes to UAB from the St. Louis University School of Medicine in Missouri. A professor in the Edward A. Doisey Department of Biochemistry and Molecular Biology, Molecular Biology, Dr. Corbett  received his undergraduate degree in chemistry from Saint Norbert College in DePere, Wisconsin and earned his PhD in biochemistry at Utah State University in Logan. He completed post-doctoral training in pathology at Washington  University’s School of Medicine in St. Louis, and joined the faculty in 1994.

An NIH-funded investigator, Dr. Corbett’s research focuses on the mechanisms of pancreatic beta-cell destruction. His lab is currently investigating the role of viral infection as one potential environmental factor that may initiate or trigger beta-cell damage and autoimmune destruction during the development of type 1 diabetes. Dr. Corbett has authored more than 80 articles for peer-reviewed journals and serves on the editorial boards of the American Journal of Physiology: Endocrinology and Metabolism and the Journal of Biological Chemistry.

Dr. Corbett’s goals for the Comprehensive Diabetes Center at  UAB include bringing together four to six new investigators whose studies are focused on T lymphocytes, antigen identification  and lymphocyte trafficking. “An initial area of concentration will be pancreas development, with the goal of interacting with UAB’s outstanding islet transplantation team on beta-cell replacement,” he says.