2024-2025 REVIEW

patient care

With more than 40,000 patient visits per year, our robust clinical care activities comprise of the treatment of diabetes, obesity, thyroid disease, and others, serving patients in Ann Arbor, Brighton, Canton, and Northville, Michigan.

Weight Navigation Program

Our Weight Navigation Program (WNP) now offers a coordinated approach to obesity care. In a combined partnership between our division, general medicine, and family medicine, patients work with a board-certified obesity specialist or endocrinologist to create personalized treatment plans. The program is led by Andrew Kraftson, MD, who partnered with a multidisciplinary team to create a comprehensive model that enhances obesity care at both the health system level and the individual patient level. “The WNP is based in the idea that safe and effective obesity care can be integrated into the primary care settings where most Americans with obesity receive the vast majority of their care,” said Hafez Griauzde, MD, MSc, who leads the program's research and quality efforts

Expanding Podiatry Services

To create continuity of care for patients, our podiatrists were given joint appointments in both the Department of Surgery and the Department of Internal Medicine. Now our podiatry experts will provide a broader, seamlessly integrated approach to the medical and surgical management of diabetic foot disease, equipping us to better serve our patients and improve outcomes for those facing diabetes-related foot complications.

Precision Diagnosis Transforms Diabetes Care

After living for more than 30 years with a presumed diagnosis of type 1 diabetes, Autumn Caris found answers through the care of Rachel Reinert, MD, PhD. Despite long-term insulin therapy, Caris continued to experience unstable blood glucose levels, significant insulin requirements, and difficulty with weight management—raising questions about the accuracy of her diagnosis. Through careful evaluation, Dr. Reinert determined that Caris’ pancreas was still producing insulin, an uncommon finding in long-standing type 1 diabetes. Genetic testing ultimately confirmed a rare form of diabetes known as maturity-onset diabetes of the young (MODY), caused by a mutation in the PDX1 gene. This condition is frequently misdiagnosed as type 1 or type 2 diabetes. With an accurate diagnosis and individualized treatment plan, Caris was able to discontinue insulin therapy, transition to oral medication, and achieve significant weight loss and improved glucose control. Today, she reports feeling healthier than she has in decades.

Research

Advancing Hope for Patients with Congenital Adrenal Hyperplasia

Richard Auchus, MD, PhD, co-authored an article in the New England Journal of Medicine presenting clinical trial results for Crinecerfont, a new treatment for congenital adrenal hyperplasia. The findings showed that Crinecerfont could improve patient quality of life by reducing the need for traditional glucocorticoid therapies, which often come with significant long-term side effects. - “My hope is that this makes it easy for any endocrinologist to transition a patient from pediatric endocrinology in good control with or without crinecerfont and then manage them for many decades, without a lot of angst and worry about concomitant comorbidities.” - Dr. Auchus

Uncovering a Reversible Cellular Mechanism in Diabetes

Previous research has shown that insulin-producing pancreatic β-cells in individuals with diabetes exhibit mitochondrial dysfunction and impaired energy production, though the underlying mechanisms were not fully understood. In a study published in Science, researchers led by Emily Walker, PhD, demonstrated in mouse models that mitochondrial dysfunction activates a cellular stress response that disrupts β-cell maturation, identity, and insulin-secreting function. These findings were validated in human pancreatic islet cells, revealing that mitochondrial signals to the nucleus can directly influence cell fate and contribute to diabetes development. Recognizing that diabetes affects multiple organs, the research team, led by Scott Soleimanpour, MD, Director of the Michigan Diabetes Research Center, extended their investigation beyond pancreatic β-cells to include liver and adipose tissue. In mouse models, these tissues activated the same mitochondrial stress response, resulting in impaired cell maturation and function, suggesting a shared mechanism across tissues affected by diabetes. Notably, mitochondrial damage did not lead to cell death, indicating that these disease-associated changes may be reversible. The researchers tested this possibility using ISRIB, a compound that inhibits the stress response, and found that after four weeks of treatment, β-cells in mice regained their ability to regulate blood glucose levels. Together, these findings identify mitochondrial dysfunction as a central and potentially reversible driver of diabetes and point to new therapeutic strategies focused on restoring normal cellular function. Ongoing work aims to further define the affected pathways and to validate these discoveries in cells derived from patients with diabetes.

Hypothalamic Neurons Identified as Key Regulators of Blood Sugar

In a study published in Molecular Metabolism, Alison Affinati, MD, and her team uncovered how a specific group of hypothalamic neurons helps maintain normal blood glucose levels during everyday conditions—not just during stress. By studying VMHCckbr neurons in mouse models, the team found that these cells prevent overnight hypoglycemia by triggering fat breakdown to produce the glucose needed between meals. The findings offer new insight into how the brain regulates metabolism and may help explain elevated nighttime fat breakdown seen in people with prediabetes.

Education

A Decade of Excellence: The 10th Schteingart Memorial Lecture

We proudly celebrated the tenth anniversary of the Schteingart Memorial Lecture, which honors Dr. David Eduardo Schteingart, a distinguished physician and scientist who served the University of Michigan for nearly 40 years. Dr. Schteingart was a recognized international expert in the treatment of adrenal cancer. He authored 98 publications in peer-reviewed journals, 33 book chapters, and 80 abstracts. Throughout his career, Dr. Schteingart supported and trained more than 100 young investigators in clinical research across disciplines, personally mentoring many along the way.