Division of Endocrinology at Howard University Hospital

The Division of Endocrinology at Howard University Hospital provides comprehensive endocrine consultation and treatment for patients of all ages. We offer a multidisciplinary approach in keeping with the hospital's mission of excellence in service, education and research. Our services are tailored to patients' goals and lifestyle. Use of innovative technology strengthens our commitment to the continuum of care.

Conditions We Treat

Doctors at the Division of Endocrinology work across multiple disciplines to provide therapeutic and diagnostic care for patients who experience endocrine disorders, diabetes, thyroid disorders, osteoporosis, calcium and bone disorders, growth and puberty disorders.

Diabetes

Diabetes affects how your body uses blood glucose, or blood sugar. Glucose is vital to your health as a source of energy for the cells that make up your muscles and tissues. If you have diabetes it means you have too much glucose in your blood, which can lead to serious health problems. There are two chronic types of diabetes, Type 1 diabetes and Type 2 diabetes.

  • Prediabetes – Blood sugar levels are higher than normal
  • Gestational diabetes – Occurs during pregnancy but may resolve after your child is delivered

Patients are screened and treated for diabetes by endocrinology physicians at the Diabetes Treatment Center (DTC) by undergoing:

  • retinopathy screening
  • podiatry evaluation
  • autonomic neuropathy screening
  • glycosylated hemoglobin testing

The DTC is recognized as a Diabetes Center of Excellence by the Global Technology Community. The Center's innovative technology services strengthen the communication bond by linking patients' personal health records with the Center's electronic medical record system. The Center sponsors the only free web portal in the area vetted by diabetes healthcare professionals where patients may learn to effectively self-manage their diabetes.

Thyroid

Thyroid disorders are second only to diabetes as the most common condition to affect the endocrine system – the glands that secrete hormones. As a result, many patients may be affected by both thyroid disease and diabetes.

Abnormal thyroid function impacts the management of diabetes since the thyroid gland plays a central role in the regulation of metabolism. Untreated thyroid disorder can increase the risk of certain diabetic complications and can aggravate many diabetes symptoms.

The Center screens for abnormal thyroid function with simple blood tests in order to determine the thyroid's effectiveness in regulating metabolism. Ultrasound fine needle thyroid biopsies are performed at the Center for patients with thyroid nodules or thyroid cancers.

Osteoporosis

Osteoporosis is a condition in which the bones become less dense and more likely to fracture. Fractures from osteoporosis can result in pain and disability. Type 1 diabetes and Type 2 diabetes are linked to increased risk for fractures.

At the Center, endocrine physicians counsel patients and assist them to develop strategies to treat and prevent osteoporosis and to avoid potential fractures. We work with the radiology department to conduct density scans (DEXA) to diagnose osteoporosis.

Adrenal

Adrenal glands release hormones essential to life such as the stress hormones cortisol and adrenaline. Cortisol helps the body respond to stressful situations such as surgery or infection.

  • Too much cortisol may increase blood sugar by stimulating the liver to make glucose and by preventing movement of glucose into the cells.
  • Too little cortisol may cause low blood pressure and even death if not recognized and treated.

The Center treats and educates patients on hormonal imbalance in the adrenal glands. DTC physicians conduct specialized tests to determine if patients have an adrenal disorder.

Calcium and bone disorders

Bone disorders and calcium-related conditions are similar to osteoporosis. Both increase a patient's risk to bone fractures. Kidney stones may develop if too much calcium is in the blood from a hormone imbalance. The Center provides and educates our patients with strategies to prevent and treat calcium and bone disorders and to avoid bone fractures.

Growth and puberty disorders

The endocrinology service provides care across the age continuum for patients with diabetes and other endocrine system problems, such as puberty, growth and thyroid disorders. The care team specializes in diagnosis, education and care management to help you and your child with approaches to better manage your condition.

Pituitary disorders

A pituitary disease is a disorder primarily affecting the pituitary gland. The pituitary gland, or hypophysis, is an endocrine gland the size of a pea at the base of the brain. The gland excretes hormones to help control body processes such as growth, blood pressure, thyroid function and energy (metabolism).

Multiple hormonal problems may result from a pituitary tumor or destruction of the pituitary gland. Factors exacerbating this condition include trauma, excessive blood loss, or surgery. At the Center, we screen, treat and educate patients about these and other pituitary disorders.

Hormone disorders

We offer reproductive endocrinology care for patients with hormone and reproductive disorders. Males are evaluated and treated for low testosterone or other irregularities. Females who have menstrual irregularity along with excessive body hair or acne are evaluated and treated for polycystic ovary syndrome, a condition which may be associated with an increased risk for developing diabetes.

Diagnostic and educational services

The Division of Endocrinology has numerous diagnostic and educational services available to patients.

Pharmacy consultation

Medication counseling is available to all patients treated at the DTC. Our pharmacy staff meets with patients to:

  • propose drug management recommendations
  • review current medication
  • ensure there are no drug interactions
  • Diabetes education

Division of Endocrinology Diabetes Self-Management Program is recognized by the American Diabetes Association for providing quality diabetes education. The program fosters group and individual diabetes education and counseling by certified diabetes educators and nutritionists. A certified staff diabetes educator nutritionist and two certified staff diabetes educator nurses are experts in diabetes education and self-management.

Patients may also be referred for other educational services including:

  • insulin initiation
  • insulin pump start instruction
  • self-blood glucose monitoring

Nutrition counseling

Individual nutritional counseling is conducted by a registered dietician certified in diabetes education. The dietician works with patients to determine daily calorie requirements, how to design meal plans, and how to achieve weight and metabolic goals.

Research

Translational research at the Diabetes Treatment Center at Howard University Hospital is conducted by the endocrinology faculty with a goal of benefitting our patients.

W.E.I.G.H.T. Study

The Working to Engage Insulin-Resistant Group Health Using Technology (W.E.I.G.H.T.) study implements and evaluates preventive benefits in African-American adolescents. The study utilizes communications and networking technologies. African-American young adults between 18-24 years of age with a diagnosis of prediabetes will be recruited for this study.

Objectives include:

  • To compare the effectiveness of a lifestyle change intervention delivered by communications networking technologies or Lifestyle Group visits    
  • To increase a Patient Activation Measure from baseline to follow-up
  • To decrease body mass index from baseline to follow-up
  • To decrease hemoglobin A1C levels from baseline to follow-up

For more information contact: Gail Nunlee-Bland, M.D. 202-865-3350

Changing the Healthcare Delivery Model: A Community Health Worker/Mobile Chronic Care Team Strategy

Type 2 diabetes is the seventh leading cause of death and hospitalization in the District of Columbia. Diabetics are at greater risk of other illnesses such as heart and kidney disease and eye problems.  There is an urgent need to find useful and affordable methods to ensure diabetics stay healthy.

Study objectives include seek to compare three specific methods of improving the health of people with diabetes, as follows:

  • Cell Phone System (C4L):  The Voxiva Care4Life mHealth diabetes management system will be used to help patients track blood sugar levels, provide medication and doctors appointment reminders, and to record exercise and weight goals. The program is designed to meet the needs of each patient.
  • Community Health Worker (CHW): The CHW coaches patients on various ways to improve their health by learning to navigate the health care system to meet their needs.
  • Cell Phone System and Community Health Worker (C4L + CHW):  Patients learn to use both the C4L and the CHW to improve their health care.

To be eligible for the study patients will be:

  • Ages 21 to 75 years old
  • Covered by Medicaid,Medicare or Affordable Care Act insurance
  • Fluent in English or Spanish and able to read a text message
  • Diagnosed with diabetes mellitus Type 2
  • A1c >8%

For more information contact: Gail Nunlee-Bland, M.D. 202-865-3350

Living Smartly With Diabetes

This study will review the patient web portal in the Howard University Hospital Diabetes Treatment Center through patient/physician focus groups. The goal is to enhance the web portal's usability, to integrate it with Smartphones, and to improve management and clinical outcomes among adult patients with diabetes.  Goals include:

  • to improve current patient web portal (PWP) usage by adult patients with diabetes and their physicians
  • to provide input in PWP redesign through focus groups
  • to integrate current patient self-management internet portal with secure patient friendly mobile messaging
  • to achieve increases in the patient activation measures (PAMs) of all participants
  • to test the hypothesis that increases will be statistically higher among participants in the Smartphone and web-based portal arms
  • to decrease hemoglobin A1C levels of all participants
  • to test the hypothesis that reductions will be statistically higher among participants in the Smartphone and web-based portal arms

To be eligible for the study patients will be:

  • African-American men and women 18 years or older
  • Evaluated as having a diagnosis of Type 2 diabetes
  • Owners and operators of Smartphones
  • Ability to read at an 8th grade level or higher

For more information contact: Gail Nunlee-Bland, M.D. 202-865-3350