MU Department of Medicine 2011-2013 Annual Report Feb. 2014 | Page 19

2011-2013

Department of Medicine

19

Overview of clinical programs + Services
The Endocrinology Division provides consultations and care at

well as continuing care for established patients. Last year, the

University Hospital & Clinics, Women’s & Children’s Hospital,

division saw more than 2,700 inpatient consultations, 1,906 new

HealthSouth Rehabilitation Center and at the Harry S. Truman

outpatients and more than 8,199 return visits to our clinics. The

Memorial Veterans’ Hospital. In addition to clinical services

division follows over 300 patients in a program dedicated to

in Columbia, Outreach Clinics occur weekly at the Lake of the

utilization of insulin pumps, and has a robust continuous glucose

Ozarks and in collaboration with Capital Region Medical Center in

sensor service as well. Our Diabetes Self-Management Education

Jefferson City.

Program, certified continuously for over 18 years by the
American Diabetes Association, offers both group and individual

Diabetes continues to be a major public health problem; we

instruction.

continue to provide the highest quality consultative care as

Overview of Education
The Endocrinology Fellowship Program continues to provide an

ill patients with endocrinologic disorders in order to learn the

all-around educational experience such that trainees acquire

natural history of disease processes as well as the effectiveness

complete competency in the field of Endocrinology; we maintain

of therapeutic programs, and to observe and manage patients

a 100% Board Pass Rate. Fellows are given opportunities to

with a wide variety of endocrine diseases on an inpatient and

assume continuing responsibility for both acutely and chronically

outpatient basis.

Overview of Research

Editorial Boards • Funded Research • Publications

Research in our laboratory, funded by the VA over the past 30
years, focuses on the regulation of insulin metabolic signaling in
cardiovascular tissue under physiological and pathophysiological
conditions. Loss of insulin metabolic signaling (insulin
resistance) is a cardinal event in the pathogenesis of
hypertension associated with the metabolic syndrome and
diabetes mellitus. Insulin metabolic signaling through the
IRS-1/PI3K/Akt pathway normally promotes endothelial derived
vasorelaxation and cardiac diastolic relaxation. There are a
number of environmental and intrinsic signaling abnormalities
that can collectively lead to insulin resistance and consequent
hypertension and metabolic/diabetic cardiomyopathy.
Consequently, our studies have focused on the role of the
renin-angiotensin-aldosterone system (RAAS) and obesity in the

development of insulin resistance in cardiovascular tissue.
We employ cell biology, proteomics rodent imaging techniques
to explore the impact of over-nutrition and the tissue RAAS
individually and collectively in the promotion of cardio vascular
insulin resistance. Over the past year, our research team has
focused on the role of serine-kinase mediated site-specific
serine phosphorylation of the critical insulin signaling docking
protein IRS-1 as a critical juncture for over-nutrition and tissue
RAAS in promoting cardiovascular insulin resistance. Recently
our research has been directed to the role of over-nutrition/
Ang II and/or aldosterone mTOR/S6K1 and in site-specific
serine phosphorylation of insulin sensitivity and associated
cardiovascular functional abnormalities.