Our goal at the Diabetes Center is to give patients the tools necessary to successfully manage the day-to-day challenges of living with diabetes and prevent long-term diabetes complications. We provide comprehensive management and education for adults with type 1 and type 2 diabetes. We focus on lifestyle interventions and use the latest medications and technologies to improve our patients’ health. We also treat patients with: Pre-diabetes and metabolic syndrome Obesity Polycystic ovarian syndrome Lipid or cholesterol abnormalities Our nationally recognized doctors and nurse practitioners work as a team to address our patients’ needs in managing diabetes and other conditions. We understand that living with diabetes presents challenges. We focus on education and making patients their own advocates. Through the most current and state-of-the-art treatments, we will help them better manage their care. Oral Medications There are several classes of oral diabetes medications that we may prescribe if patients have type 2 diabetes. These medications differ in the way they work to reduce blood glucose levels. Frequently, oral medications from different classes are used in combination. Sulfonylureas: These drugs increase the amount of insulin produced by the pancreas. Meglitinides: These drugs rapidly increase the amount of insulin produced by the pancreas. Biguanides: Metformin is the only biguanide on the market. It is thought to work by reducing the production of glucose in the liver. Alpha-Glucosidase Inhibitors: These medications reduce the amount of glucose absorbed in the intestines. Thiazolidinediones: This agent makes the body more sensitive to insulin. Dipeptidyl Peptidase 4 inhibitors (DPP-4 inhibitors): These drugs increase the amount of insulin produced by the pancreas after a meal and reduce the amount of glucose produced by the liver. Injection Therapies There are several classes of injection therapies for diabetes. These treatments are given by an injection under the skin. The most common injection therapy is insulin, which comes in many different formulations that differ in how fast they work and how long they last. Below is a list of the different types of insulins. Technologies and Experimental Treatments Insulin Pumps: Insulin pumps were first pioneered at Yale in the 1970s. An insulin pump is an electronic, pager-sized, battery-powered device that delivers insulin continuously through a small plastic catheter under the skin. Insulin is delivered in different amounts (“basal” or “bolus” levels) during the day and controlled by the patient. While fasting, patients will administer a low level of continuous “basal” insulin to keep their blood glucose in the normal range. Prior to meals, they will determine a “bolus” of insulin based on the amount of carbohydrates in the meal. Continuous Glucose Monitoring systems (CGM): A CGM is a device that measures glucose under the skin (also known as “interstitial” glucose) every five minutes thr

Urologic cancers include prostate, bladder, kidney, urothelial upper tract, testicular, penile, and urethral cancer. The Smilow Cancer Hospital Prostate and Urologic Cancers Program at Yale Medicine is uniquely qualified to treat these cancers. Our program utilizes the most advanced technology and techniques available to diagnose, manage, and treat urologic cancers. We are leaders in the use of MRI/US Fusion prostate biopsy (which blends MRI and ultrasound for increased accuracy), utilizing the ExactVu and Artemis systems across the region. This technology allows us to detect the cancer early and closely monitor it. When surgery is needed, our urologists provide extensive expertise in nerve-sparing laparoscopic and robotic surgery, traditional open surgery, and novel targeted or “focal“ treatments. Our patients also benefit from the expertise of a collaborative approach to cancer care, which personalizes treatment. We engage experts who specialize in medical oncology, radiation oncology, surgical oncology, pathology, and diagnostic imaging. Patients also have access to caregivers who can help with the physical, emotional, and psychological issues related to these cancers. The extended team includes health educators, social workers, dieticians, and complementary therapists. Our goal is to ensure the highest standard of care to support our patients and their families. Imaging and Interventional Radiology Our radiologists are experts in magnetic resonance imaging (MRI), ultrasound, computed tomography (CT), and fluoroscopy, and combine their clinical expertise with advances in technology including MR-US fusion for prostate imaging, as well as positron emission tomography (PET) scans and advanced nuclear medicine scans. In addition, Blue Light™ Cystoscopy, an advanced endoscopic technology, is employed to improve bladder cancer detection and reduce risk of cancer recurrence. Surgery Our experienced urologic surgeons are committed to achieving optimal cancer outcomes, emphasizing organ preservation and the safeguarding of sexual and urinary function as much as possible. Through advanced techniques including minimally invasive and robotic surgery, our urologists are able to optimize both cancer care and surgical recovery. Cryoablation (tumor freezing) may be a good option for some patients with prostate or kidney tumors. Focal therapy is also available for appropriate patients with prostate cancer, as it is able to treat the cancer without the use of radiation or surgery, preserving the prostate, as well as urinary and sexual function. Similarly, for some patients with cancers of the ureter or upper urinary tract, a laser can be used to treat the tumor and preserve kidney function. Medical Oncology Chemotherapy is an important component of cancer care for many patients, as it can delay or prevent tumors from recurring when used before surgery. It can also help patients with advanced or metastatic disease. As a major national

Our Greenwich-based center offers state-of-the-art care for those suffering from voice and swallowing disorders. The Voice Center provides sophisticated and expert care to all of our patients, including professional and performing vocalists, public speakers, executives, teachers, and clergy as well as to those with more routine or recreational vocal aspirations. Individuals experiencing any of the following symptoms may benefit from an evaluation: raspy or hoarse voice, voice strain, voice spasms, reduced pitch range, voice pitch breaks, aging voice changes, difficulty swallowing, frequent throat clearing, or the sensation of a lump in one’s throat (globus sensation). Receiving the right diagnosis is the most important step on the road to vocal recovery. Our voice experts perform comprehensive evaluations utilizing the latest technologies, including laryngeal videostroboscopy, laryngeal electromyography (EMG), and vocal acoustics analysis software to ensure an accurate and precise diagnosis. Our patients receive coordinated care from a team of voice experts with advanced training in the full spectrum of voice and swallowing disorders. Each patient’s care is led by a laryngologist who works closely with a team of speech-language pathologists. Our laryngologists are Yale Medicine ENT (ear, nose, and throat) physicians with additional specialization in treating the larynx, voice, and related problems such as swallowing. Speech-language pathologists are clinically trained, state licensed, and certified (by the American Speech-Language Hearing Association) in voice and speech analysis. A voice rehabilitation regimen incorporates the principles of vocal hygiene, behavioral modification, circumlaryngeal massage, and alternative therapies. Using the latest technologies, including laryngeal videostroboscopy, our patients can visualize the mechanics of their own larynx in high definition and slow motion, allowing them to more fully understand treatment options and outcomes. We offer voice therapy (exercises) and medical management as an alternative to surgery whenever possible and appropriate. However, if a procedure or surgery is indicated, our surgeons use the most advanced and minimally invasive techniques. Our specialists from Yale Medicine offer several advanced treatments performed in the office. In-office procedures include KTP laser ablation, vocal augmentation injection, EMG (electromyography), and botulinum toxin (Botox®) injections. Patients benefit from effective same-day treatments that require local or no anesthesia. Above all, we treat our patients with dignity and compassion. Conditions we treat: Aging voice: age-related changes such as voice roughness, elevated pitch, and reduced projection or volume Laryngitis: inflammation of the larynx and vocal folds, usually causing hoarseness and sore throat Muscle tension dysphonia: hoarseness or discomfort from improper use of muscles around the larynx during speech or singing Spasmodic dyspho