Departments

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

Considered one of the nation’s most respected sections in endocrinology and diabetes, our team includes nationally recognized physicians, certified nurse practitioners, nurse educators, dietitians, social workers, and other caregivers. We help children and their families with the many problems that may accompany defects in the endocrine system, including diabetes, growth problems, and obesity. Yale Pediatric Endocrinology faculty are expert in the clinical management of endocrine and metabolic disorders, including: Type 1 diabetes Type 2 diabetes Obesity & weight management in children Interdisciplinary bariatric surgery clinic Lipid disorders, including hyperlipidemia and lipodystrophy General endocrine disorders Thyroid disease Parathyroid Adrenal, including congenital adrenal hyperplasia Pituitary Neuroendocrine Growth & puberty Polycystic ovarian syndrome Metabolic bone disease, including nutritional rickets & osteomalacia Interdisciplinary differences in sexual differentiation Interdisciplinary transgender program Hormonal complications of cancer and cancer treatment

At Yale Medicine, our team of renowned physicians are leaders in the field of endocrinology. We specialize in understanding and treating the delicate balance of the endocrine system and the hormones that regulate essential body functions. Our physicians are also experts in the management of metabolic disease, which affects how your body processes food to create energy. We're here to provide you with advanced diagnostic and comprehensive treatment options that address these crucial hormonal and metabolic functions. Specialized care is offered in the following areas: Adrenal diseases, including adrenal masses, Cushing syndrome, hyperaldosteronism, and pheochromocytoma. Bone Center consists of a team of specialists with expertise in bone health who treat patients with bone diseases and disturbances in the metabolism of calcium and phosphorus, a mineral that helps build bones. Center for Weight Management, which offers assistance with weight and weight-related health conditions. Diabetes Center is comprised of diabetes specialists who help patients manage their diabetes and prevent long-term complications. Endocrine cancers of the thyroid and adrenal glands. Pituitary conditions and complex disorders. Thyroid diseases, including hyperthyroidism, thyroiditis, thyroid nodules, and thyroid cancer.

We specialize in the treatment of children with type 1 diabetes, offering comprehensive care and support for patients and their families. Ourteam of physicians, nurse practitioners/certified diabetes educators, nurses, social workers, psychologists,and nutritionists is dedicated to educating and supporting children, adolescents, and parents as they cope with this disease. We place a special emphasis on technological tools, as well as clinical research that can help our patients manage their diabetes. For our teen and young adult patients who are preparing to transition to adult diabetes care and are learning to manage their diabetes on their own, we offer the Yale FORGE Ahead Bridge Diabetes Program. FORGE stands for: Form new relationships Orient to the future Reach out for support Gain new knowledge Embrace life … Ahead and Bridge We recognize that teens and young adults need a different kind of support as they prepare to manage diabetes on their own. We aim to: Better address the unique needs of teens with type 1 diabetes who are transitioning into adulthood Support efforts for patients to assume full responsibility for their own diabetes management and exercise healthy behavior. At the Bridge Clinic, patients will have a team visit with a nurse practitioner trained in both pediatric and adult diabetes, along with our clinical nutritionist and social worker. The team will help guide patients through the transition to adult care.

We help children who are overweight or obese improve their health through a variety of strategies, including behavior and lifestyle modification. We understand that many factors can contribute to obesity, including genetics, diet, physical activity level, psychological issues, and adverse family events. Our team includes board-certified pediatric endocrinologists, advanced practice registered nurses, physician assistants, a registered dietitian, a bariatric surgeon, and an endocrinologist who specializes in diabetes and obesity management for adults and children. We work together to tailor treatment to each child and his or her family. Seventeen percent of children ages 2 to 19 in the United States are obese, according to the Centers for Disease Control and Prevention. While there is no cure for obesity, our caregivers work with children to prevent serious health complications that can accompany it, including: Prediabetes and type 2 diabetes Polycystic Ovary Syndrome (PCOS) High cholesterol Fatty liver disease When a child is referred to us—typically from a pediatrician—our first step is to do a full medical examination and check for obesity-related diseases and complications. We offer a traditional approach to weight loss through lifestyle changes, and incorporate the whole family into the process. We refer many children to Yale School of Medicine’s Bright Bodies Program in New Haven, which teaches children and their families about nutrition and encourages them to exercise. If lifestyle and behavioral modifications are not successful, medications are a potential option for children 16 and older. Our last step, if necessary, would be bariatric surgery, also for children 16 and up. There are rigid protocols for the surgery, as well as pre- and post-surgical care. Once patients turn 21, we can seamlessly transition them into an adult program for weight management.

Our uncompromising faculty and staff are dedicated to the welfare of children and adolescents. One of two major pediatric centers in Connecticut, Yale offers an extensive range of services for patients through our 14 specialties. In addition, we have several interdisciplinary centers and programs that involve collaborations with multiple departments throughout Yale Medicine and Yale New Haven Children’s Hospital. Thanks to our reputation for comprehensive pediatric care, we serve as a regional and national center for referral and consultation. Many of our physicians are internationally recognized for their innovative approaches to the diagnosis and treatment of conditions including arrhythmias, diabetes, cystic fibrosis, childhood cancers, juvenile diabetes, dyslexia, blood disorders, infectious diseases, and complications of premature birth, as well as many other disorders. We are leaders in the global pediatric community, advocates for childhood health and development, and innovators in research. We rank among the top pediatric centers in the country with respect to National Institutes of Health support for research. Neonatal and pediatric ICUs that serve our most vulnerable patients with the highest level of care 24/7 subspecialty telephone consultation service for primary care clinicians with expected response time of three minutes More than 20 years of experience with neonatal and pediatric Extracorporeal Membrane Oxygenation, a sophisticated machine that acts as an artificial heart and lungs, crucial for some seriously ill infants One-call center that provides centralized appointment scheduling for all pediatric specialties Close collaboration with other Yale departments to provide such services as molecular and genetic diagnostic services, state-of-the art management of high-risk fetuses and newborns, bone marrow transplantation, and management of complex malignancies

At the Pediatric Genomics Discovery Program (PGDP) at Yale, we offer patients and their families with potential undiagnosed genetic diseases an opportunity to be evaluated by a team of physician-researchers specializing in genetics. Roughly one in 30 babies born in the United States each year has a genetic condition. These conditions can range from abnormal limbs, to a permanently weakened heart, to an overly curved spine. In some cases, a medical team might be able to identify, at a cellular level, the exact cause of a condition. In other cases, however, the cause of a child's disease remains unclear even after extensive evaluation and testing. We are embarking on a study to uncover answers to undiagnosed diseases in children and adults by studying their genetics, and are looking for participants. The short video below explains our study. Click here to sign a consent form and to provide other demographic information. [note to tech: add an External link to Kohezion e-consent form and other demographic information.] What is this study about? We want to study undiagnosed genetic diseases because it will help us understand what these conditions are, what might happen to people with these conditions, and what doctors could potentially do to treat them. How will this study help me? We hope to provide some answers for you or your child’s condition, although we can’t know ahead of time if we will find all the answers. Your participation could help others with similar conditions in the future. What do I need to do to get started? Here is how you can participate: Learn more about the study by reviewing the information on this website. Sign up using our online consent process through this link: [LINK to e-consent form]. We will ask you to provide some background information about you, the best way to contact you, and your consent to participate in our study. Provide us with samples from kits that we will ship directly to your home. Our team’s medical experts will then reach out to you to learn your story and gather any additional medical information we might need. Our team will take it from there. What samples do I need to provide? Most of the time, a saliva sample is all we need. If we ask for further samples, these will most likely be additional saliva. However, in rare cases, we may ask for a blood sample. By enrolling in this study, you are giving us permission to ask for, collect, and use additional samples for study purposes. You can change your mind or decline to provide samples at any time—it is completely up to you. What will the research team do? We will use the samples you provide us to perform a state-of-the-art, comprehensive genetic analysis. With that, we may be able to detect previously undiscovered genetic causes of your child’s genetic disease that are not identified by conventional clinical testing. Is my family eligible to participate? To participate in the study, the affected child, Mom, and Dad will each ne

We provide preventive and urgent health care to children and adolescents in the greater New Haven community. Our pediatricians work in the Yale New Haven Hospital Pediatric Primary Care Centers at three locations: York Street, St. Raphael campus, and at Chapel Pediatrics in Hamden. We offer routine vaccinations and wellness exams, screening for childhood illness, and positive parenting support and programs. We also have particular expertise in handling conditions that occur during adolescence. Our physicians are highly trained and committed to advocating for children. In our offices, we see children with Husky or commercial insurance, and offer a sliding scale for those without insurance. In our specialty programs, we treat infants and children with a broad range of childhood problems, including: Developmental and behavioral disorders Physical and sexual abuse Rheumatologic conditions, such as arthritis and lupus

When a young person has questions or concerns related to gender, the entire family is affected. We are a safe, supportive resource and interdisciplinary program for children, adolescents, and young adults who are exploring their gender identity, as well as for their families. We provide comprehensive care for young people who are questioning their assigned gender and/or are seeking consultation and care. Our team includes pediatric-trained endocrinologists, psychologists, and psychiatrists, as well as a medical ethicist, a chaplain, and a lawyer. We work closely together as a team and also consult with a wide array of other specialists. Together, we are committed to providing care in compassionate and respectful ways. Our clinicians follow current medical protocols, and the care offered by our program is supported by professional guidelines endorsed by the American Academy of Pediatrics, the American Medical Association, the American Psychiatric Association, and the American Psychological Association. When it comes to gender identity and related concerns, our first step is to listen. Some youth are exploring their identity. Others know that how they feel inside does not match up with the gender they were assigned at birth. We help sort through these questions. After an initial consultation, we offer a thorough biopsychosocial readiness assessment, which includes obtaining information from patients and their families. This comprehensive assessment takes six to eight hours to complete and can be done in one day or divided over several sessions. If we determine that any mental health or other support is needed, we can connect patients with resources at Yale or in the community. After the evaluation and when all parties agree that it is safe, healthy, and appropriate, we offer a variety of care options related to gender affirmation. At the first visit to our program, gender affirmation visit, patients and their families will meet with both one of our a pediatric endocrinologists and a mental health provider experienced in caring for dealing with patients who report gender variance. First and foremost, we make sure we understand our patients’ needs and desires. We will discuss the risks and side effects of any proposed care options, work together to learn what support systems are already in place, and determine what additional treatments and resources our patients may need. If you are in crisis, call the confidential toll-free National Suicide Hotline at 1-800-273-TALK (8255), 24 hours a day, seven days a week. If texting is easier, you can also text the National Crisis Text Line by texting HOME to 741741.

Patients who need special assistance to become parents may benefit from our third-party reproductive program services. We help patients overcome obstacles that would have prevented them from becoming parents years ago. Through egg donation , sperm donation , embryo donation, and/or surrogacy services, parenthood may be within their reach. Our program helps a wide range of patients who seek us out for our level of expertise and personalized approach. Same-sex couples and individuals without partners who want to have babies may be matched with the necessary resources that can lead to pregnancy. For couples who have been diagnosed by our clinicians with male or female infertility , the third-party reproductive program offers options that may enable them to become parents through nontraditional routes. Patients who seek assistance from our third-party reproductive program are paired with counselors who discuss the reproductive options available and then help them decide on a care plan. Patients also meet with financial coordinators to discuss their health insurance eligibility before moving forward. Patients may feel nervous, stressed, or excited about their journey toward parenthood through assisted reproduction. Our counselors support and encourage every patient, providing guidance and perspective they’ve gained while helping other patients. Some of the procedures used to achieve pregnancy for patients who come to our third-party reproductive program are the same procedures employed during more traditional assisted pregnancies. For example, many patients in the third-party reproductive program rely on donor eggs to become pregnant. Egg donors use medications that encourage several of their eggs to mature at once, which is similar to the process that women who undergo IVF experience. When patients use donor eggs or sperm, the procedure parallels what happens during IVF: Sperm and egg are combined in a laboratory, then transferred (as an embryo) to the uterus several days later. An embryo may be transferred to your uterus or to your surrogate’s uterus, depending on your personal circumstances. Sometimes, patients choose to use egg or sperm donors whom they know. More often, patients seek eggs and sperm from anonymous donors. Counselors can connect patients with affiliated egg banks and sperm banks or to donor eggs that were obtained through direct recruitment. Our department recruits egg donors for our patients, carefully screening them in advance. Selecting an egg or sperm donor can feel daunting. Although donors are anonymous, they provide information about their individual and family health history, their physical appearance, their highest level of education, and other personal details. Our counselors can help you consider everything that you learn about different anonymous donors to make a confident decision based on your personal preferences. Choosing a surrogate, or gestational carrier, is a more complex decision than selecting an an

At Yale Medicine, our experts and caregivers give comprehensive and compassionate treatment for those with end-stage liver, kidney, and pancreas organ failure who might benefit from transplantation. We offer many treatment options and hope for high-risk patients who may have been turned down for transplant elsewhere, in addition full support services. Our expert physicians specialize in anesthesiology, internal medicine, pediatrics, surgery, transplant immunology, kidney diseases, liver diseases, diabetes mellitus, and transplant surgery. Our caring, highly skilled nurses, physician assistants, nutritionists, pharmacists, social workers, and financial counselors further support your needs. Many inherited metabolic liver diseases such as Wilson's disease, Gaucher's disease, lipidosis, alpha-1 antitrypsin deficiency, hemochromatosis, tyrosinemia, and glycogen storage diseases are cured by successful liver transplantation. We specialize in genetic testing for liver diseases and treatments that provide comprehensive care for affected patients. Even though we treat some of the most seriously ill patients, our program's survival rates are consistently higher than the national average. We offer many options for advanced liver disease, including living donor and deceased donor transplantation, liver transplantation in HIV-infected individuals, and pre- and post-transplant antiviral therapy to prevent or treat recurrent hepatitis C. Through our acute liver failure program, we can transfer patients to Yale New Haven Hospital in a timely manner for transplant evaluation and medical management. In collaboration with the hospital’s Medical Intensive Care Unit, we offer innovative techniques such as hypothermia therapy for the treatment of acute liver failure. Pancreatic transplants are less common than kidney or liver transplants and are usually performed in patients with type 1 diabetes. Our physicians perform isolated pancreas transplantation, simultaneous kidney/pancreas transplantation, and pancreas transplantation following kidney transplantation. Specialized care is offered in the following areas: Combined organ transplantation including kidney, kidney/liver, and kidney/heart Comprehensive tissue typing and immune evaluation services Follow-up and psychosocial support Leading-edge treatment options for immunosuppression Liver transplantation, including adult-to-adult living donor, pediatric living donor, and other surgeries Minimally invasive living-donor kidney surgeries Robotic hepatobiliary surgery Surgical therapy of diseases of the liver and biliary systems and end-stage kidney and liver disease Telemedicine via patient portal

Our Reproductive Endocrinology & Infertility Division specializes in aiding patients facing challenges with their reproductive abilities . We are committed to diagnosing conditions and guiding each patient through the available treatment options to help them realize their dreams of starting or expanding their family. We focus on diagnosing and managing endocrine disorders and other chronic conditions that hinder conception or the maintenance of pregnancy. Additionally, we assist patients in preserving their fertility before undergoing cancer treatments. Our expertise extends to supporting individuals without partners, same-sex couples, and transgender individuals in overcoming barriers to parenthood. With its globally recognized reputation, our academic health center is known for cutting-edge therapies and exceptional success rates. Our state-of-the-art facility is staffed by approachable clinicians, many of whom are esteemed experts in fertility treatment. Our clinicians deliver compassionate and personalized care tailored to our patients’ individual needs throughout their journey. Several of our clinicians have held or currently hold leadership positions in prestigious professional organizations, such as the American Society for Reproductive Medicine (ASRM) and the Society for Reproductive Investigation (SRI), underscoring our commitment to excellence in the field of reproductive medicine. Our clinicians have contributed to over 1,000 scientific publications, significantly advancing the field. They have also authored the seminal reference book Speroff's Clinical Gynecologic Endocrinology and Infertility , which guides clinicians in providing comprehensive care to patients with infertility and reproductive disorders. With decades of experience treating patients and helping them achieve pregnancy, our clinicians are also dedicated to advancing research in their specialized areas. Their findings have led to the development of new diagnostic tests, surgical procedures, and innovative technologies, shaping and advancing the field of assisted reproductive technology. As research is integral to our practice, patients can access clinical trials conducted at our facility. Recognizing the emotional complexities associated with infertility, our clinicians offer empathy, support, and a celebration of successes, guiding patients through their challenges. Financial coordinators are available to clarify health insurance eligibility and costs, ensuring transparency and minimizing unexpected fees. The Yale Medicine Reproductive Endocrinology & Infertility Division offers specialized programs including: Endometriosis Program: We diagnose and treat endometriosis , addressing pelvic pain and infertility to improve pregnancy outcomes. Fertility Center: We offer an array of individualized treatment options for both women and men looking to start a family. Our physicians, staff, and scientists share our patients’