The chief of endocrinology and vice chairman of medicine at New York Methodist Hospital, on how he and his colleagues are addressing the diabetes epidemic in the borough, as well as other endocrine system conditions
By megan schade • photos by alex barreto
Edmund Giegerich, M.D., did not anticipate spending his senior year of high school dealing with a diagnosis of Type 1 diabetes. But that untimely diagnosis was not just a health challenge; it ultimately led him into a life in medicine and shaped the course of his life.
“Knowledge about diabetes was limited back then,” said Dr. Giegerich, now chief of endocrinology and vice chairman of medicine at New York Methodist Hospital. “Compared to the technology we are working with today, treatment was almost primitive. It wasn’t until I was in medical school at SUNY/Downstate Medical Center’s College of Medicine that I met a physician working specifically with diabetes—he was able to treat my disease in a whole new way. Through our work together, I was inspired to help other people with diabetes and to specialize in endocrinology.”
Dr. Giegerich has had a successful clinical career in endocrinology that merged into an administrative career as chief medical officer, where he focused on teamwork training, patient safety, and quality initiatives that involved residents on both a clinical and administrative level.
“I really enjoy working with residents and feel that it is important to provide the mentorship that I received in my early days,” he said. “My wife is also a physician—a med school classmate—and our daughter is a teacher. The cycle of learning, teaching, and sharing have always been significant components of my life…of our lives.”
Endocrinology is the study of the endocrine system, a collection of glands that produce hormones which regulate many important bodily functions, including growth, metabolism, reproduction, and development. When something goes awry in a gland or in the production of a hormone, conditions such as Cushing’s disease (which causes the adrenal glands to overproduce the hormone cortisol), hypothyroidism (the thyroid gland’s failure to produce enough T3 and T4 hormone), or osteoporosis (associated with a drop in the ovaries’ estrogen production) may occur.
Diabetes is an endocrine disease that currently affects an alarming and increasing number of people. It occurs when the pancreas cannot produce enough of the hormone insulin, which facilitates the transfer of glucose (sugar) from the bloodstream to the cells for energy production. If there is not enough insulin to complete the transfer, the amount of sugar in the blood builds up. Left untreated, high blood sugar levels can lead to numerous and varied complications, including cardiovascular disease, neuropathy, kidney damage, and damage to the eyes, ears, skin and feet.
There are two main types of diabetes: Type 1 and Type 2. A diagnosis of Type 1 frequently occurs in childhood and indicates that pancreatic cells cannot produce insulin. The causes of Type 1 diabetes are unknown, but it is thought to be a disorder of the immune system, which causes the body to mistakenly attack the insulin-producing cells in the pancreas. Type 1 diabetes is a chronic condition, but it can be managed through the administration of insulin, along with adoption of a healthy, low-sugar diet and an appropriate exercise program.
Type 2 diabetes occurs when the body becomes resistant to insulin or when the pancreas cannot produce enough insulin. Type 2 diabetes is most often diagnosed in older adults and while there may be a genetic component, this form of the disease can result from lifestyle factors, such as excess weight and low physical activity. High blood sugar levels associated with Type 2 diabetes can be managed though healthy diet and exercise, and, depending on the sugar level, with medication or insulin treatment.
Dr. Giegerich joined New York Methodist Hospital in 2011 as chief of endocrinology and vice chairman and associate residency program director of the Department of Medicine. “There were simultaneous opportunities at NYM that perfectly fit my career trajectory,” he said.
Stephen Peterson, M.D., chairman of medicine at NYM adds, “Dr. Giegerich is a brilliant doctor. He is excels at diagnosis in very difficult cases and is focused on consistently improving clinical outcomes and the overall patient experience. He is also a first-rate gentleman and a scholar. We are most fortunate to have him here.”
NYM had long been a pioneering force in diabetes treatment in Brooklyn; housing the American Diabetes Association-Certificated Diabetes Education and Resource Center, part of the Hospital’s Institute for Diabetes and Other Endocrine Disorders. The Center provides comprehensive diabetes self-management education classes and support groups, which help people with diabetes manage their health, minimize long-term complications, and feel better and more confident as they live their lives.
“When I started at NYM, diabetes was exploding in Brooklyn, and it was clear we needed to expand our services to meet the growing demand,” said Dr. Giegerich. “We have such a variety of cultures in our borough, so many languages and customs, that as we grew, care was taken to have the Center reflect the borough and be sensitive to the diversity of our patients. Members of our staff speak Russian, Spanish, Chinese, Greek, and other languages. I am very proud of our ability to communicate with the people who need us.”
The staff at the Center includes seven endocrinologists, two certified diabetes educators, and a nutritionist. There is also a pediatric endocrinology program so that patients can have a continuum of care from childhood through adulthood. “The Center staff works with individual patients to tailor treatment plans that are uniquely appropriate for them,” Dr. Giegerich added. “They strategize about lifestyle changes and may also prescribe medications, insulin treatments or an insulin pump, a continuous glucose monitoring system, or another state-of the-art treatment.”
What also makes diabetes services at NYM stand out, Dr. Giegerich said, is their collaborative element. Although diabetes stems from an issue with the pancreas, the complications of the disease manifest themselves all over the body. For instance, a patient with diabetes may need to be followed by an ophthalmologist for diabetic retinopathy, a podiatrist to treat diabetic foot ulcers, and/or cardiac and vascular specialists for associated issues. “It makes such a difference to have all of these doctors in one hospital, said Dr. Giegerich. “Not only are we able to discuss as a team the best comprehensive care for our patients, but the patient can see the physicians he or she needs without having to leave the Hospital area.”
Dr. Giegerich is quick to point out that his division is more than equipped to handle all types of endocrine system disorders, not just diabetes. “Every day, we help people dealing with hypo- and hyperthyroidism, osteoporosis, and, any number of endocrine disorders. However, diabetes and complications from diabetes present the greatest number of cases we see, and that number is going up. We are doing everything we can to reverse that trend, and help our patients lead a full life.”
New York Methodist Hospital
506 6th Street / 718.780.3000 / nym.org