Overview
The primary objective of my basic research has been to elucidate the roles of placental and fetal hormones in the regulation of maternal metabolism and fetal growth. My work has focused on the lactogenic hormones produced by the pituitary gland and placenta. To that end we used targeted knockout mice to explore the molecular mechanisms by which prolactin and placental lactogen regulate pancreatic beta cell mass and insulin production during pregnancy and postnatal life.
I also have a longstanding clinical research interest in the pathogenesis and treatment of obesity and hyperlipidemia and the prevention of type 2 diabetes. In previous studies we showed that the drug metformin reduces fat stores and blood glucose and insulin levels in obese adolescents and may reduce the risk of progression to diabetes in selected patients. We have also examined the unique metabolic characteristics of Prader Willi syndrome, a genetic obesity disorder.
Finally, my colleagues and I have performed detailed studies of hormone production and intermediary metabolism in malnourished children in Uganda, Bangladesh, Liberia, and Burkina Faso and characterized the effects of concurrent HIV infection on nutritional recovery. We showed that the adipocyte hormone leptin is a major determinant of morbidity and mortality in children with moderate and severe acute malnutrition.
I also have a longstanding clinical research interest in the pathogenesis and treatment of obesity and hyperlipidemia and the prevention of type 2 diabetes. In previous studies we showed that the drug metformin reduces fat stores and blood glucose and insulin levels in obese adolescents and may reduce the risk of progression to diabetes in selected patients. We have also examined the unique metabolic characteristics of Prader Willi syndrome, a genetic obesity disorder.
Finally, my colleagues and I have performed detailed studies of hormone production and intermediary metabolism in malnourished children in Uganda, Bangladesh, Liberia, and Burkina Faso and characterized the effects of concurrent HIV infection on nutritional recovery. We showed that the adipocyte hormone leptin is a major determinant of morbidity and mortality in children with moderate and severe acute malnutrition.
Current Appointments & Affiliations
Robert C. Atkins, M.D. and Veronica Atkins Distinguished Professor Emeritus of Pediatrics, in the School of Medicine
·
2025 - Present
Pediatrics, Endocrinology,
Pediatrics
Professor Emeritus of Pediatrics
·
2025 - Present
Pediatrics, Endocrinology,
Pediatrics
Member of Sarah W. Stedman Nutrition and Metabolism Center
·
2007 - Present
Sarah Stedman Nutrition & Metabolism Center,
Duke Molecular Physiology Institute
Affiliate, Duke Global Health Institute
·
2008 - Present
Duke Global Health Institute,
University Institutes and Centers
In the News
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Recent Publications
Clinical and biochemical responses to treatment of uncomplicated severe acute malnutrition: a multicenter observational cohort from the OptiDiag study.
Journal Article Am J Clin Nutr · September 2024 BACKGROUND: Severe acute malnutrition (SAM) can be diagnosed using weight-for-height Z-score (WHZ) and/or mid-upper arm circumference (MUAC). Although some favor using MUAC alone, valuing its presumed ability to identify children at greatest need for nutri ... Full text Link to item CiteSex Differences in Branched-chain Amino Acid and Tryptophan Metabolism and Pathogenesis of Youth-onset Type 2 Diabetes.
Journal Article J Clin Endocrinol Metab · March 15, 2024 OBJECTIVES: Insulin resistance is associated with elevations in plasma branched-chain amino acids (BCAAs). BCAAs compete with aromatic amino acids including tryptophan for uptake into β cells. To explore relationships between BCAAs and tryptophan metabolis ... Full text Link to item CiteCatabolism of fats and branched-chain amino acids in children with Type 1 diabetes: Association with glycaemic control and total daily insulin dose.
Journal Article Endocrinol Diabetes Metab · November 2023 OBJECTIVE: Hyperglycaemia in Type 1 diabetes (T1D) results from an absolute insulin deficiency. However, insulin resistance (IR) may exacerbate glycaemic instability in T1D and contribute to long-term cardiovascular complications. We previously showed that ... Full text Link to item CiteRecent Grants
Long Term Extension Trial of setmelanotide (RM-493) for patients who have completed a trial of Setmelanotide for the treatment of obesity associated with genetic defects upstream of the MC4 receptor in the leptin-melanocortin pathway
Clinical TrialPrincipal Investigator · Awarded by RHYTHM PHARMACEUTICALS, INC. · 2020 - 2025Serotonin as a Novel Biomarker for Progression to Type 2 Diabetes in Obese Adolescents
ResearchCo-Mentor · Awarded by National Institutes of Health · 2018 - 2023BASKET: Setmelanotide (RM-493-014)
Clinical TrialPrincipal Investigator · Awarded by RHYTHM PHARMACEUTICALS, INC. · 2019 - 2022View All Grants
Education, Training & Certifications
Duke University ·
1976
M.D.
Brandeis University ·
1972
B.A.