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By Gary Goldenberg
New diabetes institute builds on a legacy of research and interdisciplinary care
Norman Fleischer, M.D., Einstein professor emeritus of medicine and former chief of the division of endocrinology at Montefiore, passed away in 2018.

Amputations, vision loss, kidney failure, heart disease: Diabetes and its complications can ravage the human body. “But those tragedies are not inevitable,” says David K. Bloomgarden, M.D., F.A.C.E., an endocrinologist in private practice for more than 40 years. “They should not happen with dedicated diabetes management.”

Dr. Bloomgarden’s mission in life has been to spread that preventive creed, first in his own practice and now in his philanthropic endeavors at Einstein’s Fleischer Institute for Diabetes and Metabolism.

Originally intent on a career in rheumatology, Dr. Bloomgarden switched specialties late in his residency at Einstein, following a rotation under Norman Fleischer, M.D., the founding director of Einstein’s National Institutes of Health–funded Diabetes Research and Training Center. “I was so inspired by Norman’s ability, knowledge, and kindness that I asked if I could do a fellowship with him,” he says. “Happily, he took me on, and the rest is history.”

In 1982, Dr. Bloomgarden opened his own endocrinology practice in nearby Westchester County, New York, where he put his mentor’s lessons into effect. “Norman taught us that we could make a profound difference in the lives of our patients,” Dr. Bloomgarden says. “Finger-stick glucose monitoring had been introduced a few years earlier. It helped give patients more control over their disease, which we could reinforce with education and counseling. Continuous glucose monitoring today makes that effort even more achievable.”

Over the decades, Dr. Bloomgarden honed his clinical skills, learning how to keep diabetes complications to a minimum. “Helping patients with diabetes live long and healthy lives is difficult,” he says, “but it’s doable with attentive care, collaboration, and attention to detail.”

Endocrinologist Noah Bloomgarden, M.D., tends to a patient at the new Fleischer Institute.

Building a Central Hub

As Dr. Bloomgarden’s practice grew, so did his frustration that many other diabetes patients were receiving less-than-optimal care. Four years ago, he talked with Dr. Fleischer about launching an institute dedicated to diabetology, both locally and nationally. “Montefiore physicians and Einstein scientists needed a place to come together to capitalize on their expertise, build a central hub for innovative care and research, and fill the void of a comprehensive center in the Bronx,” Dr. Bloomgarden says. “I was determined to make it happen.”

Sadly, Dr. Fleischer died shortly after that meeting, but Dr. Bloomgarden persevered. He worked with leaders at the hospital and medical school, marshaling support to create the Fleischer Institute for Diabetes and Metabolism, which opened in 2018. It combines research, clinical care, and education in one location, allowing Einstein discoveries to help Montefiore patients.

Above, David K. Bloomgarden, M.D., with his wife, Jane Bloomgarden, Ph.D., right, and Eva Fleischer, LCSW, who was at the institute’s opening to honor her late husband; at top, healthcare staff at work at the new center.

Inspired Philanthropy

Dr. Bloomgarden is quick to share credit for this accomplishment with his late father-in-law, Albert Willner, M.D., an orthopedist and philanthropist. “His philanthropy inspired both my wife [Jane, a clinical psychologist in private practice and director of the child/adolescent/parent psychotherapy training program at the Westchester Center for the Study of Psychoanalysis and Psychotherapy and adjunct faculty member at the Ferkauf Graduate School of Psychology] and me to do charitable work. He generously set aside funds to make that possible,” he says.

The example set by his father—Kermit Bloomgarden, a noted Broadway producer—also inspired him. “He was active during the Hollywood blacklists, when so many people in entertainment lost their livelihoods,” Dr. Bloomgarden says. “He taught me to be more socially conscious, and I’ve put that energy into my philanthropic work for Montefiore and Einstein.”

Dr. Bloomgarden in turn inspired one of his three sons to become an endocrinologist. Noah Bloomgarden, M.D., also had the good fortune to study under Dr. Fleischer and continues both Dr. Fleischer’s and his father’s devotion to the field as a member of the Einstein and Montefiore faculty.

“Norman was an inspirational figure, the grandfather of everything we do here in endocrinology. There’s no better name to be attached to this institute,” says its inaugural director, Jill Crandall, M.D., chief of the division of endocrinology, professor of medicine, and the Jacob A. and Jeanne E. Barkey Chair in Medicine at Einstein.

“One way we’re honoring his legacy is to create a place where patients can get truly comprehensive care,” Dr. Crandall adds. “For those with type 2 diabetes, that might mean treating both diabetes and obesity, since it’s very common for patients with diabetes to be overweight. Obesity worsens diabetes, and unless you treat the former you’ll never be able to manage the latter.” To that end, the Fleischer Institute is planning to open a comprehensive weight-loss program along with an obesity research center.

Close collaborations—between researchers in diabetes and obesity, between the lab and the clinic, and between generous partners—have been and will continue to be a priority. “We need to make sure that our research findings inform our clinical care, and vice versa,” says Jeffrey Pessin, Ph.D. He directs the Einstein–Mount Sinai Diabetes Research Center (a component of the Fleischer Institute) and oversees the work of more than 90 diabetes investigators. He is also a professor of medicine and of molecular pharmacology and the Judy R. and Alfred A. Rosenberg Professorial Chair in Diabetes Research at Einstein.

“One way we’re honoring his legacy is to create a place where patients can get truly comprehensive care.”

— Dr. Jill Crandall

 

Continuing to Grow

Thanks to Dr. Bloomgarden and other donors, the Fleischer Institute is increasingly able to meet the needs of people with diabetes. In 2019, the institute’s staff of more than 30 physicians, psychologists, nurses, technicians, dietitians, and administrators had an average of 730 patient visits per month—double the number in 2018.

“Unfortunately, Norman didn’t live to see the Fleischer Institute,” Dr. Bloomgarden says. “But I think he would be proud of what it has become. And I hope all who share this commitment will join me in helping expand this young institute’s growth.”

Counseling for ‘Diabetes Distress’

People seen at the Fleischer Institute will have access to psychological counseling—an important need of many patients who often experience “diabetes distress,” the emotional burden caused by coping with this chronic disease .

“There’s more awareness than there used to be of the mental health problems associated with diabetes, but psychological support is rare,” says Jeffrey Gonzalez, Ph.D., professor of medicine and of epidemiology & population health at Einstein. “With the Fleischer Institute’s support, we can make sure that our patients get this type of care, and we can demonstrate to providers and payers that it can improve outcomes and reduce overall costs.”

The institute’s psychological counseling services includes the Supporting Emerging Adults with Diabetes (SEAD) program, unique in that it guides young adults with type 1 diabetes during the difficult transition from pediatric to adult care. SEAD’s one-on-one counseling helps patients with diabetes meet their target blood- glucose levels and avoid serious complications and hospitalizations, according to SEAD director Shivani Agarwal, M.D., assistant professor of medicine at Einstein and director of the Young Adult Diabetes Clinic at Montefiore.

“A major reason I chose to come to Montefiore and Einstein was that its leaders—and Dr. Yaron Tomer specifically comes to mind—were willing to put the resources into this program,” Dr. Agarwal says. “They understand the power of multidisciplinary diabetes care.” (Learn more about Yaron Tomer, M.D., professor and chair of medicine and the Anita and Jack Saltz Chair in Diabetes Research at Einstein and Montefiore, in “Confronting the Covid 19 Crisis” and “Type 1: The Other Diabetes.”)

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