The Endocrinology Department of The Second Norman Bethune Hospital of Jilin University was established in 1995. Through continuous efforts and progress over the past nearly 20 years, it has developed into a leading unit in the field of endocrinology and metabolism within the province. Currently, the department is recognized as:
The Jilin Provincial Health Department Key Laboratory for Diabetes and Its Complications
A Changchun City Key Discipline during the 12th Five-Year Plan period
A Jilin Province Continuing Education Training Base
It houses:
The Chinese Medical Association Diabetes Demonstration Diagnosis and Treatment Base
The Jilin University Diabetes Insulin Pump Intensive Therapy Center
The Jilin University Diabetes Education and Training Center
A US-Asia Diabetes Cooperation Base
It is also an endocrine clinical drug trial institution certified by the National Medical Products Administration (NMPA, formerly CFDA) and an osteoporosis diagnosis and treatment base under the Ministry of Health's "Quality Tour" initiative.
The department boasts strong technical capabilities. Currently, there are 38 medical staff members, including 15 doctors, 9 nurses, and 14 appointed nurses. The team includes 2 professors and 4 associate professors; among them, 3 hold postdoctoral degrees, 2 hold doctoral degrees, and 9 hold master's degrees. There is 1 doctoral supervisor and 5 master's supervisors; additionally, there are 4 nurse-in-charge.
Based on clinical practice, the department has actively developed new technologies and therapies in recent years. The department currently has 48 hospital beds and is equipped with advanced medical equipment including 41 insulin pumps, 10 dynamic glucose monitoring system (CGMS) recorders, a US Bio-rad HbA1c analyzer, a US Discovery-Hologic DEXA bone densitometer, a US Neurotron somatosensory evoked potential tester, a UK Huntleigh Doppler vascular tester for limbs, and a digital fundus camera. This places the department at an advanced domestic level in the diagnosis and treatment of diabetes and its complications. The Endocrinology Department carries out extensive continuing education and public welfare activities for both medical staff and diabetic patients. In recent years, it has repeatedly held national training classes on new diabetes technologies and therapies; conducted over 600 patient re-education sessions; organized multiple summer and winter camps for children with diabetes; and holds large-scale free bone density screening clinics annually. The department has accumulated rich experience in diabetes prevention and treatment, screening for diabetic chronic complications, and the prevention and treatment of diabetes combined with osteoporosis.
The Endocrinology Department has always emphasized the combination of clinical work and scientific research. The department has successively presided over 3 National Natural Science Foundation projects, 1 sub-project of the 863 Program, 1 sub-project of the 973 Program, as well as numerous provincial/ministerial level projects and horizontal projects. It has undertaken over 20 international multi-center clinical studies. Research achievements have been awarded 1 Jilin Provincial Science and Technology Progress Award, 1 Nanjing Municipal Science and Technology Progress Third Prize, 1 Jilin University Medical Achievement Second Prize, 1 Third Prize, and 1 Fourth Prize, among others. In recent years, the department has published related works including multiple SCI-indexed papers. Explorations and certain research results have been achieved in areas such as the pathogenesis and early prevention of autoimmune endocrine diseases, induced differentiation of stem cells into insulin-secreting cells and treatment of experimental diabetic animal models, preclinical research on islet transplantation, research on the pathogenesis of diabetic nephropathy, clinical research on intensive insulin pump therapy for early type 2 diabetes, clinical research on the relationship between glycemic variability and diabetic microalbuminuria, clinical research on diabetes with osteoporosis, and the diagnosis and treatment of thyroid diseases through thyroid fine-needle aspiration.
Characteristic Therapies
Diabetes Typing and Personalized Treatment Plan Design
Our department possesses advanced technologies for diabetes typing diagnosis, including genetic screening, pancreatic beta-cell function assessment, islet autoantibody measurement, and insulin release tests. This allows us to provide precise typing diagnosis for newly diagnosed diabetic patients, thereby designing targeted, personalized treatment plans. Director Liu Yu has long been dedicated to research on the pathogenesis of type 1 diabetes and autoimmune endocrine diseases and has extensive experience in their diagnosis and treatment.
Multidisciplinary Collaborative Diagnosis and Treatment Center for Diabetic Foot and Related Diseases
Our department has established a Diabetic Foot Collaborative Group comprising specialists at the associate chief physician level or above from interventional radiology, vascular surgery, and orthopedic trauma surgery, along with dedicated foot care nurses. We offer screening for foot disease risk factors (diabetic lower limb neuropathy, vasculopathy), providing a new service model for foot patients featuring one-stop comprehensive assessment, triage for admission, and comprehensive, efficient treatment. New methods for vascular recanalization such as lower limb vascular intervention, stenting, and bypass surgery are performed, enabling the vast majority of patients with severe foot ulcers ("old rotten feet") to avoid amputation.
Multidisciplinary Collaborative Diagnosis and Treatment of Diabetic Nephropathy
A Joint Diabetic Nephropathy Prevention and Treatment Group has been established, consisting of experts from endocrinology, nephrology, and nutrition departments, along with diabetes educator nurses. A process for early screening, diagnosis, and treatment of diabetic nephropathy, as well as standards for triage and admission, has been established to provide comprehensive and thorough guidance for preventing the occurrence of diabetic nephropathy and the development of uremia.
Collaborative Diagnosis and Treatment of Diabetic Eye Disease
We have long collaborated with ophthalmology experts in our hospital to perform fundus photography and reading for each visiting patient, providing early screening and regular assessment for diabetic retinopathy. Ophthalmology and endocrinology experts work together to prevent blindness in diabetic patients.
Perioperative Blood Glucose Monitoring and Efficient Control
This center provides short-term intensive insulin therapy for patients preparing for various surgeries who currently have very high blood glucose levels. This helps achieve stable glucose control within a few days, which can shorten preoperative waiting time and reduce postoperative complications.
Stable Blood Glucose Control for Refractory Diabetes
As the Jilin University Diabetes Center, the department accepts many patients with refractory diabetes whose blood glucose cannot be well controlled in local or other hospitals. Through meticulous monitoring and comprehensive condition assessment, coupled with the successful implementation of the "3C"方案 (CSII - Continuous Subcutaneous Insulin Infusion, CGM - Continuous Glucose Monitoring, CareLink - Diabetes Information Management) regimen, we develop a set of long-term treatment plans suitable for these patients who struggle with difficult-to-control hyperglycemia, significant glycemic variability, or acute diabetic complications, enabling relatively stable blood glucose control.
Multidisciplinary Collaborative Diagnosis and Treatment of Gestational Diabetes
Our department, together with experts from the hospital's obstetrics and gynecology department, nutrition department, and diabetes educator nurses, has formed a working group for the diagnosis, monitoring, assessment, and treatment of gestational diabetes. Technologies such as glucose tolerance tests, continuous glucose monitoring systems, and insulin pumps are used for the diagnosis and treatment of gestational diabetes, safeguarding the health of both mother and child.
Multidisciplinary Collaborative Diagnosis and Treatment of Thyroid Diseases
Our department performs thyroid fine-needle aspiration (FNA) for pathological diagnosis, local injection therapy for thyroiditis and thyroid cysts, and the diagnosis and treatment of hyperthyroidism, hypothyroidism during pregnancy, juvenile hypothyroidism, and hyperparathyroidism. Together with experts from thyroid surgery, nuclear medicine, and pathology departments, we have established a multidisciplinary team for thyroid nodules, providing patients with complete thyroid function assessment, FNA biopsy, and determination of nodule nature to choose appropriate treatment plans. We also offer comprehensive services for maintaining postoperative endocrine function.
Diagnosis and Treatment of Endocrine Hypertension
Our department has implemented tests such as recumbent and upright aldosterone, renin, and angiotensin levels, and cortisol rhythm measurements at 0:00, 8:00, and 16:00 hours. Combined with the patient's relevant history, signs, and imaging data, we conduct targeted screening and develop reasonable treatment plans for patients with specific forms of hypertension, such as young-onset hypertension or hypertension uncontrolled by antihypertensive medications.
Diagnosis and Treatment of Osteoporosis
Osteoporosis is one of the most common diseases. With increasing attention to quality of life, it has become a clinical focus. Our department possesses a US Discovery-Hologic DEXA bone densitometer and has established an osteoporosis clinic. We have implemented a series of biochemical and imaging tests combined for investigating the causes and managing the diagnosis and treatment of osteoporosis, achieving significant results.
Diagnosis and Treatment of Other Endocrine Diseases
Through nearly 20 years of clinical practice, our department has also established diagnostic processes for endocrine diseases such as adrenal diseases, pituitary tumors, anterior pituitary hypofunction, and sexual development disorders, as well as metabolic diseases like gout, dyslipidemia, and obesity. We possess good diagnostic and treatment conditions and a high level of expertise.
Characteristic Diagnostic and Treatment Services
I. Introduction to Insulin Pump Therapy
Intensive insulin pump therapy is currently the optimal method for insulin treatment of diabetes. It mimics the normal pancreas by continuously infusing small doses of insulin 24 hours a day to simulate basal secretion and delivering larger bolus doses before meals to simulate prandial pulsatile secretion, making it more physiological. It reduces the local insulin "depot" formed by subcutaneous injections, potentially decreasing insulin requirements; controls blood glucose rapidly and effectively, reduces hypoglycemia, and effectively controls the "dawn phenomenon"; eliminates insulin resistance, avoiding the cardiovascular negative effects of hyperinsulinemia; and offers patients greater freedom, especially suitable for those with irregular lifestyles.
Our department introduced insulin pump therapy in 2001 and currently applies it to all patients requiring insulin.
For diabetic patients with acute or chronic complications, short-term (3-5 days) intensive insulin pump therapy is usually adopted, allowing for rapid glycemic control, significantly shortening the course of illness, and ensuring good control for diabetic patients in other departments. This reduces hospitalization time and costs.
For perioperative diabetic patients in surgical and orthopedic departments, insulin pump therapy allows for faster blood glucose reduction, enabling earlier surgical intervention. Strict glycemic control also promotes postoperative wound healing and is particularly suitable for patients who cannot eat regularly after surgery. This reduces the perioperative period for diabetic patients and provides better surgical timing for surgeons.
For newly diagnosed type 2 diabetic patients, early intensive insulin pump therapy is advocated. After 2-3 weeks of intensive pump therapy, islet function can be partially restored in some newly diagnosed type 2 diabetics. 65% of patients can gradually reduce insulin doses, and some may even discontinue insulin, maintaining normal blood glucose levels仅 through diet control and exercise alone, with a remission period lasting 1-4 years. This represents a breakthrough in diabetes treatment, crucial for reducing or delaying the onset and progression of complications and improving patients' quality of life.
To date, our department has provided insulin pump therapy to over ten thousand diabetic patients. Among them, over a thousand newly diagnosed type 2 diabetic patients, after short-term application of this therapy, were able to stop hypoglycemic drugs and maintain good glycemic control for a considerable period with diet control alone.
In 2004, the Jilin Province Insulin Pump Intensive Therapy Center was officially established at The Second Norman Bethune Hospital of Jilin University. The establishment of this center filled the gap of not having an insulin pump intensive therapy center in Jilin Province and even the Northeast region, marking that the province's diabetes prevention and treatment level has stepped into the domestic forefront and aligned with international standards.
II. Bone Density Examination
As one of the first batch of "Osteoporosis Diagnosis and Treatment Bases" designated by the Ministry of Health, the Endocrinology Department has set up an osteoporosis clinic and carries out related work. Osteoporosis, currently one of the most prevalent chronic diseases, is known as the silent killer of the 21st century and is increasingly gaining attention. A report from the International Osteoporosis Foundation indicates that among people over 50, 1 in 3 women and 1 in 5 men may experience an osteoporotic fracture. It can reduce patients' quality of life, consume substantial medical resources, and seriously threaten the health of middle-aged and elderly people. China has the world's largest elderly population, with an estimated 90 million osteoporosis patients, accounting for 7.1% of the total population. With the aging of society, the incidence of osteoporosis is rising, making early diagnosis and treatment highly significant. Bone density testing is the clinical gold standard for diagnosing osteoporosis. Our department possesses the most advanced Discovery-Hologic DEXA bone densitometer, which has reached the highest precision in the industry. It can combine bone density measurement with whole-body muscle/fat analysis assessment and bone geometry/biomechanics assessment to predict health status, and non-invasively, quickly, and accurately diagnose osteoporosis due to various causes, guiding clinical treatment. It is an ideal means for diagnosing osteoporosis and monitoring treatment efficacy.
III. Introduction to Continuous Glucose Monitoring (CGM)
The Continuous Glucose Monitoring System (CGMS) is a new breakthrough in diabetes detection technology, enabling continuous automatic monitoring of glucose concentration in subcutaneous interstitial fluid. The sensor it uses is the only one in the world that can be used on diabetics under normal living conditions for up to 72 hours continuously. Implanted in the patient's abdominal subcutaneous tissue, it sends an interstitial glucose value to the recorder every 10 seconds, recording an average glucose value every 5 minutes. Through 288 glucose data points per day, it continuously monitors blood glucose for 72 hours, providing an accurate trend graph.
CGM can capture glycemic fluctuation intervals missed by fingerstick checks or HbA1c, providing the most detailed information on glycemic variability, precisely locating points of fluctuation such as unaware hyperglycemia or hypoglycemia, and offering a comprehensive understanding of the patient's glucose patterns – information that was previously completely unavailable. This helps determine the impact of meals, exercise, medications, and insulin on glucose values, accurately tracks rapid glucose fluctuations like hyperglycemia and hypoglycemia, enables patients to better understand the cause-and-effect relationship between various daily life factors and glucose fluctuations, and thus improve self-monitoring and lifestyle modifications. This allows for the formulation of the most suitable personalized treatment plan for the patient.
IV. Introduction to Dual "C" Therapy
Dual "C" therapy combines Continuous Subcutaneous Insulin Infusion (CSII, insulin pump) with Continuous Glucose Monitoring (CGMS) for diabetes treatment. By wearing a CGMS and using an insulin pump (CSII), insulin pump doses can be finely adjusted based on dynamic glucose changes, achieving glycemic control targets in the shortest possible time and providing an optimized glucose management方案 for diabetic patients. This is currently the most advanced international insulin treatment regimen.
In 2004, our department took the lead in the province by fully applying this advanced treatment method clinically. Extensive clinical application has accumulated rich experience, relieving the suffering of many patients and receiving high praise. Currently, our department's diabetes treatment has reached internationally advanced levels.
V. Introduction to Somatosensory Evoked Potential (SSEP) and Lower Limb Doppler Flow Testing
Diabetic peripheral neuropathy is one of the most common chronic complications of diabetes. Patients with a diabetes duration exceeding 10 years often have明显的 clinical diabetic peripheral neuropathy, its prevalence correlating with duration. Neurological function tests reveal that 60%-90% of patients have varying degrees of neuropathy, 30%-40% of whom are asymptomatic. The prevalence is higher among smokers, patients over 40, and those with poor glycemic control. It seriously affects patients' quality of life.
Compared to non-diabetic individuals, the prevalence of atherosclerosis is higher in the diabetic population, with onset at a younger age and faster progression. Macro- and microatherosclerosis often affects the aorta, coronary arteries, cerebral arteries, renal arteries, and peripheral limb arteries. Peripheral arterial disease (PAD) often primarily affects the lower limbs, manifesting as lower limb pain, sensory abnormalities, and intermittent claudication. Severe ischemia combined with peripheral neuropathy can lead to diabetic foot.
Diabetic foot is a serious complication leading to disability and death in diabetic patients. The lifetime incidence of foot problems in diabetics is as high as 15-20%. Over 50% of non-traumatic amputations annually are performed on diabetic patients. The treatment cost for diabetic foot is enormous. Therefore, early diagnosis and scientific treatment can significantly improve patient quality of life and reduce treatment costs. In 2007, our department introduced a diabetic foot screening and diagnostic kit produced by UK's Huntleigh company. Using Doppler to measure the Ankle-Brachial Pressure Index (ABI), it enables comprehensive analysis of the vascular system, objective diagnosis of lower extremity arterial disease and assessment of its severity, allowing for early diagnosis of diabetic lower extremity peripheral vascular disease. Simultaneously, we possess a US Neurotron Somatosensory Evoked Potential (SSEP) tester. SSEP testing provides objective basis for the diagnosis and treatment of diabetic peripheral neuropathy, enabling early detection of peripheral neuropathy and thus providing a basis for early treatment.
