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Clinical Research and Epidemiology in Diabetes and Endocrinology


Todd Brown

Todd T. Brown, MD, PhD


 Professor of Medicine and Epidemiology
 Division of Endocrinology, Diabetes, and Metabolism

Todd Brown

Sheela N. Magge, MD, MSCE


Associate Professor of Pediatrics
Director, Division of Pediatric Endocrinology and Diabetes


Diabetes mellitus has reached epidemic proportions in the US and abroad. Other endocrinologic diseases, like hypothyroidism and osteoporosis are also extraordinarily common. Patient- and population-oriented researchers with expertise in these conditions are urgently required.

With this need in mind, in 2002, we established a training program at Johns Hopkins devoted to clinical and epidemiologic research in diabetes and endocrinology and funded by the National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK). 20 years later, it remains the only one of its kind in the US. The training program accepts three pre-doctoral students and two post-doctoral fellows per year and leads them to the MHS or PhD in clinical epidemiology or clinical investigation. Thus far, we have successfully trained 50 young scholars (25 pre-docs and 25 post-docs) who have produced over 128 peer-reviewed scientific papers and who hold research positions across the country.

Program Goals

The goals of our training program are:

  1. To recruit a diverse group of top-notch young trainees in endocrinology (post-docs) and epidemiology (pre-docs) from a national pool of talent attracted to Johns Hopkins.
  2. To enroll them in rigorous, thesis-bearing Masters’ and PhD programs in Epidemiology and Clinical Investigation in the Johns Hopkins Bloomberg School of Public Health.
  3. To expose them to a strong team-oriented, multi-disciplinary clinical and epidemiologic research culture in the Welch Center—the premier educational home for clinical research training at Johns Hopkins.
  4. To guide each trainee to an experienced, NIH-funded mentor who will take responsibility for the successful completion of a significant thesis project.

Program Strengths

The strengths of this program include:

  1. Strong existing diabetes and endocrine research collaborations between the Division of Endocrinology, Diabetes and Metabolism; Division of Pediatric Endocrinology; the Welch Center for Prevention, Epidemiology, and Clinical Research (Welch Center); the School of Public Health; and the School of Nursing
  2. Outstanding thesis-based degree programs in Epidemiology and Clinical Investigation at the School of Public Health
  3. Outstanding clinical expertise in diabetes and endocrine disorders
  4. Seasoned mentors experienced in grooming young scientists for academic careers, and
  5. High-caliber trainees wanting to pursue clinical and epidemiologic research careers related to diabetes and other endocrinology disorders.

Program Features

Program Options

Our pre-doctoral fellows are eligible for tuition support for their PhD program.  Our post-doctoral trainees have the opportunity of pursuing a MHS or PhD in the Graduate Training Program in Clinical Investigation.

Faculty Mentors

Rexford Ahima, MD, PhD Josef Coresh, MD, PhD, MHS Jenna Mammen, MD, PhD
G. Caleb Alexander, MD Jeanne M. Clark, MD, MPH Nestoras Mathioudakis, MD, MHS
Lawrence J. Appel, MD, MPH Gail Daumit, MD, MHS Erin Michos, MD, MHS
Sara Benjamin-Neelon, PhD Joel Gittelsohn, PhD Noel T. Mueller, PhD
Wendy Bennett, MD, MHS Kimberly Gudzune, MD, MHS Wendy Post, MD, MS
Todd T. Brown, MD, PhD Rita Kalyani, MD, MHS Jodi Segal, MD, MPH
Lisa A. Cooper, MD, MPH Sheela Magge, MD Elizabeth Selvin, PhD, MPH
Deidra Crews, MD, ScM Nisa Maruthur, MD, MHS Jessica Yeh, PhD

Areas Of Endocrine Research Training

Behavioral Science, Mental Health,
and Diabetes

Lawrence J. Appel, MD, MPH
Gail Daumit, MD, MHS
Kimberly Gudzune, MD, MHS
Disease Management
Lisa A. Cooper, MD, MPH
Rita Kalyani, MD, MHS
Human Physiology
Rexford Ahima, MD, PhD
Todd T. Brown, MD, PhD
Sheela Magge, MD
Nisa Maruthur, MD, MHS
Cardiovascular Disease
Josef Coresh, MD, PhD, MHS
Erin Michos, MD, MHS
Wendy Post, MD, MS
Elizabeth Selvin, PhD, MPH
Josef Coresh, MD, PhD, MHS
Noel T. Mueller, PhD
Wendy Post, MD, MS
Elizabeth Selvin, PhD, MPH
Jessica Yeh, PhD
Lawrence J. Appel, MD, MPH
Joel Gittelsohn, PhD
Sara Benjamin-Neelon, PhD
Clinical Trials
Lawrence J. Appel, MD, MPH
Jeanne M. Clark, MD, MPH
Lisa A. Cooper, MD, MPH
Nisa Maruthur, MD, MHS
Nestoras Mathioudakis, MD, MHS
Endocrinology & Metabolism in Aging
Todd T. Brown, MD, PhD
Rita Kalyani, MD, MHS
Jenna Mammen, MD, PhD

Lawrence J. Appel, MD, MPH
Jeanne M. Clark, MD, MPH
Joel Gittelsohn, PhD
Kimberly Gudzune, MD, MHS

Diabetes Prevention
Jeanne M. Clark, MD, MPH
Nisa Maruthur, MD, MHS
Nestoras Mathioudakis, MD, MHS
Health Disparities
Wendy Bennett, MD, MHS
Lisa A. Cooper, MD, MPH
Deidra Crews, MD, ScM
Pediatric Endocrinology
Sheela Magge, MD
Health Services & Comparative Effectiveness Research
Lawrence J. Appel, MD, MPH | Jeanne M. Clark, MD, MPH | Lisa A. Cooper, MD, MPH | 
Jodi Segal, MD, MPH | G. Caleb Alexander, MD | Wendy Bennett, MD, MHS

Research Data Resources

National Surveys



National Health and Nutrition Examination Survey (NHANES)

Personal interview, physical exam, lab tests, nutritional assessment
5,000 persons, all ages. Oversample young, old, minorities

National Health Interview Survey (NHIS)

Personal interview. ~ 40,000 household. Oversample blacks and Hispanics

Mortality Follow-ups for the NHANES and NHIS

NHANES III (baseline 1988 – 1994) has been linked to death through 2000. 9000-15,000 adults followed 8-12 years to mortality

Nation Hospital Discharge Survey (NHDS)

Hospital records, Computerized data sources from 500 hospitals with 300,000 discharges

Community-based Cohorts

Atherosclerotic Risk in Communities Study (ARIC)

Prospective cohort; 16,000 mid-aged adults from 4 U.S. communities
Details on cardiovascular disease risk factors

Multi-Ethnic Study of Atherosclerosis (MESA)

Prospective cohort from 6 sites with diverse and representative sample of ~ 7,000 men and women
Studies progression to clinical CVD

Jackson Heart Study (JHS)

Prosepective cohort of 5,200 African-American adults from Jackson, MS, USA

Studies risk factors for and progression of cardiovascular disease in African Americans

Clinical Trials



DPP Outcome Study (DPPOS)

Cohort after RCT; all DPP participants
Evaluate long-term effects of active DPP interventions on the development of diabetes, and microangiopathic and CVD outcomes


Largest study of weight loss ever conducted; 5,000 participants with diabetes
Hopkins is home to multiple federally supported ancillary studies including a) fatty liver; b) heavy metal exposure; c) environmental influences on weight and weight loss

Practice-Based Opportunities for Weight Reduction (POWER) Trial

Real world effectiveness trial designed to establish approaches to translate findings from major NIH lifestyle trials into clinical practice

Administrative and Clinical Datasets



Johns Hopkins Inpatient Diabetes Database

Over 33,000 patient-level inpatient observations including glucometrics, insulin prescribing, and demographic data from 2006-2010 covering timeframe of hospital-wide glucose management initiatives

CMS 5% Sample Longitudinal Dataset

5% nationally random sample of Medicare beneficiaries; 2 million per year
Claim and enrollment; JHU has research identifiable version of data


Linkage of US cancer registries data and Medicare data
Cancer characteristics, health care services data since 1986

Blue Shield and Blue Cross Claims from 7 regions

Claims and HRA data from Hawaii, PA, Michigan, NC, TN, IW, SD


Medicaid database including 7 million patients and link to labs

Maryland Statewide Hospital Discharge

~ 6 million patient records over the past 10 years
Inpatient discharges from all Maryland hospitals

Johns Hopkins Hospital and Bayview Discharge Abstracts

Over 600,000 patient records over the past 10 years
Internal data includes functional units within which the patient was treated, cost recovery data, and total charges

Johns Hopkins Community Physicians Health Plan

Electronic records for 100,000 individuals
Include personal and financial demographics, encounters, appointments, lab, medications, ICD-9, CPT, and HCPCS codes

Medical Expenditure Panel Survey (MEPS)

AHRQ national information resource for patient-level health care data
Data on specific health services and related cost and insurance information from 13,000+ family and 32,000+ individuals

Affiliated Research Centers And Departments

Division of Endocrinology, Diabetes, and Metabolism (Rexford Ahima, MD, PhD, Director)

The Johns Hopkins Division of Endocrinology, Diabetes, and Metabolism offers expert care for various metabolic, pituitary, thyroid and diabetes-related conditions. The team is committed to delivering compassionate care, advancing novel research and educating the next generation of health experts. The Division of Endocrinology, Diabetes, and Metabolism is located at the Johns Hopkins Hospital and Bayview Medical Center.  Their mission is to (1) provide superb evidence-based care for patients with diabetes, obesity, diseases of thyroid, adrenal and pituitary glands, bone and mineral disorders, and male and female reproductive disorders; (2) foster innovative basic, clinical and translational research to generate new knowledge and improve treatment of endocrine diseases; and (3) provide outstanding educational programs for students, fellows, clinicians and the community. The division has a history of accomplishment in clinical and epidemiological research and research training in diabetes and endocrinology. Under the leadership of Dr. Rexford Ahima, an internationally recognized diabetes researcher, the Division is consistently ranked in the top 5 programs in the country according to US News and World Report. The research within the Division is diverse and includes clinical, epidemiological, translational, and basic science research.  

Division of Pediatric Endocrinology and Diabetes (Sheela Magge, MD, Director)

The Division of Pediatric Endocrinology and Diabetes offers a wide variety of clinical services, research, and training opportunities. In addition to the diagnosis and treatment of endocrinological problems, faculty members are also involved in a variety of clinical, translational, and basic science research. The division is staffed by a team of 12 physicians, an NP, and 4 diabetes educators, a social worker, community health worker, and multiple research coordinator teams. The division offers expertise in all areas of pediatric endocrinology, including disorders of growth, puberty, sex differentiation, glucose metabolism, bone and mineral metabolism, the pituitary/hypothalamus, the thyroid, the adrenal and the gonads. The Pediatric Diabetes Center employs a multidisciplinary approach in which a team consisting of physicians, nurse educators, dietitians, behavioral health specialists, and a social worker provide comprehensive care to children and adolescents with all types of diabetes, and support to their families.  Faculty are engaged in a range of clinical and basic science research, in areas such as bone, cystic fibrosis-related diabetes, type 1 and 2 diabetes, as well as risk factors for cardiometabolic risk. They are supported by NIH funding as well as foundational support. The Division is consistently rated among the top pediatric endocrinology programs in the nation by U.S. News & World Report.

The Welch Center for Prevention, Epidemiology, and Clinical Research

The Welch Center for Prevention, Epidemiology, and Clinical Research, composed of 30 multidisciplinary core faculty, is an institutional resource for prevention-oriented clinical research and training and is home to the Prevention and Control Core of the Baltimore Diabetes Research and Training Center (DRTC). Jessica Yeh, PhD directs this Core.

Division of General Internal Medicine

Division of General Internal Medicine, led by Jeanne Clark, MD, MPH, has 75 full-time faculty who hold $25 million in federal grants (annual direct costs) with research expertise in type 2 diabetes, gestational diabetes, obesity, fatty liver disease, minority health, racial disparities, clinical epidemiology, quality of care, outcomes research, health services research, evidence-based medicine, pharmacoepidemiology, and comparative effectiveness research. Among our major centers are the Center for Health Equity, the Agency for Healthcare Research & Quality(AHR!)-funded Evidence-based Practice Center, the Johns Hopkins Brancati Center for the Advancement of Community Care, the ALACRITY Center for Health and Longevity in Mental Illness, and the Brancati Center for the Advancement of Community Care.  Other centers are co-directed by General Internal Medicine faculty members, including the Center for Health Services and Outcomes Research, the Center for Women's Health, Sex and Gender Research, and the Center for Drug Safety and Effectiveness.

Department of Epidemiology

Department of Epidemiology (Bloomberg School of Public Health) is home to the Master of Health Science (MHS) and PhD programs in Clinical Epidemiology for our trainees and the Diabetes and Obesity Epidemiology course. Its faculty in the Welch Center lead internationally recognized epidemiologic studies, including the ARIC Study, with 30-year metabolic and clinical follow-up data on a biracial cohort of 16,000 adults.

Johns Hopkins Center for Health Equity

Johns Hopkins Center for Health Equity includes a Training Core directed by Lisa A. Cooper, MD, MPH, to promote equity in health and healthcare for socially at-risk populations through advancing scientific knowledge, promoting sustainable changes in practice and policy, partnering with communities, raising public awareness of health inequities, and training the next generation of health equity scholars.  The Center includes over 30 faculty members from the Johns Hopkins School of Medicine, Nursing, and Public Health.

Center for Human Nutrition

Center for Human Nutrition is a multidisciplinary center developed in order to advance research, training, and public service in the field of human nutrition and includes an educational program in laboratory, clinical, and public health nutrition.

Johns Hopkins School of Nursing

Johns Hopkins School of Nursing, known for its PhD research program, is home to the PROMOTE Center for Chronic Conditions and the Center for Cardiovascular and Chronic Care.

Baltimore Metropolitan Diabetes Regional Partnership

The Baltimore Metropolitan Diabetes Regional Partnership (BMDRP) is a $45 million program funded by the Maryland Health Service Cost Review Commission (HSCRC) to prevent and improve diabetes outcomes in the State population, as a joint project between Johns Hopkins Health System and the University of Maryland Medical System.  17 zip codes within Baltimore City are identified as the prediabetes target patient population to focus Centers for Disease Control and Prevention (CDC)-approved National Diabetes Prevention Program (DPP) activities.  Residents in these zip codes have high prevalence of risk factors for incident diabetes and face numerous social determinant challenges.  The BMDRP will also implement American Diabetes Association-approved Diabetes Self-Management Training (DMST) clinical service in hospital services areas in Baltimore City, Howard County, and Montgomery County.  DSMT services will address the disproportionate diabetes burden among racial/ethnic minorities in each of these geographical regions, including higher diabetes prevalence, emergency department visits, and mortality rates due to diabetes.  In the DPP, 10-15 participants attend weekly to biweekly sessions (33 total sessions) over 12 months.  Sessions are facilitated by a CDC-certified DPP Lifestyle Coach.  The DMST consists of individual and groups diabetes-educator led sessions to enhance self-efficacy and improve diabetes related outcomes, with frequency of visits tailored to the needs of the individual patient.  The goal for DPP is 3,938 referrals and for DMST is 3,676 enrolled patients in 2022.  Referral and enrollment targets are even higher in 2023 and 2024, focusing on patient retention and completion in programs.  Both programs have clinical goals as well, including target of patients achieving 5% weight loss for the DPP and reduction in the Prevention Quality Indicators-93 diabetes quality measure for the DSMT.  Outcomes will be ascertained through links to an integrated electronic medical record system and health information exchange (CRISP).  The project is a rich resource for T32 trainees, especially for those interested in implementation science, bioinformatics or health disparities.

Johns Hopkins Claude D. Pepper Older Americans Independence Center (Jeremy Walston, MD, Director, Karen Bandeen-Roche, PhD, Co-Director)

Frailty is recognized as an age-related condition in which older adults lose the capacity to cope with stressors and become vulnerable to functional decline, loss of independence, and mortality. Frailty research provides a highly productive framework for clinical, population-based and biological discovery and for the development of junior investigators for academic careers in frailty and aging research. The mission of the Johns Hopkins Older Americans Independence Center (OAIC) is to provide a hypothesis-driven, frailty-focused, highly interdisciplinary center where supported investigators receive the expertise, resources, and training necessary to make fundamental discoveries related to the origins and causes of frailty and then move these discoveries towards frailty- focused interventions. Since its original funding in 2003, the novel approaches of the Johns Hopkins OAIC have helped to demonstrate that frailty is a syndrome driven by multiple biological mechanisms that are expressed through characteristics of decreased resiliency and reserve in older adults. The OAIC has  six cores that work synergistically to accomplish the goals of the center; the Research Career Development Core; the Pilot / Exploratory Studies Core; the Biostatistics Core; the Biological Mechanisms Core;  the Clinical Translation and Recruitment Core; and the Leadership and Administrative Core. Though these cores, the center supports research training for junior faculty, cutting edge pilot studies, data analytic expertise, biological expertise, clinical translational research support, and scientific leadership. The JHU OAIC collaboration initiative, known as the Pepper Scholars Program, consists primarily of monthly research-in- progress sessions that allow for OAIC- supported investigator interaction and discourse, along with progress updates and access to mentors and methodological experts.

For additional information about the training program, contact:    

Todd T. Brown, MD, PhD
Director, T32 Clinical Research and Epidemiology
in Diabetes and Endocrinology Training Program