Dr. Kenneth Izuora, who heads the UNLV School of Medicine Division of Endocrinology and serves as program director for the endocrinology fellowship training program, grew up nearly 8,000 miles from Las Vegas. When he flies to see members of his family, it takes nearly 16 hours in the air.
To many Americans, particularly those who pay attention to the critical role fossil fuels play in the global economy, Nigeria — where Izuora spent his early years and graduated from medical school — means oil. The former British colony is Africa’s largest oil producer, generally a top 10 oil producer worldwide. To those who follow the demographics of the huge African continent, Nigeria is Africa's most populous nation. One in five Africans is Nigerian.
Izuora, an associate professor in the medical school’s department of internal medicine as well as a member of the UNLV Medicine COVID-19 Task Force, is well aware of the economic and demographic forces of the place he was born. But what comes to his well-trained mind in science as he remembers his hometown of Ogidi in Eastern Nigeria is the power of a microscope.
“My dad was a biology teacher so I got to use his microscope...what I saw was so amazing,” said Izuora, who now is an American citizen. Under the microscope, an organism he may have seen with his naked eye that seemed smooth was actually covered in scratches — or something he thought was round actually had straight edges and angles.
Early Love of Science
“I fell in love with a whole new world,” said Izuora, whose mother was an elementary school principal. “I feel I have always loved science. I enjoy understanding how things work. I was told I asked a lot of, “why is” questions as a child. My parents motivated me to always be inquisitive. I believe my passion for teaching came from them.”
At one point during high school, he thought his love for science would manifest itself in a career in engineering. But the human dimension of medicine won out. He was proud of how two uncles, both physicians, made a difference in the lives of his neighbors. “They’d bring their stethoscopes and blood pressure instruments home with them, write prescriptions. It made quite an impression. I came to think of medicine as a sort of engineering of the human body to keep it running healthy for as long as possible.”
After medical school in Nigeria, where Izuora says the training was highly influenced by the British system of medical education, he completed an internal medicine residency in New York at the University of Rochester/Unity Health System and a fellowship in endocrinology and metabolism at Georgia’s Emory University. He also had previously done research and received an MBA in health administration at the University of Colorado.
“Beyond medical school, my first exposure to endocrinology was while conducting diabetes-related research at the University of Colorado with Dr. Peter Chase,” said Izuora, who is married and the father of two young boys. “I was amazed by the effect of receiving the right treatment on alleviating the anxiety and improving the health of patients with endocrine disorders. I was also amazed by the promise of research to make a bigger impact in the future of medical care. It was an easy decision to pursue a fellowship in the field.”
The technology he was able to use, both clinically and for research, during his post-graduate training went a long way toward convincing him to stay in the U.S. “The technology allows you to make a difference with more people,” said Izuora, whose considerable research on the endocrine system has appeared in peer-reviewed publications ranging from the Journal of Clinical & Translational Endocrinology to the Journal of Investigative Medicine.
Izuora still speaks with wonder about the endocrine system, which involves an intricate network of glands that produce hormones that regulate various functions in the body. “In disease,” he pointed out, “when the hormones are too high or too little, those functions they regulate become abnormal. Diabetes, for example, is from too little effective insulin and hyperthyroidism is from too much thyroid hormone.”
Link Between Diabetes, COVID
About half of Izuora’s patients today have diabetes. There are two types of diabetes: Type 1, an autoimmune disease, and Type 2, a metabolic disorder. Both are chronic diseases that affect the way the body regulates blood sugar or glucose. Glucose is the fuel that feeds the body’s cells, but to enter cells it needs a key. Insulin is that key. People with Type 1 diabetes don’t produce insulin. People with Type 2 diabetes don’t respond to insulin as well as they should and later in the disease often don’t make enough insulin. Both types can lead to chronically high blood sugar levels, increasing the risk of diabetic complications, which include cardiovascular disease, nerve and kidney damage, and now an increased risk of COVID-19 complications.
In the U.S., a government study found that nearly 40 percent of people who have died with COVID-19 had diabetes. That statistic, according to Izuora, seems on the mark in Las Vegas. COVID-19 appears not only to thrive in a high-sugar environment but to exacerbate it. High blood sugar can weaken the immune system or damage vital organs. The virus often targets the heart, lungs, and kidneys, organs already weakened in many diabetes patients. High glucose and lipid counts in patients with diabetes can trigger a “cytokine storm,” when the immune system overreacts, attacking the body and sometimes causing lethal blood clots to form. Studies now suggest the virus may also trigger new cases of diabetes.
Izuora, whose research focuses on diabetes and its complications, sees research breakthroughs coming in endocrinology, particularly in the management of diabetes. “Over the course of my career, I have seen so much change and anticipate even more,” he said. “This includes new medications and devices that have resulted in improved quality of life and better life expectancy for our patients. This is why it is important to invest our efforts in research.”
A former president of the Nevada Chapter of the American Association of Clinical Endocrinologists (AACE) and a current member of the National AACE Board of Directors, Izuora said the risk of catching the virus isn’t higher in patients with diabetes than for anyone else. But they can have worse complications if they do get exposed. That’s especially true, he said, if their diabetes isn’t well-controlled.
“I keep telling my patients to take all precautions not to be exposed,” said Izuora, who as a member of the UNLV Medicine COVID-19 Task Force has helped develop some of the algorithms used to guide clinical decisions related to the virus.
“Just wearing a mask can help so many of my patients keep free of the virus.”
