Episode 77: Endocrine Practice Endocrine Legends Series: Dr. Guillermo E. Umpierrez

Summary

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Episode Overview

Podcast: AACE Podcasts
Episode: 77 – Endocrine Practice Endocrine Legends Series: Dr. Guillermo E. Umpierrez
Host: Dr. Cecilia Lansing
Date: July 6, 2026

This special "Endocrine Legends" episode honors Dr. Guillermo E. Umpierrez (Pierre), professor of medicine at Emory University and world-renowned expert in inpatient diabetes care and research. Through a rich discussion with host Dr. Cecilia Lansing, Dr. Umpierrez shares his journey from Ecuador to a leadership position in U.S. endocrinology, details pivotal research milestones, reflects on mentorship, and dispenses practical wisdom for upcoming endocrinologists.

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Key Discussion Points and Insights

Early Life and Medical Inspiration

• Background: Dr. Umpierrez grew up in Ecuador, attending medical school there before moving to the U.S. for further training (02:14).
• Early Medical Interest: Decided on medicine as a teenager, due to the educational structure in South America where students choose medicine as their university focus at age 18 (02:45).
• Entry into Endocrinology: First real exposure came during internship via a clinical study on diabetic ketoacidosis (DKA), sparking his passion for the field (03:12).

Inspirational Mentorship and Career Development

• Mentorship:
  • Initially lacked significant research support; later found mentorship under division chief Larry Phillips and especially Dr. Abbas Kitabchi, whom he invited to collaborate, shaping his career trajectory (07:27–09:45).
  • Dr. Kitabchi's mentorship: “He would use his red pen and mark all my papers and…always ask me why you are asking these questions” (08:49).
• Early Challenges:
  • Faced difficulty transitioning from clinical to research roles due to a lack of training and support for junior faculty. Networking and proactive mentorship-seeking were critical for advancement (07:27–09:39).

Pioneering Work in Inpatient Diabetes

• Initial Observations:

  • On joining Emory’s faculty, Dr. Umpierrez observed a high rate of obesity in patients with DKA at Grady Hospital—contradicting the prevailing stereotype that DKA affects only young, lean, Caucasians (03:52–05:59).
  • “We had 50% at that time of those patients presented with newly diagnosed DKA were overweight and/or obese…At that time we used to call it obese DKA—now we changed the name to ketosis-prone diabetes.” (05:11)

• Key Studies and Impact:

  • Led studies defining the clinical characteristics of this group, coining “ketosis-prone diabetes,” and examining beta cell dysfunction in minority populations (05:11–05:59).
  • Published a seminal 2002 observational study on hospital hyperglycemia (“…has over a thousand citations”), highlighting the prevalence and complications of inpatient hyperglycemia and leading to systemic changes in hospital glucose management (10:50–12:37).
  • “The glycemic control was terrible … we implemented inpatient diabetes care, wrote some protocols, trying to change outcome.” (11:49)

• Influence on Hospital Practice:

  • Insights from his and peers’ work led to creation of dedicated inpatient diabetes teams beyond intensive care units in many U.S. hospitals (12:37–13:32).
  • “Many hospitals now have dedicated teams just to see patients with diabetes, not necessarily endocrine.” (12:40 — Dr. Lansing)

Perspectives on Work-Life Balance

• Personal Satisfaction:
  • Despite accolades, Dr. Umpierrez prioritizes family and supportive environments: “I received multiple awards, but they really second by far my satisfaction working in this environment.” (06:26)
• Hobbies and Travel:
  • Enjoys exercise, travel (often for lectures or family trips), and spending time with his granddaughters: “My hobbies are going to the gym or walking or running…exercising and…spending time with family.” (13:49)
  • Favorite travel locations: a tie between Europe and Latin America (14:34).

Advice and Reflections for Junior Faculty / Trainees

• Importance of Mentorship and Team:
  • “The big challenge for junior people... is finding the right person, the right mentor to... support you.” (09:45)
  • Encourages joining groups with a focus on teaching, research, and collaborative work.
• Research Tips:
  • Be patient—becoming an independent investigator takes years: “Very few people have great ideas when you’re a fellow…It’s going to be several years until you are an independent investigator.” (15:44)
  • Regular group research meetings are vital: “Try to meet for research in your institution at least once a month to discuss ideas…most institutions…that doesn’t happen.” (16:40)
• Personal Fulfillment:
  • Celebrate small successes, not just major grants and papers: “Enjoy what you do and celebrate your little successes…because that will keep you going.” (18:02)

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Notable Quotes & Memorable Moments (with Timestamps)

• On mentorship’s transformative impact:

  • “He would come to my office every day…always ask me why are you asking these questions and made me think about why research should be done.”
    — Dr. Guillermo Umpierrez (08:49)

• Observational research that changed practice:

  • “We had 50% at that time of those patients presented with newly diagnosed DKA were overweight and/or obese…we changed the name to ketosis-prone diabetes.”
    — Dr. Guillermo Umpierrez (05:11)

• On career satisfaction:

  • “I received multiple awards, but they really second by far my satisfaction working in this environment.”
    — Dr. Guillermo Umpierrez (06:26)

• Advice to fellows/early-career endocrinologists:

  • “If you find the right person, the right environment to do research within your institution or outside…then you can start doing research…It’s going to be several years until you are independent investigator.”
    — Dr. Guillermo Umpierrez (15:30)
  • “Enjoy what you do and celebrate your little successes…that will keep you going.”
    — Dr. Guillermo Umpierrez (18:02)

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Important Segments with Timestamps

• Dr. Umpierrez’s Journey to Endocrinology: 02:14–03:42
• Mentors and Building a Research Career: 07:27–09:45
• Pioneering Diabetes Research & Key Observations: 03:52–05:59, 10:50–12:37
• Personal Life, Hobbies, and Work-Life Balance: 13:49–14:42
• Advice to Early Career Clinicians: 15:04–17:27
• Final Wisdom on Finding Fulfillment: 18:02–18:20

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Summary

This episode provides a rare glimpse into the personal and professional journey of one of endocrinology’s highly influential figures, Dr. Guillermo Umpierrez. From humble beginnings in Ecuador, through crucial discoveries in diabetes care at Emory, to shaping hospital practices worldwide, Dr. Umpierrez credits mentorship, curiosity, and collaborative teams for his success. Aspiring endocrinologists will find actionable advice about persistence, mentorship, and the need to value incremental progress—richly illustrated by Dr. Umpierrez’s own life and legacy.

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Transcript

[Dr. Guillermo Pierre]

Foreign.

[ACE Podcasts Host]

Welcome to ACE Podcasts. Thanks for tuning in as we elevate clinical endocrinology by taking deep dives into trends and topics that can help us improve our patient care and global health. Find the Latest episodes on aace.com podcasts and now let's meet the endocrine experts who will be talking with us today.

[Dr. Cecilia Lansing]

Thank you for listening in. I have the pleasure of doing today's interview. My name is Cecilia Lansing. I direct endocrinology at Main Campus at the Cleveland Clinic, and I'm professor of medicine at the Cleveland Clinic Learner College of Medicine. Our special guest today is no other but Dr. Guillermo Impieres.

[Dr. Guillermo Pierre]

Hello, I'm Guillermo Pierre. I'm a professor of medicine in the Division of Endocrinology at Emory University School of Medicine in Atlanta. I'm a clinician, educator and researcher, especially in the area of inpatient diabetes care. I've worked for the last 20, 30 years in trying to find out the mechanism for beta cell dysfunction in minority populations and the management of inpatient hyperglycemia. I've been lucky enough to work and be invited to participate in national international studies and guidelines, especially with major organizations. In addition, I've served as the director of the Emory Latino Diabetes Education Program, a national accredited Spanish diabetes education dedicated to provide diabetes and education to Latinos. Thank you so much, Cecilia.

[Dr. Cecilia Lansing]

So again, this is a special way of honoring the people who have shaped endocrinology throughout the years. But tell us about the young Guillermo A. Pierre's. What was he like? What was life like before you even entered medicine?

[Dr. Guillermo Pierre]

Well, I grew up in Ecuador in South America, did my training at Emory University, and I've stayed in Atlanta off and on for 40 years. I've joined the faculty 1992, left for a couple of years to University of Tennessee Memphis, but then came back to Emory and still here.

[Dr. Cecilia Lansing]

You've obviously had a successful academic life, but when do you think you decided to go into medicine? How did that happen?

[Dr. Guillermo Pierre]

Well, I always very intrigued about medicine and health issues since I was a teenager. So in South America, you had to decide if at age 18, when you go to the university for seven years, you don't get a chance to go to college. So I made that decision and stayed.

[Dr. Cecilia Lansing]

Boom. Nice. And then what about endocrinology? What made you think about that as your specialty?

[Dr. Guillermo Pierre]

As an intern, I was invited to participate in a clinical study and at that time, the meters were not very well developed. So we did a study on diabetic ketoacidosis and diluted Blood samples to be able to get a more accurate ingredients. And that allowed me to be part of the endocrine section, I guess. So when I finished my internal medicine residency, I applied and stay at Emory.

[Dr. Cecilia Lansing]

That's nice. And so who were your earlier mentors over there that kind of shaped you to be of course, who you are now?

[Dr. Guillermo Pierre]

This is interesting. Well, I signed my contract and I think it was one page agreement and the description of my job was take care of diabetes at Grady Hospital, a large community hospital, a thousand beds and by the way, you need to do research. So you know, as a junior faculty, I talked to the diabetes educator and I said, what kind of patient do you see? And I was very intrigued by the fact that for a large number of patients with diabetic ketoacidosis, so we look at all of the patients that we have seen during that year. The year before, I was surprised by the rate of obesity in patients with diabetic ketoacidosis at that time. 1992, when you ask tell me about a patient with DKA, they say, well, it's a Caucasian, it's young. But what I was seeing at Grady was middle age. In the late 30s, early 40s, newly diagnosed without precipitating costs, developed TKA and they were overweight or obese. So we had 50% at that time of those patients presented with newly diagnosed TKA were overweight and or obese. We, we did some studies, determined the clinical characteristics and then I got my first grant, I guess within a year after I started working at Emory as a faculty, determine what was the insulin secretion. Why did this patient develop diabetic ketoacidosis? And then that will start all of this investigation that we had. And at that time we used to call obese dka. Now we, with time we changed the name to ketosis prone diabetes because we knew that some people develop ketosis, some people did not, but they all presented with noly diagnosis diabetes so common.

[Dr. Cecilia Lansing]

No, I, I think that's great that you latched on an observation and then ran away with it because you certainly are looked upon as the father of inpatient diabetes and diabetic ketoacidosis. So amongst your accomplishments then academically, what are you the most proud of?

[Dr. Guillermo Pierre]

Honestly, to be a faculty member at Emory has been incredible in the way that they are very supportive environment would allow me to be with family and two daughters, four granddaughters. So I'm home for the past 40 years. So that would be, I mean, in academic medicine, I guess. I received Multiple awards, but they really second by far my satisfaction working in this environment.

[Dr. Cecilia Lansing]

I think that's good for other people to know that you can have all the accolades. But really what's important to someone like you is to be available for family. So that's great. But I'm sure not everything was smooth all the way. So what obstacles did you face face that was really challenging and because this is also part of the advice that you could give to junior faculty. So tell us about those.

[Dr. Guillermo Pierre]

Yeah, you know, as a young faculty member I didn't have much experience in doing clinical research. During my fellowship I did basic research and there was no much support or training as a faculty to develop a research experience. So Larry Phillips at that time was the division chief. He helped me some. But then somewhere around three or two or three years later after I joined the faculty, I was allowed to invite one professor from outside our institution and I invited Abbas Kitapji who at that time was the top notch guy in diabetic ketoacidosis. He was the one who did a lot of these studies to determine the frequency what happened to people with DK. And, and he accepted to come to Emory and when I was there I told him about my, my research that was about all these African American facing with DKA and I invited him to, to join my research at that time and to mentor me. So he, he, he, he, he accepted. So we did some number of studies with Avi and Larry Phillips and then a few years later when year 2000 when we got the Look Ahead trial, be part of the Look Ahead. I moved to Memphis, Tennessee for three years and Avi Kitachi was as the most incredible mentor. He would come to my office every day and see what are you doing. At that time we didn't have much computer system so he would use this red pen and mark all my papers and everything and always ask me why are you asking these questions? And made me think about why research should be done. And that's, that's, I think that's why it's what I took over in my research experience and, and now of course this is what I do for a living, I guess.

[Dr. Cecilia Lansing]

Yeah, no, that's great. So finding true mentorship, invested in your

[Dr. Guillermo Pierre]

success and, and that's the big challenge for junior people. That's right. I think that you Finish your training 3, 3 years internal medicine, 3 years of endocrinology fellowship. But that's not enough to find the right person to the right mentor to that will have time and support you I think is Is, is, is needed to be, I guess, successful in academic medicine. The problem that we have is that there are not too many people who would like to invest in junior faculties. But at that time I was lucky enough to get Abby.

[Dr. Cecilia Lansing]

I think that there is indeed somewhat of a shift in some resources for medical school and training. But there are still great institutions who are keeping that tradition, which is good. So tell us about your research nowadays. What are you into?

[Dr. Guillermo Pierre]

So for the past 15, maybe 20 years, I've been very involved in inpatient diabetes care or hospital diabetes care. That was my job description. So we started doing the first studies. It was very observational what happened to patients in the hospital. I remember in 2002 we published a paper that now has over a thousand citationists that just a description of patients who present with hyperglycemia in the hospital. And we showed that, you know, 36% have high blood glucose, 12% was newly diagnosed with stress related hyperglycemia, and 20 plus percent were patient with diabetes. And those patients had increased mortality and increased complications rate. Even those with newly diagnosed diabetes, they have more complications than those with previously known diabetes. The other thing that we learned is that the glycemic control was terrible. And in 2000, oh my goodness, people run, go around even with bypass surgery with glucose in the 200s. So we implemented in inpatient diabetes care, wrote some protocols, trying to change the outcome. And I continue to do this and we're lucky to get good faculty, junior faculty joining us. And many of them are extreme, most of them are extremely successful with care worth who are one now and they have their own line of investigation. But I think I have been blessed by having good people and a good institution.

[Dr. Cecilia Lansing]

I remember that article that you mentioned and I have cited it several times myself. I think it really pushed the envelope towards better inpatient diabetes management. And many hospitals now have dedicated teams just to see patients with diabetes and not necessarily endocrine.

[Dr. Guillermo Pierre]

So and if I tell you something, I mean, this is life. That's right. And in 2001, Grif Vandenberg, who is a good friend of mine, published the paper of the surgical patients in the icu. And we came with this paper at more or less at the same time with just a couple of months difference. And of course that's what everybody became very interested in patient diabetes care greatly in the icu. Our team in the non ICU settings. Lucky me. Yes.

[Dr. Cecilia Lansing]

Great partnerships all along. That's great. So when you're not thinking of medicine, what do you do? What are your hobbies? Where have you been going? What are your favorite places to visit in the world?

[Dr. Guillermo Pierre]

Well, my hobbies are going to the gym or walking or running. And I try to do exercise at least 5, 6 days a week if I can. Every day, I guess. And that's my main hobby, I guess, exercising and unfortunately working, I guess, or spending time with family. Last few years. Our granddaughters now are growing so we try to take them to different trips within the United States and abroad. And because of diabetes research, I'm being invited to give lectures all around the world. So I travel. Maybe too much according to my wife, but I do enjoy traveling a lot. If you ask me what's my favorite place, it would be a battle between Europe and Latin America, I guess.

[Dr. Cecilia Lansing]

Yeah, no, that's good. So do you have any parting words for the people who are trying to again forge through their careers in medicine? What would be your take home message for them?

[Dr. Guillermo Pierre]

Yeah, well, especially for the fellows and I meet with them and I tell them about academic medicine and the same like myself, when I finished my fellowship I was offered a job to do research and said no, I'm a clinician. I'm a clinician educator. And of course I didn't want to spend at that time my life writing papers and grants with study. So I was more mostly dedicated to do education and patient care accreditation, but of course some research. And I was happy to just publish a couple of papers a year, but that number increase with time. And I think the fellows need to know that diabetes in academic medicine is important because it allows you to do education, patient care and research. And for most fellows, I believe when they finish their training, they are very comfortable in patient care as an adult patient. But if you find the right person, the right environment to do research within your institution or outside your institution, then you can start doing research. No, very few people have great ideas. When you're a fellow that doesn't happen too often. So take in consideration that it's going to be several years until you are independent investigator. And that's where we have practiced and we have had I think like 7 or 8k awardees in the last 10 years in our institution because we work as a group. The other thing is that for junior faculties is join a group of people who are willing to invest in education, teaching and research because in that way you have more ideas and try to meet for research in your institution at least once a month to discuss ideas. And unfortunately most institutions that I visit, that doesn't happen. So you say you have to do research you need to have a good environment, a good team, supportive team to be able to take off with research projects.

[Dr. Cecilia Lansing]

I think it is great if you are surrounded by people who are invested in your academic career. So I'm glad to hear that you're passing it to the next generation. Again. What you have done and what you continue to do inspires many people. So thank you and it was a pleasure conducting this interview with you. Thank you Guillermo, thank you so much

[Dr. Guillermo Pierre]

and for the opportunity to share my little experience in life. The other thing for junior faculty is that enjoy what you do and celebrate your little successes of a little paper, a big paper because that will keep you going.

[Dr. Cecilia Lansing]

Now that's good advice because it can't always be just the large multi center grants that will make your day. So thank you.

[Dr. Guillermo Pierre]

Thank you.

[ACE Podcasts Host]

Thanks for listening to another great ACE podcast. Join us for another [e-mail] podcasts and help us in our mission to elevate clinical endocrinology. Together we are ACE.