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Kenneth Cusi, M.D., F.A.C.P., F.A.C.E.

Adult Medical Director, UF Diabetes Institute

Dr. Cusi received his medical degree in Argentina from the University of Buenos Aires School of Medicine and is board certified in both Internal Medicine and Endocrinology, Diabetes & Metabolism.  He completed his residency at the Center of Medical Education & Clinical Research (CEMIC) in Buenos Aires, Argentina, and a clinical fellowship at Baylor College of Medicine in Houston. Prior to joining the University of Florida, Dr. Cusi was a faculty member of over 15 years in the Diabetes Division at the University of Texas Health Science Center at San Antonio (UTHSCSA) and the Veterans Health Administration System in Texas; one of the leading diabetes programs in the country.  He is a fellow of the American College of Physicians (ACP) and the American Association of Clinical Endocrinologists (AACE).

Dr. Cusi currently serves as Chief of the Adult Division of Endocrinology, Diabetes & Metabolism in the Department of Medicine at the University of Florida. He oversees all adult endocrinology/diabetes inpatient consult activities and outpatient clinics at UF, Shands and the VAMC with the mission to provide the highest level of clinical care. He serves as a mentor for all clinical and laboratory research efforts, as well as mentors faculty and fellows in the division to help UF Health take the next step in becoming an international leader in adult diabetes, metabolism, and obesity.  His experience in diabetes prior to UF was in the department of medicine at the University of Texas Health Science Center at San Antonio for more than 15 years. Cusi is the principal investigator of various ongoing clinical translational research projects in obesity, Type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD).

Dr. Cusi has found in screening studies that most obese patients with T2DM have a fatty liver (as many as four out of five). This poses considerable long-term health risks: dyslipidemia, cardiovascular disease and liver damage. He discovered in a pilot study that pioglitazone (Actos), a drug used in the treatment of T2DM, may reverse a fatty liver in patients with prediabetes or T2DM (Belfort et al, NEJM 2006). Most recently, Dr. Cusi’s laboratory completed the first long-term study (presented at the June 2013 American Diabetes Association annual meeting) that has confirmed and extended the original findings about the efficacy of pioglitazone in obese patients with T2DM and a fatty liver (Cusi et al, Diabetes, suppl 1, 2013).

Research Interests

Dr. Cusi is the principal investigator of various ongoing clinical translational research projects in obesity, Type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD), particularly in Hispanics. His grants focus on cutting-edge research in adult endocrinology, diabetes and metabolism, both on clinical and basic research aspects related to the role of obesity and lipotoxicity in the development of Type 2 diabetes and its complications, in particular, the pathogenesis of NAFLD.  He has published more than 90 original articles, invited reviews and book chapters in the main journals in the fields of obesity, diabetes and liver disease.  Dr. Cusi is a nationally and internationally recognized investigator and speaker on the impact of NAFLD in humans, including a frequently cited paper in the New England Journal of Medicine on the first effective pharmacological agent for the treatment of NAFLD, a common and potentially serious complication of obesity and T2DM that may lead to severe liver damage. He is a reviewer in numerous scientific journals and has also served in various leadership positions within the Southwest Chapter of the National Lipid Association, the American Diabetes Association (current member of the ADA Research Grant Review Committee, collaborator in past ADA scientific sessions planning committees, past president of the San Antonio Chapter 2009-2010), and the American Association of Clinical Endocrinologists (AACE), including past President of the Texas Chapter (2008-2009). Dr. Cusi is also vice-president and co-founder of Children in Need, Inc., an organization created to assist disadvantaged children and their families in third world countries, with emphasis on hospitals and schools in Southern Africa. All activities aim to increase awareness about diabetes and other endocrine conditions and improve patient care.

Staff

Publications

  1. Ortiz-Lopez C, Lomonaco R, Orsak B, Finch J, Chang Z, Kochunov V, Hardies J, Cusi K.  Prevalence of prediabetes and diabetes and metabolic profile of patients with nonalcoholic fatty liver disease (NAFLD).Diabetes Care 2012, in press.
  2. Lomonaco R, Ortiz-Lopez C, Orsak B, Webb A, Hardies J, Darland C, Finch J, Gastaldelli A, Harrison S, Tio F, Cusi K. Effect of adipose tissue insulin resistance on metabolic parameters and liver histology in patients with NAFLD.  Hepatology 2012, in press.
  3. Lomonaco R, Ortiz-Lopez C, Orsak B, Finch J, Webb A, Bril F, Louden C, Tio F, Cusi K. Role of ethnicity in overweight and obese subjects with nonalcoholic steatohepatitis (NASH) Hepatology 54:837-845, 2011
  4. Wang S, Kamat A, Pergola P, Swamy A, Tio F, Cusi K. Metabolic factors in the development of hepatic steatosis and altered mitochondrial gene expression in vivo.  Metabolism 60:1090-99, 2011
  5. Ortiz-Lopez C, Policarpio-Nicolas ML, Cusi K. Effect of pioglitazone in a patient with impaired glucose tolerance and NASH. Diabetes Management August 2011.
  6. Belfort R, Berria R, Cornell J, Cusi K. Fenofibrate reduces systemic inflammation markers independent of its effects on lipid and glucose metabolism in patients with the metabolic syndrome. JCEM 95:829-36, 2010
  7. Jones P, Cusi K, Davidson MH, Kelly MT, Setze CM, Thakker K, Sleep D, Stolzenbach JC. Efficacy and safety of fenofibric acid co-administered with low- or moderate-dose statin in patients with mixed dyslipidemia and Type 2 diabetes mellitus: results from a pooled subgroup analysis from three randomized, controlled, double-blind trials. Amer J Cardiovascular Drugs 10:73-84, 2010
  8. Glass L, Cusi K, Berria R, Petz R, Cersosimo E, DeFronzo RA, Gastaldelli A. Pioglitazone improvement of fasting and postprandial hyperglycemia in Mexican-American patients with Type 2 diabetes: a double tracer OGTT study. Clinical Endocrinology 73:339-45, 2010
  9. Gastaldelli A, Harrison S, Belfort-Aguiar, A, Hardies J, Balas B, Schenker S, MD, Cusi K. Pioglitazone in the treatment of NASH: role of adiponectin. Alimentary Pharmacology & Therapeutics 32:769-75, 2010
  10. Mathew M, Tay E, Cusi K. Elevated plasma free fatty acids increase cardiovascular risk by inducing plasma biomarkers of endothelial activation, myeloperoxidase and PAI-1 in healthy subjects. Cardiovascular Diabetology 16:9-15, 2010
  11. Gastaldelli A, Harrison S, Belfort R, Hardies J, Balas, B, Schenker S, Cusi K. Importance of changes in adipose tissue insulin resistance to histological response during thiazolidinedione treatment of patients with nonalcoholic steatohepatitis. Hepatology 50:1087-93, 2009
  12. Cusi K, Kashyap S, Belfort R, Bajaj M, Cersosimo E, Lee, S.  Effects on insulin secretion and action of short-term reduction of plasma free fatty acids with acipimox in  non-diabetic subjects genetically predisposed to Type 2 diabetes.  Am J Physiol 292:E1775-81, 2007
  13. Belfort, R, Harrison S, Brown K, Darland C, Finch J, Balas B, Gastaldelli A, Tio F, Hardies J, Pulcini J, Berria R, Ma JZ, Dwivedi S, Havranek R, Fincke C, DeFronzo RA, Bannayan GA, Schenker S, Cusi K. A placebo controlled trial of pioglitazone in patients with non-alcoholic steatohepatitis (NASH). New Engl J Med355:2297-2307, 2006
  14. Belfort R, Mandarino L, Kashyap S, Wirfel K, Berria R, Pratipanawatr T, DeFronzo RA, Cusi K. Dose response effect of elevated plasma FFA on insulin signaling.  Diabetes 54:1640-48, 2005
  15. Kashyap SR, Belfort R, Berria R, Suraamornkul S, Pratipranawatr T, Finlayson J, Barrentine A, Bajaj M, Mandarino L, DeFronzo R, Cusi K.  Discordant effects of a chronic physiological increase in plasma FFA on insulin signaling in healthy subjects with or without a family history of type 2 diabetes. Am J Physiol287:E537-46, 2004
  16. Kashyap S, Belfort R, Gastaldelli A, Pratipanawatr T, Berria R, Pratipanawatr W, Bajaj M, Mandarino L, DeFronzo R, Cusi K. A sustained increase in plasma free fatty acids impairs insulin secretion in non-diabetic subjects genetically predisposed to Type 2 diabetes. Diabetes 52:2461-2474, 2003
  17. Cusi K, DeFronzo RA. Recombinant human insulin-like growth factor I treatment for 1 week improves metabolic control in Type 2 diabetes by ameliorating hepatic and muscle insulin resistance. JCEM 85:3077-84, 2000
  18. Cusi K, Consoli A, DeFronzo RA.  Metabolic effects of metformin on glucose and lactate metabolism in non-insulin dependent diabetes mellitus. JCEM 81:4059-4067, 1996
  19. Cusi K, Maezono K, Osman A, Pendergrass M, Patti ME, Pranawatapatr T, DeFronzo RA, Kahn CR, Mandarino L. Insulin resistance differentially affects the PI 3-kinase and MAP kinase pathways of insulin receptor signaling in human muscle.  JCI 105:311-320, 2000
  20. Cusi K, Cunningham G, Comstock JP.  Safety and efficacy of normalizing fasting glucose with bedtime NPH insulin alone in NIDDM.  Diabetes Care 18:843-51, 1995

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