Information Articles

Diabetes (General)
WASIM HAQUE M.D., F.A.C.E.

Are you at risk of developing diabetes?

Diabetes Mellitus (DM) is a group of conditions in which blood glucose (BG) levels are elevated.   The 3 most common types of diabetes are: DM may lead to serious complications.  The best strategy is to try and prevent DM from occurring.  Therefore, it is useful to understand who is at risk of developing DM

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General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Dexamethasone Suppression Test

A screening test for Cushing syndrome! Step 1: Go to the lab and get the first set of blood tests around 8-9 am. (Serum ACTH and cortisol level) Step 2:  Take one tablet of Dexamethasone (1 mg.) at 11 pm with a snack (this should be done the night before the second blood test and

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Nutrition
WASIM HAQUE M.D., F.A.C.E.

Diet and Exercise in Diabetes Mellitus

Diet and exercise are the key elements in managing diabetes successfully in the long term.  It is important to understand the key elements of a successful strategy.  Some of these are: 1. SET REASONABLE GOALS:   To keep yourself motivated and avoid frustration, set reasonable goals. Studies show that people who lose weight gradually and steadily have

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Diabetes (General)
WASIM HAQUE M.D., F.A.C.E.

Gestational Diabetes Mellitus – 1 (Clinical Features & Diagnosis)

Clinical Features and Diagnosis Background: Diabetes mellitus (DM) is a group of disorders in which blood glucose (BG) levels are higher than normal. Glucose is a simple sugar and is the final single-unit molecule produced as the body digests and breaks down all the carbohydrates. Glucose is then absorbed from small intestines and travels in

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General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Cushing Syndrome

The adrenal gland is a triangular-shaped gland that sits on top of each kidney. Cortisol is one of the key hormones in our body and is made by the adrenal gland. Cortisol production is regulated by multiple steps in the brain. A part of the brain called the hypothalamus makes a hormone called ‘CRH.’ CRH

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General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Hypercalciuria

Calcium is an important electrolyte that regulates vital physiologic processes in the body including hormonal secretion, cardiac contraction, and blood clotting. It also helps to grow and repair our skeletons.  Hypercalciuria is defined as excess calcium in the urine. It occurs in 5%-10% of the adult population. This excess calcium may come from the intestines,

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Thyroid
WASIM HAQUE M.D., F.A.C.E.

Hyperthyroidism

What is hyperthyroidism?  Hyperthyroidism is a condition in which the thyroid gland produces too much thyroid hormone. When this occurs, the body’s metabolism is increased, which can cause a variety of symptoms.  These symptoms may include: Untreated mild cases may cause no symptoms (subclinical hyperthyroidism) but may lead to osteoporosis or heart irregularities.  What causes

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General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Adrenal Insufficiency

The human body has two adrenal glands, one above each kidney. Adrenal glands normally produce 3 different classes of steroid hormones:  Normal adrenal gland hormone production depends on hormonal signals from the pituitary gland, which in turn depends on hormonal signals from the hypothalamus. The pituitary and hypothalamus are glands in the brain.  Adrenal insufficiency

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General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Low T levels

Hypogonadism (Deficiency of Testosterone) Hypogonadism is the inability of the testes (testicles) to produce testosterone or sperm or both. Testosterone is a hormone that plays an important part in the development and maintenance of typical male masculine characteristics. In adult males, testosterone maintains muscle mass and strength, fat distribution and bone mass as well. Testosterone

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Nutrition
WASIM HAQUE M.D., F.A.C.E.

Nutrition – Low Iodine Diet

Low Iodine Diet Food Group  Allowed  Not Allowed  DAIRY  None  Ice cream, cheese, milk, yogurt, sour cream  EGGS  None  All egg containing products  SEAFOOD  None  Specially shellfish, kelp, sardines, canned tuna  SALT  Non-iodized salt  Iodized salt, Sea salt  MEATS   Fresh chicken, turkey or beef  Canned, dried, salted, cured meats (sausage, ham, chipped beef,liver, beef stew, bacon,

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Thyroid
WASIM HAQUE M.D., F.A.C.E.

Radioiodine therapy for thyroid cancer (General Information)

Radioiodine Therapy For Thyroid Cancer (General Information) Thyroid cells have the capacity to take up iodine and iodine is essential for the growth and function of thyroid cells. This principle is utilized in radioiodine treatment of thyroid cancers after initial surgery. Radioactive iodine (called I131) can seek out and destroy any remaining thyroid cells (including

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Thyroid
WASIM HAQUE M.D., F.A.C.E.

Goitre & Thyroid nodules

Goitre & Thyroid Nodules WHAT IS A GOITER?  A goitre is an enlarged thyroid gland. A goitre can mean that the whole thyroid gland is swollen or enlarged (Simple Goiter), or one or more swellings or lumps develop in part or parts of the thyroid (Nodular Goiter).  The thyroid gland makes thyroid hormones -called thyroxine

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Thyroid
WASIM HAQUE M.D., F.A.C.E.

Hypothyroidism

The thyroid gland is located in the lower part of the front of the neck. It is responsible for the formation and secretion of thyroid hormones. Around 90% of the hormone made by the thyroid gland is thyroxine (T4) which is inactive, and 10% is the active thyroid hormone called triiodothyronine (T3). T4 is released

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Nutrition
WASIM HAQUE M.D., F.A.C.E.

Nutrition – Diet to lower blood pressure

High Blood Pressure What is high blood pressure & why is it dangerous?  High blood pressure (also called hypertension) is a condition in which blood pressure remains elevated (generally greater than 140/90).  Hypertension increases the work your heart is to perform which can lead to heart damage over time called congestive heart failure.  In addition,

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Nutrition
WASIM HAQUE M.D., F.A.C.E.

High Blood Triglyceride Levels

High Blood Triglyceride Levels Triglycerides (TG) are a type of blood fat.  They are called triglycerides because their backbone is a form of glucose called glycerol and 3 fatty acids are attached to this backbone.  They may be saturated, unsaturated on both. Fatty acids are the building blocks of fat.    Fig 1: Triglyceride structure:  We

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Nutrition
WASIM HAQUE M.D., F.A.C.E.

Nutrition – Tips for Weight Loss & Maintenance

Tips for Weight Loss and Maintenance  Post DisclaimerWe are not your healthcare provider, and your use of this website does not establish a patient-client relationship.  All the information contained on this website is for informational purposes only.  No material on this site is intended to be a substitute for professional medical advice (diagnosis, treatment, testing or nutritional information).  Always seek

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Insulin Pump Basics

Normal insulin release The pancreas is an organ in the upper abdomen that releases insulin in two ways: What is an insulin pump?  Insulin pump therapy is part of the wave of new advances in medical technology that has revolutionized the management of diabetes.  Insulin pumps deliver rapid-acting insulin in a manner that closely mimics

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Insulin Preparations & Insulin Treatment

Insulin Preparations & Insulin Treatment Insulin is the hormone that helps our body use glucose (sugar). In diabetes, the body is unable to use glucose because of deficiency or ineffectiveness of insulin. In type 1 diabetes, the body can not make insulin. In type 2 diabetes, the body can make insulin but does not respond

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Diabetes Complications
WASIM HAQUE M.D., F.A.C.E.

Diabetic Neuropathy

Diabetes is a chronic and common condition in which blood glucose BG (sugar) level is increased. It can be controlled with diet, exercise, medications or insulin depending on the type of diabetes. Untreated, high BG may damage nerves either directly or because the blood supply to the nerves is reduced as a result of diabetes-related

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Diabetes Meds – An Overview 2022

Diabetes (a disease in which blood sugar is high) is a chronic lifelong condition. Broadly speaking, diabetes can be divided into two types. Type 1 diabetes occurs when the insulin-producing cells in the pancreas are destroyed by the immune system (autoimmune). Type 2 diabetes occurs in people who are generally overweight or inactive and have

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Diabetes Meds – Trulicity

Trulicity What is Trulicity?  Trulicity® (Dulaglutide) is a once-a-week, injectable medicine indicated to manage type 2 diabetes or to reduce the risk of future cardiovascular events in people with type 2 diabetes.  It mimics the action of GLP-1, and naturally occurring hormone that helps to regulate blood glucose levels.  By binding to and activating the

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Diabetes Meds – Ozempic

Ozempic  What is Ozempic?  Ozempic® (Semagltide) is a once a week, injectable medicine indicated to manage type 2 diabetes or to reduce the risk of future cardiovascular events in people with type 2 diabetes.  It mimics the action of GLP-1, and naturally occurring hormone that helps to regulate blood glucose levels.  By binding to and

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Diabetes Meds – GLP-1 Analogs

Glp-1 & Gip analogs for diabetes treatment  (Ozempic®, Trulicity®, bydureon®, rybelsus®)  Insulin is a hormone produced by the pancreas which help movement of glucose from our blood into our cells and tissues. Diabetes mellitus is a disorder in which blood glucose (BG) is higher than normal.  This occurs because of insufficient insulin release from the

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Diabetes Meds – Metformin

Metformin (Glucophage)  Metformin is the most prescribed initial medication for patients with type 2 diabetes, when lifestyle interventions (diet and increased exercise) are not enough to control blood glucose levels (BG).  Insulin is a hormone produced by the pancreas which help movement of glucose from our blood into our cells and tissues. Diabetes mellitus is

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Diabetes Meds – SGLT 2 Inhibitors

SGLT 2 Inhibitors Most diabetes experts now recommend SGLT-2 inhibitors as the first line choice for patients with type 2 diabetes.  Compared to most other diabetes medications, and these agents have the unique ability to improve diabetes control & protect the heart and the kidney.  These medicines work by promoting excretion of glucose in the

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Diabetes (General)
WASIM HAQUE M.D., F.A.C.E.

Dietary Guidelines – Gestational Diabetes

Dietary Guidelines: The first and the most important step in the management of Gestational Diabetes Mellitus (GDM) is to refer the patient for medical nutritional counseling and diabetes self-management coaching through a certified diabetes educator (CDE).  Patient education should address the following topics: Because of an increase in blood volume during pregnancy, normal BG and

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Nutrition
WASIM HAQUE M.D., F.A.C.E.

Nutrition -Tips for Weight Loss and Maintenance

Tips for Weight Loss and Maintenance  This information is for general knowledge & is not a substitute for medical advice from your doctor.  Post DisclaimerWe are not your healthcare provider, and your use of this website does not establish a patient-client relationship.  All the information contained on this website is for informational purposes only.  No material on this site is

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Diabetes (General)
WASIM HAQUE M.D., F.A.C.E.

Sick Day Rules – Type 2 Diabetes

Sick Day Rules – Type 2 Diabetes Insulin is a hormone produced by the pancreas to help our body utilize sugar and other starches. In diabetes, blood glucose (BG) levels are high because of absence of insulin production (type 1 diabetes) or deficiency of insulin plus insulin resistance (type 2 diabetes).  Type 2 diabetes is

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Diabetes (General)
WASIM HAQUE M.D., F.A.C.E.

Sick Day Rules – Type 1 Diabetes

Sick Day Rules for Patients with Type 1 Diabetes Mellitus  Insulin Pump Patient  When you are sick you may notice that your blood sugars are higher than usual. This is usually a result of your body producing stress hormones to compensate for your illness. You may also experience low blood sugar, perhaps due to decreased

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Diabetes (General)
WASIM HAQUE M.D., F.A.C.E.

Diabetes Distress

For many patients, the management of diabetes mellitus can be a complex and often overwhelming task. This is because it involves many different components: planning meals, engaging in regular exercise, blood glucose monitoring, taking medication on time (often coordinating them with a busy life, variable schedules, and, work or home commitments), taking time out for

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Diabetes Complications
WASIM HAQUE M.D., F.A.C.E.

Hypoglycemia in Diabetes Mellitus

Insulin is a hormone produced by the pancreas and released into the blood. Insulin helps our body utilize sugar and other starches. In diabetes, blood glucose (BG) levels are high because of the absence of insulin production (type 1 diabetes) or a relative deficiency of insulin plus insulin resistance (type 2 diabetes).  Diabetes is managed

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Diabetes (Medications)
WASIM HAQUE M.D., F.A.C.E.

Insulin Preparations & Insulin Treatment

Insulin is the hormone that helps our body use glucose (sugar). In diabetes, our body is unable to use glucose because of deficiency or ineffectiveness of insulin. In type 1 diabetes, the body cannot make insulin. In type 2 diabetes, the body can make insulin but does not respond to it (called insulin resistance). Treatment

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Nutrition
WASIM HAQUE M.D., F.A.C.E.

Nutrition – Diet and Exercise in Diabetes

Lifestyle Changes, Obesity & Diabetes  FIBER: Food items with high fibre such as beans, whole grains, fruit with peel and green leafy vegetables (broccoli, carrots and leafy greens are recommended.  Look for food with 2.5 or more grams of fibre per serving (fruits, vegetables, and whole grains). Fibre slows down absorption and helps stabilize blood

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Diabetes (General)
WASIM HAQUE M.D., F.A.C.E.

Diabetes Care – Basic Information

Care of Patients with Type 2 Diabetes                                Diabetes (a disease-causing high blood sugar) is a chronic, lifelong condition that can lead to various serious complications. These complications include heart attacks, strokes, kidney failure, leg amputation, impotence, and blindness. Reasonable control of blood glucose (BG) can help prevent these complications.   Type 2 diabetes occurs in people

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thyroid, endocrine, diabetes-1405039.jpg
General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Adrenal Insufficiency

Your body has two adrenal glands. Each gland is located above a kidney. The adrenal gland normally produces 3 different classes of steroid hormones: Glucocorticoids (cortisol), mineralocorticoids (mainly aldosterone), and androgens (DHEA).  Cortisol helps the body deal with stress and is involved in the regulation of glucose, protein and fat metabolism.  It also affects the

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thyroid, endocrine, diabetes-1405039.jpg
General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Adrenal Insufficiency instructions for Stress Dosing

  The adrenal glands normally produce 3 different hormones – cortisol, aldosterone, and DHEA (Dehydroepiandrosterone).  Cortisol helps the body deal with stress and is involved in the regulation of metabolism, blood pressure, and the immune system.  Aldosterone plays a vital role in controlling blood pressure and in maintaining normal blood electrolyte levels.   DHEA is

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General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

LAB TESTS & WHAT THEY MEAN

This table outlines some of the common lab tests ordered by endocrinologists & provides some information about them. Test What it means Average/Normal range Creatinine (Cr) A waste product of metabolism: excreted by the kidney: if it is ↑means kidney function is lower. Usually < 1.1 to 1.3 eGFR An estimate of kidney function. Calculated

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General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Hypogonadism (Deficiency of testosterone)

Hypogonadism is the inability of the testes (testicles) to produce testosterone or sperm or both. Testosterone is a hormone that plays an important part in the development and maintenance of typical male masculine characteristics. In adult males, testosterone maintains muscle mass and strength, fat distribution and bone mass as well. Testosterone determines sex drive and

Read More »
thyroid, endocrine, diabetes-1405039.jpg
General Endocrinology
WASIM HAQUE M.D., F.A.C.E.

Do you have Low T levels? Read this before you start treatment

Testosterone is the male sex hormone and controls normal male sex drive & sperm production. Testosterone also helps maintain bone strength, muscle strength, red blood cell production and physical stamina in men. As you age, your Testosterone level (T Level) gradually declines (~1% per year after age 30-40). It is important to differentiate between the

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Diabetes Complications
WASIM HAQUE M.D., F.A.C.E.

Diabetic Neuropathy

Diabetes is a chronic and common condition in which blood glucose BG (sugar) level is increased. It can be controlled with diet, exercise, medications or insulin depending on the type of diabetes. Untreated, high BG may damage nerves either directly or because the blood supply to the nerves is reduced as a result of diabetes-related

Read More »
Nutrition
WASIM HAQUE M.D., F.A.C.E.

LOW IODINE DIET

An important part of radioiodine treatment – allows radioiodine to enter thyroid cells (normal or cancerous that were not visible to the surgeon or could not be removed) Generally started 2 weeks before the radioactive iodine therapy for thyroid cancer patients. Usually needs to be continued until the whole-body-scan is completed (7 days after the

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Diabetes (General)
WASIM HAQUE M.D., F.A.C.E.

Care of Patients with Type 2 Diabetes

Diabetes (a disease-causing high blood sugar) is a chronic, lifelong condition that can lead to a variety of serious complications. These complications include heart attacks, strokes, kidney failure, leg amputation, impotence and blindness. Good control of blood glucose (BG) can help prevent these complications.  Type 2 diabetes occurs in people who are generally overweight or

Read More »