Internal Medicine - Endocrinology

Clinical Programs

Diabetes Outpatient Intensive Treatment Program

Our diabetes program offers comprehensive evaluation and treatment of diabetes and related complications. Particular expertise includes diabetes care in the setting of organ transplant, peri-operative care, extreme insulin resistance (patients needing > 200 units insulin/day) and patients with multiple diabetes complications. We provide diabetes care and education for adults with diabetes, including those with type 1 diabetes, type 2 diabetes, other types of diabetes, and diabetes in pregnancy. Our program offers a number of services including:

• Intensive insulin therapies, including pump therapy and 72 hour continuous glucose monitoring
• Comprehensive diabetes education by our American Association of Diabetes Educators (AADE)-certified program
• Computer-assisted glucose monitoring and analysis
• Pharmacotherapies for Type 2 diabetes
• Clinical research involving new treatment therapies

Self-management training services are offered covering a complete range of topics related to your diabetes. The focus of the program is personal goal setting and the development of a plan to help you achieve your goals. The UK Diabetes Program has access to research in the latest developments in diabetes care. A variety of topics and management options are offered.

1. Blood sugar monitoring, sick day rules, traveling guidelines, intensive insulin injection programs and insulin pump therapy.
2. Individualized eating program tailored to your lifestyle, habits and medical needs. Instructions on eating out, shopping techniques, and weight-reducing diets.
3. Our certified educators offer innovative, effective instruction incorporating diabetes management into an active lifestyle.

Diabetes One Stop Clinic

The Diabetes One Stop clinic is a half day comprehensive evaluation and educational opportunity for individuals who want a streamlined experience regarding their disease status and an in depth educational opportunity. This includes an early visit to the lab followed by a diabetes eye exam, educational sessions with 2 certified diabetes educators on nutrition and all aspects of self care including medication management. The clinic is concluded with a physician visit including comprehensive exam and written summary of labs, disease status and a hard copy of goals and treatment recommendations. Appointments are available through our usual scheduling systems.

Obesity Management

Our obesity program is aimed at medical management of complications associated with obesity, including hypertension, diabetes, metabolic syndrome and lipid and cholesterol disorders. Patients are offered comprehensive evaluation by endocrinology providers, laboratory assessment, dietician counseling, and a group therapy lifestyle intervention class. Treatment programs include:

• Low-calorie diets
• Lifestyle changes through the incorporation of group therapies
• Clinical investigations
• New nutritional applications

In co-operation with the University of Kentucky, Division faculty and senior trainees provide medical supervision for the HMR Program, an intensive multidisciplinary weight loss program located at Tates Creek Center. Further information is available at Health Management Resources

Lipid and Cholesterol Problems

Elevated levels of cholesterol and/or triglycerides are associated with increased rates of cardiovascular disease. In this clinic patients will receive expert advice for lipid/ cholesterol management based on current research and their individual needs. We particularly specialize in the treatment of cholesterol and triglyceride disorders in the setting of complex metabolic disease, such as diabetes, kidney disease, and metabolic syndrome. Resources include dietician counseling and medication management.

Thyroid Disease

Thyroid disorders are among the most common endocrine disorders and can present in a variety of ways, including over-activity of the thyroid, under-activity of the thyroid, inflammation of the thyroid (“thyroiditis”), thyroid nodules, or thyroid cancers. The appropriate adjustment of thyroid hormone levels can improve blood cholesterol and triglycerides, improve energy levels and mood, and can greatly improve overall quality of life. Our thyroid program includes comprehensive laboratory assessment of thyroid function and thyroid imaging including collaboration with Nuclear Medicine assessments, and thyroid ultrasounds and fine needle biopsies performed in clinic by Endocrine Certification of Neck Ultrasound (ECNU) accredited providers. In the case of thyroid cancer diagnoses patients are referred to our unique thyroid cancer program.

Thyroid Cancer

Under the direction of Kenneth B. Ain, MD, the UK Thyroid Oncology Program has been an internationally recognized program of excellence in the management of thyroid cancer for the past two decades. We are pleased to see all thyroid cancer patients for state-of-the-art care. At the UK Thyroid Oncology Program, we use a team approach to develop effective, consistent and comprehensive health care plans for every patient. We welcome all patients with thyroid masses and malignancies, including those with new thyroid nodules, those with thyroid nodules/masses that have been biopsied as suspicious or malignant, and post-operative thyroid cancer patients. In addition, the UK Thyroid Oncology Program has extensive experience helping patients with highly aggressive and/or disseminated thyroid cancers that have proven difficult to treat with standard therapies. We have served such patients from all regions of North America and nearly every continent. We pride ourselves on our efforts to educate and involve patients in their treatment plans, as well on our attention to maintaining communication with all primary and referring physicians.

Adrenal Disorders and Endocrine Hypertension

Adrenal tumors, endocrine hypertension, or abnormal adrenal hormone function require careful evaluation and management by experienced providers. Patients will receive comprehensive hormonal assessment including dynamic and intra-vascular measurements if needed, adrenal imaging, and hormonal management. We work closely with endocrine surgeons to co-manage patients with adrenal tumors.

Bone Disease and Osteoporosis Management

Low bone density and osteoporosis are common and can be treated medically. Our providers have expertise in assessment of bone density, including evaluation and screening for associated causes, and therapeutic options. Bone density assessments can be performed at the University of Kentucky, or patients can bring in outside records for assessment.

Calcium Disorders

Disorders of calcium homeostasis can include elevated levels of calcium that is often asymptomatic or decreased levels of calcium. Abnormal calcium levels are often found incidentally on laboratory blood work. Our evaluation of patients with calcium disorders includes diagnostic assessment, analyses of bone such as Dual energy X-ray absorptiometry (DEXA) bone mass measurements, and assessment of need for surgery. We work in close collaboration with the Endocrine Surgery group and provide both pre- and post-operative assessments in individuals needing neck surgery.

Pediatric to Adult Endocrine Care Transition

As children reach maturity they need to transition their care to adult endocrinologists. We work in close collaboration with the pediatric endocrine group at the University of Kentucky, and will transition care to address the needs of the individual.

Pituitary Gland Disease

Our pituitary program includes comprehensive diagnosis, treatment and follow up of pituitary tumors or other hormonal issues with the pituitary. This includes collaboration with Radiology and Neurosurgery for measurement and monitoring of pituitary gland tumors, pre and post-operative pituitary hormone assessments, and hormone replacement and monitoring. Evaluation mechanisms include:

• Stimulation and suppression testing to evaluate function of the pituitary gland
• Magnetic Resonance Imaging (MRI) / computerized axial tomography (CT) scans for visualization of a pituitary mass

Treatments include:

• Neurosurgical consultation and procedural evaluation
• Hormonal replacement therapies
• New medical therapies

Low Testosterone

Low testosterone levels can affect libido, energy, strength, body weight and cholesterol levels. We provide comprehensive diagnostic testing and testosterone replacement therapy for adult men with low testosterone, including monitoring of safety and side effects.

Transgender Care

Our transgender management program offers comprehensive evaluation and hormonal management of transgendered individuals (both MTF and FTM). Unfortunately we do not provide care for children. To schedule an appointment please call 859-323-2232 and have your primary care provider and/or therapist fax a letter to 859-257-2637. To facilitate your evaluation, current (within the last six months) laboratory evaluations are required, including fasting lipid panel, metabolic panel, liver function tests, and a blood count or hemogram. These can be obtained from your primary care provider.