Endocrinology & Metabolism

• Diabetic ketoacidosis
• Hyperosmolar hyperglycemic state
• Adrenal crisis or new adrenal insufficiency
• Severe hypercalcemia (>3.50 mmol/L or symptoms)

Process
1) PHONE 902-473-2220 "Endocrinologist on call"

• Newly diagnosed Type 1 diabetes
• Hypercalcemia >3 mmol/L
• Hypocalcemia < 2 mmol/L albumin-corrected calcium
• Hypertriglyceridemia > 20 mmol/L
• Decompensated diabetes insipidus
• Severe hyperthyroidism
• Pituitary tumor with visual impairment

Process
1) FAX referral marked URGENT
2) OR PHONE 902-473-2220 "Endocrinologist on call"

• Hyperthyroidism
• Severe hypothyroidism
• Pituitary tumour
• Diabetes A1C>12
• Suspected osteoporosis with new hip or vertebral fracture
• Suspected pheochromocytoma
• Suspected Cushing’s syndrome
• Enlarging thyroid nodule/abnormal result on thyroid biopsy

Process
1) FAX referral

• Any diabetes not at target or with management difficulties (e.g. hypoglycemia)
• Type 1 diabetes
• Diabetes on insulin pump
• Transgender
• Hypercalcemia < 3 mmol/L or hypocalcemia
• Osteoporosis
• Other non-osteoporosis bone disorders (e.g. Paget’s disease, rickets, osteogenesis imperfecta)
• PCOS/Hirsutism
• Thyroid lump
• Endocrine hypertension
• Hyperlipidemia
• Adrenal adenoma
• Stable hypoadrenalism
• Male hypogonadism
• Morbid obesity

Process
1) FAX referral