Frequently Asked Questions
Please see below for more information to commonly asked questions about endocrinology.
Endocrinology is a branch of medicine dealing with disorders of the endocrine system and its specific secretions called hormones. Although every organ system secretes and responds to hormones (including the brain, lungs, heart, intestine, skin and kidney), the clinical specialty of endocrinology focuses primarily on the endocrine organs, meaning the organs whose primary function is hormone secretion. These organs include the pituitary, thyroid, adrenals, ovaries, testes and pancreas.
Who is an endocrinologist?
An endocrinologist is a physician specialized in internal medicine the diagnosis and treatment of hormonal abnormalities, diabetes and metabolic diseases. Many endocrinologists are also involved in clinical science and medical research and hospital patient care. The evaluation and treatment of endocrine diseases are guided by laboratory tests to a greater extent than for most other specialties.
Many diseases are investigated through stimulation or suppression tests. This may involve injection with a stimulating agent to test the function of an endocrine gland. Blood is then drawn to assess the changes of the relevant hormones or metabolites. An endocrinologist needs extensive knowledge of clinical chemistry and biochemistry to understand the uses and limitations of the tests.
What type of medical training do endocrinologists receive?
Endocrinologists finish four years of medical school and then spend three or four years in an internship and residency program. These specialty programs cover internal medicine, pediatrics, or obstetrics and gynecology. They spend two or three more years of fellowship training learning how to diagnose and treat hormone conditions. Overall, an endocrinologist's training will take more than 10 years.
Who is a Nurse Practitioner?
A nurse practitioner (NP) is a registered nurse who has completed advanced education and training in diagnosis and treatment of medical conditions. Nurse practitioners are licensed by the state and have board certification in their area of practice. Nurse practitioners are able to specialize in an area of study that they desire and then provide care within the scope of their expertise. A NP can serve as a patient’s regular health care provider under the supervision of a physician. They can prescribe medications, order tests, diagnose and treat patients just as a physician would.
Who is a Physician Assistant?
A physician assistant (PA) is a licensed health professional who practices medicine under the supervision of a physician. A physician assistant provides a broad range of health care services. They perform physical exams, diagnose illnesses, develop and carry out treatment plans, order and interpret lab tests, provide preventive health care counseling and write prescriptions. Physician assistants are found in all areas of medicine and work closely with the physicians that they supervised by.
Who is a Clinical Research Coordinator?
The Clinical Research Coordinator (CRC) is responsible for conducting clinical trials using good clinical practice (GCP) under the auspices of the Principal Investigator (PI). All trials are conducted ethically, as defined by the Declaration of Helsinki, rigorously, as defined by the International Conference on Harmonization Guidelines.
What medical conditions do endocrinologists treat?
Endocrinologists treat a wide variety of medical conditions including:
- diabetes mellitus
- PCOS
- metabolic syndrome
- thyroid diseases (hyperthyroidism, hypothyroidism or underactive thyroid, thyroid nodules and cancer)
- pituitary disorders
- Cushing’s syndrome
- Congenital adrenal hyperplasia (CAH)
- metabolic disorders
- over or under production of hormones
- menopause
- bone disorders (Paget’s disease, osteoporosis and osteopenia)
- high blood pressure (primary aldosteronism, pheochromocytoma)
- high cholesterol
- infertility (male and female)
- growth disorders (short stature, tall stature)
- benign tumors, multiple Endocrine Neoplasia and cancers of the endocrine glands
- nutritional deficiencies
- obesity
- acne, hair loss, excessive body hair
How do I make an appointment?
You can call our office Monday through Thursday from 7.30 a.m. to 5:00 p.m. and Friday from 7:30 a.m. to 1:00 p.m. at (714)639-1815 to make your appointment. You can go to our website to leave preferred appointment dates and time. You can also call after hours and leave a message with the front desk (or telephone exchange on weekends) and specify what your name and call back number and give 3 preferred appointment dates and time. Referrals are not needed in order to make an appointment if you have a PPO, or Medicare. You will need a referral from your Primary Care Physician if you have an HMO, otherwise you will be billed for the visit or may not be seen. We accept SJHAP and Greater Newport HMOs.
What should I do if I need to cancel my appointment?
If you must cancel an appointment, we’ll be happy to reschedule at a more convenient time, but we ask that appointments be cancelled 48 hours or more in advance, permitting us to better serve other scheduled patients. You may be billed a no-show or late cancellation fee for missed appointments or cancellations without 48-hours notice. We do recognize that there will be times when this is not possible; however, we regret that we will not be able to continue to care for you if you have two unexplained absences.
What insurances do you take?
We take all major insurances including, Blue Cross, Blue Shield, Healthnet, United Healthcare, Cigna, Aetna, Medicare, Tricare. Due to the huge number of insurances and different plans: It is always best to contact your individual plan and make sure that we are contracted with them.
What do I need to bring to my first office appointment?
If you have an HMO please confirm that you have a valid referral authorization that has not expired.
Bring your current insurance card or cards, legal identification or driver license, copay (cash or check).
Please print from this website and complete the relevant new patient forms. Confirm from your primary physician or referring physician what medical condition or diagnosis you are being referred for so that you can fill out the correct questionnaire. If you cannot fill it out prior to your appointment, then please arrive 30 minutes early for your appointment so we can process the paperwork and have you still on time for your appointment.
Bring all your medication bottles, insulin boxes or an updated medication list with exact milligram doses and dosing frequency to each office visit. This includes any over the counter supplements or vitamins. Please bring your actual medications in their original bottles so the doctor can see exactly what you are taking. You may bring the pharmacy print out of the medications if you prefer this approach.
Bring your glucose meter and blood sugar log if you have diabetes. For 1-2 day prior to your visit, check your sugars 7 times a day (before each meal, 2 hours after each meal and at bedtime) and bring these numbers written down to your appointment.
Bring relevant medical records, including recent labs, scans, biopsy and reports or make sure the referral doctor has faxed them and they have been received. It is very important that we have any previous records and reports that relate to your concern so they can be reviewed during your appointment. If we don’t receive them by the time of your appointment, then we may have to repeat costly tests or schedule you a second visit to complete the initial phase of your evaluation. You or your primary care doctor can fax those records to us or you can pick them up and bring them with you to your appointment.
The office fax number is (714) 639-2374.
Please arrive early for your appointment.
If you do not speak English your office visit will be expedited if you bring a family member who can interpret for you.
If you think you have a communicable disease such as the FLU, Shingles, Chickenpox, call ahead to alert the office.
You can pay on any past due balance at you appointment if you have not already done so. We accept personal checks. You may not be seen if you have an outstanding balance.
What do I need to know about co-payments?
All co-payments are required to be paid on the date that services are provided. Endocrinology is a specialty, so if your insurance plan requires a higher co-pay for specialty care, that is the co-pay we are required to collect. Dr. Madu is a specialist in Endocrinology and is board certified.
Who should I talk to if I have billing questions?
The number for our billing office is (714) 639-1815 and press option 5.
How do I obtain prescription refills?
Requests for prescription refills are best made at the time of your routine office visit so the physician can make any necessary changes. Ask the provider at the start of the office visit for refills. Prescription refills can also be made by contacting your pharmacy to send us a refill request by fax. This ensures that we have the correct medication and dosing prior to refilling the medication. It could take up to 3 business days to get a prescription refill. In other to ensure timely refills please do the required blood tests and do not skip appointments. Please understand that many health conditions require careful monitoring, and we generally cannot refill prescription requests without an office visit and monitoring laboratory test results and your refill request may be denied for your own safety. We will only refill those medications that we have actually prescribed and not the medications prescribed by non-endocrine specialists. You will be given enough refills of your medications to last until your next appointment. If you should run low prior to your next scheduled appointment allow up to 3 business days to have the physician authorize your refill request. Otherwise please call your usual pharmacy to request a refill of your medication. Please ask your pharmacy to fax a refill request. Fax# for prescription refill requests: (714)639-2374.
Please see the section on medication policy.
How do I transfer my prescription to a different pharmacy?
To transfer your medication to a different pharmacy, please inform your current pharmacy of your desire to move your prescription to a new pharmacy.
How do I obtain mail order prescriptions?
If you are using a mail order pharmacy, make sure to inform the doctor at the start of your visit to the doctor and pick up your prescriptions at our office and mail this to your pharmacy.
What tests do I have to fast for?
You need to fast for at least 10-12 hours before doing certain tests. Don’t have coffee, alcohol, tea, juice or any liquid other than water and don’t chew gum, don’t smoke and don’t even exercise on the morning of the test. When fasting, in other to avoid low blood glucose, do not take your diabetes medications, but take your other prescription medications such as your thyroid medication, steroid, blood pressure medication etc. The tests that require a fasting state include and not limited to the blood glucose, cholesterol panel, cortisol, c-peptide, insulin, oral glucose tolerance test (carbohydrate loading is encouraged for 3 days before a glucose tolerance test, or OGTT but fast for at least eight hours before the OGTT) .This means you may drink water and take any current medications, but you should not eat or drink anything else during this period of time. Common drugs such as aspirin, alcohol, caffeine, acetaminophen, ibuprofen, cough syrup, vitamins and allergy medication should be avoided during the fast before a blood test.
Do I have to fast for an A1C test?
No, you do not have to fast when you for an A1C test as this reflects the average blood sugar level over a 2-3 month period and fasting overnight will not change this value. The A1c test can be done in 5 minutes at your office visit with Dr. Madu.
Do I have to fast if I am having thyroid function tests?
No, the TSH test reflects the average blood thyroid hormone level over several weeks and fasting overnight will not change this value. In general the TSH is slightly higher in early morning, fasting when compared to later on in the day. If you are taking T3—such as in Cytomel, or Armour Thyroid, or Thyrolar, you need to be aware of when you took the medication and the timing of the blood test, as T3 is active only for hours in the body. If you are taking T4 both synthetic and natural-- such as in Levothyroxine, Synthroid, Armour Thyroid, or Thyrolar you need to know that has a much longer period of activity.
When is the blood cortisol level drawn?
Normally, cortisol levels rise during the early morning hours and are highest about 7-8 a.m. and they drop low in the evening and early phase of sleep. The blood cortisol should be scheduled before 8:00 am
When is the blood Testosterone level drawn?
Testosterone levels vary and are generally highest in the morning. Blood testing is usually best done early in the day.
When can I expect my lab results?
Please do your blood tests 1-2 weeks before your scheduled appointment. For critical lab results, the patient is notified by phone within 24 hours. You will be contacted as soon as possible about test results that require immediate action. The physician prefers that you come into the office to review the results, to answer your questions and review your medical problems and to make the best care recommendations.
How do I receive my test results?
Most of the tests we run are complicated, it is best if test results are gone over during your follow up visit and the test results are correlated with your complaints or symptoms and compared with your previous results and to changes expected based on the last medication changes. Some laboratory results may be normal when not pregnant and the same result may not be satisfactory during pregnancy. Some results are interpreted based on the time of the menstrual cycle. Some results are interpreted differently based on age, sex, other concomitant medical problems and other medications that you may be taking. Make sure to let Dr. Madu know any new medications or supplements that you may be taking and what time of day you are taking them in relation to your prescribed hormonal therapy.
If I am on Metformin, how do I prepare for a CT scan with intravenous contrast?
If you are receiving intravenous contrast for a CT scan, on the day of your CT scan do not take metformin (Avandamet, Glucovance, Fortamet, Metaglip, and Riomet also contain Metformin) and do not restart Metformin until your doctor has advised you to do so. After the CT scan, hydrate well and you must do a blood test to check your kidney function before you can begin to take metformin again. Call your physician for the results of the kidney function blood test and for advice before resuming metformin. This is to prevent a serious reaction called lactic acidosis and to prevent kidney damage.
What should I do if your office is closed and I need medical care?
Even though all routine requests, such as scheduling or canceling of appointments, test results or prescription refills, should be taken care of during normal business hours, we understand that sometimes emergencies arise when the office is not open. If you need to reach someone with an urgent medical issue after business hours, call our office number and remain on the line to speak to a member of our answering service. They will put you in touch with the physician on call.
Do you have financial assistance plans?
We provide care for patients without health insurance at a discount. Payment in cash is due at the time of service.
What forms of payment do you accept for your services?
For your convenience, our office accepts credits card, personal checks and cash as payment of services.
How do you handle forms, letters or medical records I may need you to complete for me?
We will complete certain medical forms within 7 business days provided that you have been seen in our office within the last 3 months. If it has been longer than 3 months since your last appointment, please make an appointment with our physician and bring the form with you. You will be asked to come in for an appointment if the form requires a physical examination or other information that require that you answer certain medical questions.
No Show, Copay and Deductible Policies
Our goal is to provide quality service to our patients. Failure to keep scheduled appointments is costly to the practice and to the patients. This notice is to inform you of our policy concerning “No Shows”
Patients who are not able to keep their appointments are asked to cancel 48 hours prior to their appointment. We realize that is not always able to be done due to unforeseen circumstances and we will consider that on a case by case basis. Providing this notice gives us the opportunity to work in other patients who are on a waiting list thus utilizing the practice time efficiently. If any patient cancels his/her appointment 3 times in a row they will be considered dismissed from the practice and a dismissal letter will be sent out. We ask that all office visits be paid for at the time services are provided. If we participate with your insurance plan we will bill your insurance as a courtesy to you. If your Insurance plan requires a copay or a deductible we do require that those are paid at the time that service is rendered. Your insurance may require that you receive a referral from your primary care provider. If this is the case please make sure that your doctor sends that over to our office so that your visit will be paid for. If we do not receive this information, we will bill the visit directly to you. Please let us know if your insurance requires a referral and we will work with you to obtain authorization for your visit to our practice. Please be prepared to pay your co-payment or deductible every time you are seen.
How do I get a copy of my medical records from Diabetes Associates Medical Group?
Due to federal laws, we need a written medical records request. This should include what type and/or date range records you are requesting. Please also include your name, date of birth and signature. You can come into our office during office hours and sign a release or fax one to us at our fax number (714) 639-2374. If the records are for another physician we would be happy to fax the records to that physician, just make sure the request includes the doctors name, address, phone number, fax number and the pertinent records will be sent to the physician. Any records request by the patient, or for disability insurance companies or attorneys will need to be paid for prior to having the records copied.
Our charge for copying medical records is as follows:
- $15.00 search/ clerical costs
- $0.25 for each page of the first 25 pages
- $0.10 per page for copies in excess of 25 pages
- $ actual postage cost
- $ the actual cost of reproducing X-rays and other special medical records
How do I contact someone after hours for an urgent matter?
Our after-hours phone system will notify the doctor of an urgent issue after our office has closed and on the weekends. Please follow the voice prompts on the phone system and make sure to flag the message as for the doctor, otherwise it will not notify the doctor until the next open office day. The doctor will call you back within 1- 2 hours.
1310 West Stewart Drive, Suite 610 