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Our board certified Endocrinologists provide consultative, diagnostic, treatment and management of a wide spectrum of endocrine disorders including Thyroid, Diabetes, Pituitary, Adrenal, Osteoporosis, Calcium issues, Polycystic Ovarian Disorders and Transgender hormonal therapy. The endocrine system affects the function of our entire body influencing how we feel day to day.
Ultrasound exams are simple and painless. It uses harmless sound wave technology (no radiation exposure) to generate images of the thyroid and surrounding structures. During the ultrasound, the patient lies flat with the neck slightly extended. Gel is placed to enable the sound waves to travel from the ultrasound probe through the skin to create real-time images. Information gathered during the ultrasound procedure includes the size of the thyroid, detection of any inflammation in the thyroid, and the blood-flow through the thyroid. Thyroid nodules and cysts are measured and detailed descriptions of their characteristics are recorded. For thyroid cancer patients, we perform a review of the surrounding lymph nodes to help determine if the cancer has spread to these lymph nodes. Ultrasound follow-up has replaced nuclear medicine imaging for thyroid cancer recurrence detection.
At Accent Endocrinology our exams are done by our physicians and not radiology technicians. This allows immediate evaluation, interpretation, and discussion with the patient incorporating the patient’s clinical situation.
↑ Back to topFine needle aspiration (FNA) is used to evaluate thyroid nodules and neck lymph nodes. A fine needle is inserted, under ultrasound guidance, into the targeted nodule and a small sample of cells is obtained. Ultrasound guidance allows visualization of the needle tip to assure that the specimen is obtained from the targeted nodule. The needle used for fine needle aspiration is much thinner that that used for routine blood draws. Therefore, local anesthesia is not routinely required for the majority of biopsies. FNA does not require any special preparation (no fasting) or restrictions (can immediately return to their normal activities) after the procedure and typically has no ill effects.
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Results of FNA biopsies are sometimes limited by the number of thyroid cells available for evaluation. In the past to limit the chances of an inadequate sample, multiple needle passes were performed. Now, to limit the number of passes and to minimize the problem of inadequate samples, our endocrinologists perform cytological adequacy assessment of the FNA samples in the office. After slides are prepared and stained, our endocrinologist can review them microscopically to determine adequacy.
The slides are then sent to expert thyroid cyto-pathologists at the University of Arkansas for Medical Sciences or the Diagnostic Reference Laboratories at UF & Shands for further study and diagnosis. Some insurance companies are not contracted with these facilities and in these cases, either the patient elects to pay for the expert reading or the slides are sent to the contracted facility. Results are typically available within a week of the procedure.
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While thyroid cancer is uncommon with less than 1 in 10 thyroid nodules harboring cancer, the annual incidence of thyroid cancer in the United States is about 34,000 cases. 74 percent of newly diagnosed patients are women, making thyroid cancer the seventh most commonly diagnosed female malignancy.
When thyroid cancer is detected, the typical treatment is surgery to remove the entire thyroid gland.
When preparing patients for surgery, it is critical to evaluate the surrounding neck area for any abnormal lymph nodes to which the cancer may have spread. A comprehensive neck ultrasound is the most sensitive and effective method to determine if there are abnormal lymph nodes. Preoperative neck ultrasound enables identification of abnormal lymph nodes that can be further evaluated with biopsy. This helps to confirm or exclude the presence of cancer to guide the extent of needed surgery.
After surgery and radioiodine therapy for thyroid cancer, post-operative neck ultrasound is essential in monitoring for recurrence of cancer.
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The iPro Continuous Glucose Monitor (CGM) is a system which includes a tiny sensor inserted under the skin by our clinic nurse to measure interstitial sugar levels for a 72 hour period. The iPro Continuous Glucose Monitor (CGM) provides clinical insights, not revealed with A1C or fingersticks alone, which help your Endocrinologist uncover problems and make important therapy adjustments. This is a 3 step process:
Step 1: A tiny glucose sensor is inserted under the skin in clinic by our nurse. This sensor records glucose levels every 5 minutes for 3 days. The sensor will be linked to a recorder and a blood sugar meter. You will be provided a log sheet and instructions. Over the next 3 days you will check your blood sugars 4 times a day, and record your daily activities (eg. meals, exercise, insulin) on the log sheet.
Step 2: You will return to clinic to have the sensor removed and the recorder returned. The information from the recorder can then be downloaded and given to your Endocrinologist for review.
Step 3: The information downloaded is reviewed by your Endocrinologist, who can then make changes in your therapy based on trends revealed by your recorded blood sugar readings in conjunction with your log sheets.
↑ Back to topInsulin pump therapy, also known as continuous subcutaneous insulin infusion (CSII), is a method for providing insulin to people with diabetes without the need for multiple daily injections (MDI). Insulin pump therapy allows greater freedom, flexibility, and control. Insulin is delivered continuously 24 hours a day through a small needle or cannula inserted into your subcutaneous tissue. Like your pancreas, the insulin pump releases small amounts of rapid-acting insulin to keep blood glucose levels steady between meals and during sleep. This is called the basal rate. Then, at meal or snack time, you can tell the pump to deliver the amount of insulin needed to match the grams of carbohydrate in the food that is eaten, just like a healthy pancreas. This is called a bolus.
Insulin pump therapy is not ideal for everyone. Individuals who might benefit from insulin pump therapy include: those with erratic schedules, frequent severe high or low blood sugars, those who would like an alternative to multiple daily injection, those who would like increased flexibility in their eating and exercise schedules.
To ensure the success of your insulin pump therapy, appropriate training is required prior to the start of your insulin pump therapy. Pump training with a nurse or diabetes educator may be done in several sessions. These sessions include carbohydrate counting instruction, detailed instructions on the technical aspects of the pump, and diabetes self management for pump patients. At the initiation of insulin pump therapy, frequent blood sugar readings (8 to 10 times daily) are essential to the determination of the most optimal pump settings for you. Frequent communication with your care providers and adjustments in your insulin pump settings will be occurring over the initial weeks of your pump start. Regular glucose monitoring is essential to the success of insulin pump therapy.
Several different insulin pumps are commercially available. Your endocrinologist will work with you to determine which pump suits your lifestyle. Please access the links below to view the most commonly used pumps in our practice.
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We utilize the NEUROMetrix NC-stat System for our nerve conduction testing. Nerve conduction studies are very helpful to diagnose certain diseases of the nerves of the body. During the testing, sensors and electrodes are applied to the skin. A low level of electrical current is applied to help stimulate the nerves. The response of the nerves is then recorded and evaluated. This helps to distinguish nerve dysfunction due to compression (carpal tunnel, disc disease) from metabolic causes such as diabetes.
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Retinopathy (damage to the retina or the back of the eye) is a major cause of morbidity in patients with diabetes, which can eventually lead to blindness. 80% of all patients who have had diabetes for 10 years or more are at risk for developing eye changes. The vast majority of patients who develop diabetic retinopathy have no symptoms until the very late stages (by which time it may be too late for effective treatment). Early detection and treatment are important for preventing progression to possible blindness. We recommend all our diabetic patients who have not had routine eye examinations by an ophthalmologist to have retinal photography done as a screening for detection of retinal changes.
We use a computer-integrated digital imaging system to record a detailed view of the retina. Since nothing touches the eye, photo-documentation is painless. Our retinal photographs are interpreted by a board certified Ophthalmologist. This digital image provides an excellent reference point for future comparisons.
↑ Back to topFind Board Certified Endocrinologists at Accent Endocrinology Services in Gainesville, Florida. Our endocrinologist doctors, thyroid specialists, and diabetologists diagnose and treat hormonal imbalance and diseases of the endocrine system including thyroid diseases, thyroid weight gain, diabetes, osteoperosis, osteomalacia, hypertension, cholesterol/lipid disorders, etc.
Our medical staff consists of top thyroid doctors and nurses in Florida who are board certified and specilize in endocrinology, metabolism and diabetes. Our thyroid specialists and diabetes doctors will provide you with in-depth evaluations, treatments and management of your endocrine needs. Patients throughout North Central Florida including Gainesville, Ocala, Lake City, and Tallahassee are referred to us for thyroid evaluation, thyroid ultrasound, thyroid nodule biopsy, thyroid cancer treatment and a wide spectrum of endocrine disorders.
Accent's board certified endocrinologists and diabetes doctors specialize in the management of thyroid diseases that include hyperthyroidism (overactive much thyroid hormone), hypothyroidism (underactive thyroid hormone), non-cancerous thyroid disease and thyroid cancer.
Thyroid Ultrasound - A lump or abnormal growth in the thyroid gland is called thyroid nodule. At Accent Endocrinology, we offer thyroid nodule ultrasound, a simple and painless technology, that uses harmless sound wave technology (no radiation exposure) to generate images of the thyroid and surrounding structures. Thyroid nodules and cysts are measured and detailed descriptions of their characteristics are recorded. For thyroid cancer patients, we perform a review of the surrounding lymph nodes to help determine if the cancer has spread to these lymph nodes. Our exams are performed by our thyroid specialists and endocrinologists. This allows immediate evaluation, interpretation, and discussion with the patient incorporating the patient's clinical situation.
Neck Ultrasound
Glucose Monitoring
Our team of endocrinologists is ready to help provide better care for your health. Please contact Accent Endocrinology department today to get started.