Endocrinology Menu

Centre for Integrated Diabetes Care

 Diabetes is a metabolic condition leading to elevated glucose (sugar) levels in the blood. Insulin is a hormone that controls the amount of glucose in the blood. Type 1 diabetes is a chronic condition where the pancreas produces little or no insulin. Type 2 diabetes occurs when your body does not use insulin properly. We take a holistic approach to diabetes health as our multidisciplinary team includes: physician specialists (endocrinologists), advanced practice nurses, a registered dietitian and a social worker.

  • Your Care

    This program offers a team based, integrated approach for patients with Type 1 diabetes, young adults with Type 1 diabetes (ages 18-26), and complex patients with Type 2 diabetes. This program also provides support for patients who are using an insulin pump, or are interested in using an insulin pump. The multidisciplinary team offers tailored treatment plans for patients with complex diabetes care needs. 

    Pre-visit Requirements

    Once a completed referral has been received, you will be notified of an appointment date and time by a member of our administrative staff.

    What to Expect

    We would ask that you plan to arrive at least 10-15 minutes before your scheduled appointment time so that we can complete your registration.

    Please remember to bring your Ontario Health Card with you to this appointment. Please Note: If you do not have a valid Ontario Health Card, you will be required to pay directly for the clinical service(s) provided at the time of your visit. Details are available from any of our program secretaries.

    At your first appointment please bring:

    • List of medications, supplements or herbal remedies

    • Home glucose meter if you are using one

    • Insulin pump printouts if able. You can also download at WCH

    If you are unable to keep your appointment, please notify the program scheduling secretary at 416-323-6013 to cancel and/or re-schedule your appointment. Please try to ensure you give 48 hours’ notice of cancellation or rescheduling requests.

     

  • Our Team

    Nurse Practitioner

    The Nurse Practitioner (also a Certified Diabetes Educator) works in collaboration with the endocrinologists and multidisciplinary health care team to help individuals living with Type 1 diabetes, Type 2 diabetes or polycystic ovary syndrome manage their condition.  The Nurse Practitioner works in partnership with the individual to assess their health care goals and needs. They provide counselling, education, health promotion and revise treatment plans on an ongoing basis. The Nurse Practitioner is a registered nurse with addition education and an increased scope of practice.

    • Nicola Farnell BSc, MN, NP-Adult, CDE
      Nicola Farnell –BSc, MN, CDE, NP-Adult, CDE headshot

      Nicola Farnell –BSc, MN, CDE, NP-Adult, CDE

      Nicola obtained her Bachelor of Science in Nursing (Honours) degree in 2003 from University of Toronto and her Master of Nursing degree and Acute Care Nurse Practitioner certificate in 2007 from the University of Toronto. She holds a cross appointment with the University of Toronto as an Adjunct Lecturer at the Lawrence S. Bloomberg Faculty of Nursing. Working in her current role as a nurse practitioner in the Centre for Integrated Diabetes Care at Women’s College Hospital since 2007, Nicola is a Certified Diabetes Educator specializing in working with adults who have complex Type 2 diabetes and pregnant women with Type 2 diabetes or gestational diabetes. She has a particular interest in diabetes and pregnancy. 

    • Stephanie Gomer BSc, MN, NP-PHC 

      stephGomer.jpg (85 KB)Stephanie Gomer BSc, MN, NP-PHC - Stephanie obtained her Bachelor of Science in Nursing from the University of Toronto in 2011. She worked in pediatric inpatient transplant and medical specialties, including endocrinology, at the Hospital for Sick Children for 7 years. There she worked closely with the Good to Go program to help adolescents prepare for transition to adult care. She joined the Centre for Integrated Diabetes Care at Women’s College Hospital in January 2019 after completing her Masters of Nursing, Nurse practitioner Degree at the University of Toronto. In this role, she functions as a transition navigator for Young Adults living with Type 1 diabetes and specializes in supporting young adults to engage in their self-management of Type 1 diabetes. She is interested in new and innovative ways to provide in person and virtual care to young adults living with type 1 diabetes.

    Advanced Practice Nurse 

    The Advanced Practice Nurse (also a Certified Diabetes Educator) works in consultation with the endocrinologist to improve the health and well-being of individuals living with diabetes. Through individual counselling, the Advanced Practice Nurse educates and facilitates self-management techniques to patients with Type 1 diabetes, Type 2 diabetes and those on insulin pump therapy

    • Leah Drazek RN, BScN, MN, CDE

      Leah Drazek Leah Drazek – RN, BScN, MN, CDE, Advanced Practice Nurse at Women’s College Hospital – Leah obtained her Bachelor of Science in Nursing degree in 1999 from Dalhousie University in Halifax, NS and her Master of Nursing degree in Adult Clinical Care in 2008 from the University of Toronto, Toronto, ON. She holds a cross appointment with the University of Toronto as an Adjunct Lecturer at the Lawrence S. Bloomberg Faculty of Nursing. Working in her current role as an advanced practice nurse in the Endocrine Program at Women’s College Hospital since 2008, Leah is a Certified Diabetes Educator and Certified Pump Trainer specializing in the clinical education and self-care management of Young Adults with Type 1 diabetes and adults living with Type 1 and Type 2 diabetes. Living with Type 1 diabetes herself for 33 years, she has a particular interest in Type 1 diabetes, insulin pump therapy and continuous glucose monitoring.

    Social Worker 

    The clinical social worker can help assist with psychosocial and behavioural issues of diabetes. They help a diverse population cope and adjust their lifestyle to be able to manage their diabetes. This can include: locating financial/compassionate programs to assist with the costs of diabetes medication and supplies; to developing coping strategies when managing life stressors (work, financial, family, extended family, other medical concerns and taking care of one’s diabetes as they manage their life).

    • Cheryl Harris-Taylor MSW, RSW

      CherylHarrisTaylor.jpg (73 KB)Cheryl Harris-Taylor BSW, MSW, RSW – Cheryl received her Masters of Clinical Social Work degree from the University of Calgary. She has worked in a variety of social work settings: Child Welfare investigations, foster and adoption departments in Calgary; and in a private practice office in the Netherlands. In 2009, she joined the Endocrinology Department and Chronic Disease Management at Women’s College Hospital.  She holds a cross appointment with as an Adjunct Lecturer, Factor-Inwentash Faculty of Social Work, University of Toronto. In the Endocrinology program, Cheryl has become very involved in the psychosocial and behavioral concerns of diabetes, helping a diverse population cope as they live with diabetes. She was the principal investigator researching the importance of a young adult clinic for individuals living with type 1 diabetes. The research supported the creation of the Young adult clinic which commenced in 2012. 

      Ms. Harris-Taylor enjoys challenges and stimulation in her life. One specific accomplishment was climbing Mt. Kilimanjaro in 2009.

    Dietitian 

    The Registered Dietitian (RD), who is also a Certified Diabetes Educator, works in consultation with the endocrinologist and interprofessional health care team to provide nutritional assessment and education to individuals living with Type 1 Diabetes, Type 2 Diabetes, gestational diabetes and polycystic ovary syndrome. The dietitian works closely with patients to identify specific nutritional needs and design a care plan that works with the individuals’ lifestyle.

    • Janis Rusen MSc, RD, CDE

      JanisRusen.jpg (98 KB)Janis Rusen MSc, RD, CDE - Janis has worked in clinical practice at Women’s College Hospital for the past 20 years, where she's gained expertise in women’s health and transitional care. She joined the Endocrinology Program in 2010 and became a certified diabetes educator in 2011. Janis works closely with young adults diagnosed with Type 1 Diabetes and adults with complex Type 2 Diabetes, diabetes in pregnancy and gestational diabetes. Janis is a preceptor to dietetic interns and participates in the education of medical students, interns and residents. 

       

    Physician Specialists (Endocrinologist)

    The Endocrinologists specialize in the treatment of hormone imbalances to help restore the normal levels of hormones in the body.

    • Dr. Afshan Zahedi

      Afshan Zahedi, BASc, MD (Active Staff, Clinician Teacher, Assistant Professor, Division of Endocrinology, Department of Medicine, University of Toronto) Primary appointment in Division of Endocrinology at Women's College Hospital with cross appointment to Division of Endocrinology UHN/MSH. Dr. Zahedi is involved in both undergraduate and postgraduate education at the Faculty of Medicine. Her research focuses on Quality Improvement with a multidisciplinary approach to delivery of health care. She is currently the Medical Director of the Thyroid Program at Women’s College Hospital and focuses on implementing multidisciplinary (surgical and medical) team approach to Thyroid cancer. Other research includes impact of continuing education for primary care and allied health professionals to improve outcomes for chronic disease management including diabetes in geriatric populations.

    • Dr. Catherine Kelly

      Catherine Kelly, MD, FRCPC is a Clinical Educator and a Professor of Medicine at the University of Toronto. She is the former Division Director of Endocrinology at Women’s College Hospital, and the former U of T Endocrine Postgraduate Program Director from 1999 to 2007. She is the Peters Boyd Academy Director for the academic year 2009/2010 and is site director of the PB Academy at WCH since 2007-2013. She is a faculty member of the Institute for Healthcare Communication and is the University DOM Champion for the Communicator role. She has expertise in implementing Lean Management processes into clinical settings. Her clinical interest is in thyroid disease and she has created a Thyroid Cancer Program at WCH. She has won several teaching awards. Here

    • Dr. Geetha Mukerji

      DrMuckerji.jpg (95 KB)Geetha Mukerji, MD, MSc, FACP, FRCPC - (full-time staff, Clinician in Quality and Innovation, Assistant Professor, University of Toronto). Her primary appointment is in the Division of Endocrinology at Women's College Hospital with cross appointment to Division of Endocrinology at UHN/MSH. She has a Master’s degree in Quality Improvement and Patient Safety from the Institute of Health Policy and Management Evaluation at the University of Toronto. Her clinical interests include general endocrinology, diabetes, endocrinology in pregnancy care, PCOS, and thyroid diseases. She is actively involved in the Young Adults Type 1 diabetes Transition Care program at WCH. She also works in General Internal Medicine in the Acute Ambulatory Care Unit and has a special interest in the care of patients with chronic, complex diseases. Her academic interests include: 1) system quality improvement efforts for those with complex chronic diseases such as diabetes 2) quality improvement in endocrinology in pregnancy care and transitional care populations, and 3) safety and quality care processes in the ambulatory setting. She is an active clinical teacher in the endocrine division at WCH and also has a strong interest in teaching quality improvement and patient safety to undergraduate and post-graduate trainees.

    • Dr. Iliana Lega

      Iliana Lega, MD, MSc, FRCPC is an Assistant Professor in the Department of Medicine. She has a Master’s degree in Clinical Epidemiology from the University of Toronto and is a Clinician Scientist at the Women’s College Research Institute. Her research interest is in diabetes and cancer, with a specific focus on cancer survivorship. Her reserch has specifically focussed on the association between diabetes and breast cancer outcomes. Her other active research interests include evaluating the risk of endocrine complications, including diabetes, following cancer treatments in both children and adult cancer survivors. Clinically, she is involved in the joint Gynecology-Endocrinology Premature Ovarian Insufficiency and Turner’s syndrome clinics. Other areas of clinical interest include osteoporosis and reproductive endocrinology.

    • Dr. Lorraine Lipscombe

      DrLiscombe.jpg (92 KB)Lorraine Lipscombe, MD, MSc, FRCPC is an Associate Professor in the Department of Medicine and Institute for Health Policy Research and Evaluation at the University of Toronto. She has a Master’s degree in Clinical Epidemiology and is a Clinician Scientist at the Women’s College Research Institute and an Adjunct Scientist at the Institute for clinical Evaluative Sciences in Toronto. She is the director of the Centre for Integrated Diabetes Care at WCH, and coordinates the Young Adult Type 1 Diabetes Transition Program. Her research interest is in diabetes epidemiology and health services, with a specific focus on the association between cancer and diabetes and improving diabetes prevention in women with previous gestational diabetes.

    • Dr. Sandra Kim

      Sandra Kim (MD, MSc, FRCPC) is an Assistant Professor of Medicine and Clinician Teacher at the University of Toronto. She completed the Master Teacher Program and was the former site Education Coordinator for Endocrinology at WCH. She is currently the Medical Director of the Centre for Osteoporosis & Bone Health at Women’s College Hospital and a member of the Scientific Advisory Council for Osteoporosis Canada. She is involved with the Ontario Osteoporosis Strategy as a lead in the Inter-Professional Education initiative and Osteoporosis Care Outreach delivered through the Ontario Telemedicine Network. Dr. Kim is the recipient of several education awards and has an interest in quality improvement and patient safety strategies.

    • Dr. Shoba Sujana Kumar

      Shoba Sujana Kumar, MD, FRCPC is an Assistant Professor in the Department of Medicine at the University of Toronto. She has an MSc in Community Health and Medical Education. She is an active teacher in both undergraduate and postgraduate medical education and Director of the Core Internal Medicine Academic Half-Day at the University of Toronto. In 2012, she was the recipient of the "Young Clinician Award" at WCH. Her clinical interests include diabetes, the endocrinology of pregnancy, PCOS and thyroid cancer. She is director of the Endocrine Preconception and Pregnancy Program at WCH and continues to work in General Internal Medicine in the Acute Ambulatory Care Unit.

    • Dr. Zoe Lysy

      Bio coming soon

    • Dr. Adrian Lau

      Dr. Adrian Lau obtained his medical degree in 2007 at the University of Toronto, where he also completed his postgraduate training in Internal Medicine, and Endocrinology and Metabolism. In 2016, he obtained his Masters of Science in Community Health (Health Practitioner Teacher Education program) at the University of Toronto.  

      Currently, he is an Assistant Professor and Clinician Teacher in the Division of Endocrinology and Metabolism at Women's College Hospital. His particular clinical interests are in osteoporosis and metabolic bone diseases.  

      He is actively involved in teaching at both the undergraduate and postgraduate levels. He is currently a tutor for first year undergraduate medical students, for clinical skills and case-based learning. 

      In research, he is currently involved in a study to better understand the genetic risk factors associated with atypical femur fractures.

      Dr. Lau is also involved with the osteoporosis community nationally and internationally. He is currently serving as a member of the Scientific Advisory Committee of The International Society For Clinical Densitometry since 2017, and a member of the Scientific Advisory Council of Osteoporosis Canada since 2018. 

    • Dr. Eleni Dimaraki

      Dr. Eleni DimarakiDr. Eleni Dimaraki graduated from the University of Athens Medical School and completed her endocrinology training at the University of Michigan. She also obtained a Masters of Science in clinical research design and statistical analysis from the University of Michigan. Prior to coming to Women’s College Hospital in 2016, she was on faculty at Northwestern University and the University of Michigan. Her clinical interests include type 1 diabetes mellitus in young adults, pituitary disorders and osteoporosis. She is the clinical director of the Centre for Integrated Diabetes Care at Women’s College Hospital. Dr. Dimaraki is also very active in the education of University of Toronto medical students, residents and fellows.

    • Dr. Arno Kumagai 

      DrKumagai_pic.jpg (94 KB) K. Kumagai, M.D.  Arno Kumagai is Professor of Medicine and Vice Chair for Education, Department of Medicine at the University of Toronto. He also holds the F.M. Hill Chair in Humanism Education at Women’s College Hospital, where he has a clinical practice focused on working with individuals with type 1 diabetes mellitus.  
      Dr. Kumagai received his B.A. in Comparative Literature from U.C. Berkeley and his M.D. from UCLA School of Medicine.  He completed postgraduate training and postdoc research fellowships at UCLA and in Tokyo, Japan.  He was on faculty at the University of Michigan Medical School from 1996 to 2016 and joined the University of Toronto’s Department of Medicine as Vice Chair for Education in April 2016.  
      Dr. Kumagai’s scholarly interests are in the use of narratives and humanities in medical education, dialogical teaching, and teaching for equity and social justice.  He is the recipient of numerous teaching awards in teaching, humanism, educational innovation, and diversity. He was most recently named as the 2018 Daniel C. Tosteson Visiting Professor in Medical Education at Harvard Medical School and is a member of the Editorial Board of Academic Medicine.

  • Our Clinics

    Our Clinics

    We are all here to work with you, and to help you manage the different aspects of your diabetes care. The clinics in the Centre for Integrated Diabetes care include:

    Integrated Diabetes Clinic
    This Nurse Practitioner (NP) led clinic is for individuals with complex Type 2 diabetes whose A1C is 9.5% or higher at time of referral. The NP works closely with these individuals to help them adjust their diabetes medications and lifestyle to optimize their diabetes management.

    • Young Adult Program: The Young Adult program is dedicated to assisting emerging adults make a smooth transition to an adult diabetes clinic from their paediatric providers. The multidisciplinary diabetes team specializes in complex type 1 diabetes care for people 18-25 years old and works in partnership with paediatric endocrinology treatment centres to help improve the transition. The Young Adult Program is also supported by a Nurse Practitioner who functions as a transition navigator to assist young people in achieving their self-management goals and reduce patients becoming lost to follow up. Through this program, patients also have access to a social worker and dietitian at each appointment. The team provides counseling on living independently with diabetes, travelling, stress management, and how to navigate competing priorities on a young person’s time.

    General Endocrinology Clinic: People living with diabetes who do not fit into the above clinics are seen in general endocrinology clinic by one of our endocrinologist. They continue to have access to the multidisciplinary team to provide integrated, holistic diabetes care.


    Diabetes in pregnancy: People living with type 1 or type 2 diabetes who are planning pregnancy, are currently pregnant, and people who develop diabetes during pregnancy (gestational diabetes) are seen in the OB-Endo clinic. Through this program, patients followed by an endocrinologist and/or a nurse practitioner. They will also have access to a dietitian to manage their glucose control or the social worker for support.

  • Patient Resources
  • Physician Resources

Forms

Patient Referral

Patient Referral - (.pdf) - FOR PHYSICIANS ONLY -

Please complete and fax referral form to 416-323-6534. 

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