Dr. Hegele is a specialist who has a special interest and expertise in providing health care to patients whose blood lipids - such as cholesterol and triglycerides - are out of balance.  As an endocrinologist, Dr. Hegele also provides health care to patients with diabetes and other metabolic problems that sometimes occur together with lipid disorders.  Dr. Hegele has over 1200 patients under his care.

Dr. Hegele conducts clinical trials of new medications that may not yet be available for prescription. He also directs a research laboratory, and his team has discovered the genetic basis of many different lipid disorders, inherited forms of diabetes and other rare conditions. His research accomplishments have been recognized by awards from societies such as the American Heart Association, the Canadian Diabetes Association and the Heart and Stroke Foundation of Canada. Dr. Hegele is also a Distinguished Professor of Medicine and Biochemistry in the Schulich School of Medicine, University of Western Ontario.

• On first visit for diagnosis and a baseline level to determine need for and type of treatment.
• On follow-up visits to determine how well treatment is working and whether adjustments are required.

• To detect undiagnosed or untreated thyroid disease, since thyroid imbalance can affect the lipid profile.

• Tests of liver function, to obtain a baseline since these tests can increase in rare patients on treatment.
• Also, to detect undiagnosed or untreated liver disease, since liver problems can affect the lipid profile.

• Sugar in the urine can indicate diabetes, which can affect lipid profile.
• Protein in the urine can indicate a kidney condition.

• Improved glucose control in diabetes can help the lipid profile
  
• Suboptimal lipid profile in a diabetic patient needs to be managed aggressively.

• A long term index of blood sugar control to determine how good blood sugar control has been.

• Tests of kidney function, since kidney disorders can affect the lipid profile.

• Muscle enzyme test, to obtain a baseline since the tests increase in rare treated patients.

• A test of inflammation that some believe is associated with increased vascular disease risk

• A general test to rule out disturbances of blood salts

• High fasting insulin levels suggest insulin resistance, a risk factor for lipid disorders and type 2 diabetes

• The protein component of the HDL particle; some feel it is a more precise test than HDL.

• The protein component of the LDL particle; some feel it gives a better risk index than LDL alone.

• A clotting factor in the blood that could increase risk; it is included in determining risk level to guide management of the lipid profile.

• A clotting factor in the blood that could increase risk; it is included in determining risk level to guide management of the lipid profile.

• A marker inflammation in the blood associated with increased risk; it is included in determining risk level to guide management of the lipid profile.

• This is done on a research basis, with informed consent of the patient.

• This is measured by a certified technologist and is routine for all patients seen in the Lipid Genetics clinic. If plaques are seen, this will probably affect treatment.

• Dr. Hegele has been studying DNA and heart disease risk for almost 20 years and might request a small sample of your blood for research into genetic markers that might increase the risk of a heart attack or stroke.