Dr. Audrey Paula Simonne Dalac

Dr. Audrey Paula Simonne Dalac diagnoses and treats a wide range of hormonal and metabolic disorders, including:

Diabetes & Related Metabolic Disorders

• Type 1 Diabetes Mellitus (T1DM): An autoimmune condition resulting in the destruction of insulin-producing beta cells in the pancreas, requiring lifelong insulin therapy for survival and glucose management.
• Diabetes Complications (Neuropathy, Nephropathy, Retinopathy - endocrine management aspects): Management focused on glycemic, blood pressure, and lipid control to prevent or slow the progression of nerve damage, kidney disease, and eye damage associated with diabetes.

Pituitary, Adrenal & Gonadal Axis Disorders

• Adrenal Insufficiency (e.g., Addison's Disease, Secondary/Tertiary Adrenal Insufficiency): Condition where the adrenal glands do not produce sufficient amounts of steroid hormones, primarily cortisol and sometimes aldosterone, leading to a range of symptoms and potentially life-threatening adrenal crisis.
• Diabetes Insipidus (Central or Nephrogenic): A rare disorder characterized by intense thirst and the excretion of large amounts of dilute urine, caused by problems with the hormone vasopressin (ADH) or the kidneys' response to it.

Bone Health & Mineral Metabolism Disorders

• Rickets & Osteomalacia: Conditions characterized by softening and weakening of bones, typically due to severe and prolonged vitamin D deficiency. Rickets occurs in children, leading to skeletal deformities, while osteomalacia occurs in adults.
• Vitamin D Deficiency and Insufficiency: Inadequate levels of vitamin D, which is essential for calcium absorption and bone mineralization, leading to potential bone pain, muscle weakness, and increased fracture risk.

This list is not exhaustive. For personalized advice regarding your specific endocrine condition, please consult with Dr. Audrey Paula Simonne Dalac.

• Genetic Counseling Coordination & Testing for Hereditary Endocrine Neoplasia Syndromes & Familial Disorders: Risk assessment and coordination of genetic testing and counseling for individuals and families with suspected hereditary endocrine tumor syndromes (e.g., Multiple Endocrine Neoplasia - MEN1, MEN2; Von Hippel-Lindau), familial thyroid cancer, or other inherited endocrine conditions.
• Transitional Care for Young Adults with Chronic Endocrine Conditions: Facilitating the smooth transition of adolescents and young adults with lifelong endocrine disorders (e.g., Type 1 diabetes, congenital adrenal hyperplasia, hypopituitarism) from pediatric to adult endocrine care services.
• Inpatient & Outpatient Management of Endocrine Emergencies & Crises: Acute diagnosis and management of potentially life-threatening hormonal imbalances such as diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), thyroid storm, myxedema coma, adrenal crisis, severe hypoglycemia, and acute hyper/hypocalcemia, typically initiated in an emergency or hospital setting with ongoing outpatient follow-up.
• Comprehensive Endocrine System Consultation & Hormonal Health Evaluation: In-depth clinical assessment of potential hormonal imbalances and disorders affecting the endocrine glands (e.g., thyroid, pituitary, adrenal, pancreas, parathyroid, gonads). Includes detailed medical history, family history review, targeted physical examination, analysis of symptoms, and formulation of a personalized diagnostic and management plan.
• Interpretation of Complex Hormonal Assays, Dynamic Endocrine Function Tests & Genetic Markers: Expert analysis and clinical correlation of specialized blood, urine, and saliva tests measuring various hormone levels. Includes interpretation of dynamic stimulation and suppression tests (e.g., ACTH stimulation, dexamethasone suppression, oral glucose tolerance test for acromegaly) to precisely evaluate endocrine gland function and identify genetic predispositions.
• Expert Second Opinion Consultations for Complex or Rare Endocrine Disorders: Providing specialized second opinions on challenging endocrine diagnoses, interpretation of ambiguous hormone test results, or evaluation of complex or multi-faceted treatment plans.

Note: This list provides a general overview. Specific tests and treatments are determined after a thorough evaluation. Discuss with Dr. Dalac for care relevant to your specific condition.

All medical services are provided in accordance with the standards of practice set by the Collège des médecins du Québec (CMQ) and relevant endocrinological care guidelines. Contact the clinic or your referring physician regarding new patient intake and referral processes.

Hôpital de Gatineau is situated in Gatineau's Gatineau Sector East (Pointe-Gatineau, Le Baron) neighborhood, serving as a vital medical facility within the region. The hospital's specialized endocrine unit, where Dr. Dalac practices, is conveniently located within this hospital, providing access to comprehensive hormone and metabolism care. The facility is situated near Federal Government Buildings (Place du Portage), with public transit options including the Société de transport de l'Outaouais (STO), which includes the Rapibus BRT service. The hospital is fully wheelchair accessible and offers parking at or near the facility to accommodate patients' needs. It is a key healthcare hub for residents seeking expert endocrine and metabolic services.

Are consultations, hormone tests, and treatments with Dr. Dalac, an Endocrinologist (Diabetes & Metabolism Focus), covered by Régie de l'assurance maladie du Québec (RAMQ) in QC?

Medically necessary consultations with a licensed Endocrinologist (Diabetes & Metabolism Focus) like Dr. Dalac, most standard diagnostic hormone blood tests, dynamic endocrine function tests when indicated, and treatments for provincially insured endocrine conditions (e.g., diabetes, thyroid disorders, adrenal insufficiency, osteoporosis management as per guidelines) are generally covered by Régie de l'assurance maladie du Québec (RAMQ) in QC when a referral from a family doctor or another specialist is in place. Some newer or specialized medications (e.g., certain advanced diabetes drugs, some growth hormone therapies, specific osteoporosis agents), medical devices (like some insulin pumps or continuous glucose monitors and their supplies), or treatments considered primarily for lifestyle or cosmetic reasons may have different coverage criteria or require special authorization. It's crucial to discuss coverage specifics for any proposed investigation or treatment with Dr. Dalac's office, the hospital/clinic, or Régie de l'assurance maladie du Québec (RAMQ) directly.

Is a referral required to see Dr. Dalac, an Endocrinologist (Diabetes & Metabolism Focus)?

Yes, for services covered by the provincial health plan, a referral from your family physician or another specialist (e.g., an internist, pediatrician, or gynecologist) is almost always required to schedule an appointment with an Endocrinologist (Diabetes & Metabolism Focus) such as Dr. Dalac. Endocrine system disorders often involve complex interactions and can have wide-ranging effects, so an initial assessment by your primary care provider helps determine if specialist care is needed and ensures that relevant preliminary tests and medical history are available to the endocrinologist. This facilitates a more focused and efficient consultation.

Dr. Dalac mentioned 'dynamic endocrine testing'. What does that mean?

Dynamic endocrine testing involves tests that assess how your endocrine glands respond when stimulated or suppressed by specific substances. Unlike simple blood tests that measure baseline hormone levels, these tests evaluate the gland's functional reserve or its responsiveness to normal control mechanisms. For example, an ACTH stimulation test checks how well your adrenal glands produce cortisol when stimulated. A dexamethasone suppression test helps diagnose Cushing's syndrome by seeing if cortisol production can be suppressed. An oral glucose tolerance test can be used to diagnose diabetes or acromegaly. These tests usually involve taking a baseline blood sample, then administering a medication or substance, followed by one or more timed blood samples to measure hormone changes. Dr. Dalac uses these tests for more precise diagnosis of certain complex endocrine conditions.

How does Dr. Dalac typically approach managing diabetes (Type 1 or Type 2)?

Dr. Dalac's approach to diabetes management is comprehensive and individualized. For Type 1 diabetes, the focus is on intensive insulin therapy (using multiple daily injections or an insulin pump), continuous glucose monitoring (CGM), carbohydrate counting, and education on managing blood sugar fluctuations and preventing hypoglycemia. For Type 2 diabetes, management often starts with lifestyle modifications (diet, exercise, weight loss), followed by oral medications if needed. Newer injectable medications (like GLP-1 receptor agonists or SGLT2 inhibitors) or insulin may be added as the disease progresses or if blood sugar targets aren't met. In both types, a key goal is to achieve optimal glycemic control (measured by HbA1c and glucose monitoring) while minimizing side effects and preventing long-term complications affecting the eyes, kidneys, nerves, and cardiovascular system. This often involves a multidisciplinary team approach.

What treatment options for osteoporosis might Dr. Dalac discuss?

If you are diagnosed with osteoporosis, Dr. Dalac will discuss a management plan aimed at reducing your risk of fractures. This starts with lifestyle modifications, including ensuring adequate intake of calcium and vitamin D (through diet and/or supplements), engaging in regular weight-bearing and muscle-strengthening exercises, smoking cessation, and limiting alcohol intake. Fall prevention strategies are also important. If medication is indicated based on your bone density (DXA scan) and fracture risk assessment (e.g., using FRAX or CAROC tools), options include antiresorptive medications that slow bone loss (like bisphosphonates or denosumab) or anabolic agents that stimulate new bone formation (like teriparatide or romosozumab). She will help choose the most appropriate therapy based on your individual circumstances, potential side effects, and treatment goals.

I have a thyroid nodule. What can I expect during an evaluation with an Endocrinologist like Dr. Dalac?

When evaluating a thyroid nodule, an Endocrinologist like Dr. Dalac will conduct a thorough assessment. This typically involves reviewing your medical history (including any symptoms of thyroid dysfunction or family history of thyroid disease), performing a physical examination of your neck and thyroid gland, and ordering blood tests to check your thyroid function (TSH, and possibly free T4, T3, and thyroid antibodies). A thyroid ultrasound is almost always performed to precisely characterize the nodule's size, number, and sonographic features (e.g., solid, cystic, calcifications, irregular margins). Based on these ultrasound characteristics and the nodule's size, Dr. Dalac will determine if a fine-needle aspiration (FNA) biopsy is needed to obtain cells for microscopic examination to rule out thyroid cancer. Most thyroid nodules are benign.

Hôpital de Gatineau
909 Boul La Vérendrye
Gatineau, QC J8P 7H2

Phone: (819) 966-6100 | Fax: (819) 966-6290

The facility is wheelchair accessible.

Dr. Dalac is a licensed Endocrinologist (Diabetes & Metabolism Focus) regulated by the Collège des médecins du Québec (CMQ) under the Medical Act in QC. A referral from a family physician or appropriate specialist is typically required for consultations with Dr. Dalac for services covered by the provincial health plan.

Verify registration with the Collège des médecins du Québec (CMQ): https://www.cmq.org/en/directory/physicians?number=17089