Endocrinology

Department of Endocrinology, Diabetology and Metabolic Disorders

Caritas diabetes care provides a comprehensive and customized treatment plan for the all endocrine and metabolic disorders. Most common among them is diabetes for which our Endocrinologist and registered dietitian provides expert care to adults through a comprehensive and personalized treatment plan for the prevention, management and treatment of Diabetes. The Endocrinology department has expertise in treating people with all types of diabetes, including those with advanced and complex diabetes. Referral and prompt access to Ophthalmologists, Nephrologists, Neurologists and Surgeons are also readily available to treat the complications of diabetes.

Common endocrine conditions

• Diabetes clinics
• Thyroid clinics
• Metabolic bone disease
• Obesity / Weight management clinics
• Sexual disorders
• Obstetrics and gynecology endocrinology
• Puberty and growth disorders
• Adrenal and Pituitary problems

Subspecialties and service

A. Diabetes

• Comprehensive Diabetes management for Adults (Type 1 and 2 diabetes care)
• Antenatal diabetes (diabetes in pregnancy) care
• Assessment and treatment of associated complications of diabetes such as neuropathy, nephropathy and retinopathy
• Specialized lab tests (C-peptide, anti-GAD, TSH receptor antibodies, Chromogranin, IGF 1, IGFBP3)
• Dynamic endocrine tests ACTH stimulation tests, glucose tolerance test, dexamethasone suppression test and water deprivation test
• Continuous Glucose Monitoring (CGM) using Ipro 2 CGM device
• Insulin pump therapy
• Assesement of diabetic retinopathy
• Treatment for associated diseases such as hypercholesterolemia and hypertension

The diabetes and endocrine care provides specialized screenings for early diagnosis of Diabetic Peripheral Neuropathy (DPN) and Peripheral Artery Disease (PAD). These tests are simple, non-invasive, quick to perform and painless.

Specialized tests include:

1. Vibration Perception Threshold (VPT)

• Fully computerized method which tests vibration thresholds at least at 7 points in both feet using a probe
• Abnormal VPT values suggest early neuropathy which is a risk factor for foot ulceration, deformity and amputation

2. Thermal sensitometer

• This non-invasive test detects temperature for cold and hot sensation
• Abnormal results indicate that the patient is at risk for heat and cold injuries which can be prevented

3.   Foot pressure using foot scan

• Foot scan/mapping measures pressure in different areas of foot, booth in static and dynamic phase
• Screening is also done using monofilament test
• Based on the results, the Endocrinologist can advise patients to use special footwear and ways to prevent ulcer formation

4. Non-contact infrared thermoscan

• A hand held thermoscan is used to detect skin temperature at different points in of both feet
• In PAD skin temperature can decrease due to reduced blood supply and in DPN it may increase or decrease

5. Peripheral Doppler to test ABI and peripheral circulation

• A computerized doppler is used to assess the ratio of blood pressure between brachial artery (upper limbs) and different segments of lower limbs such as ankle (ABI) and toe (TBI)
• Abnormal ABI suggests Peripheral Artery Disease (PAD), which can be treated, if detected early

B.  Endocrine and Metabolic disorders

• Thyroid disease management
• Pituitary disorders
• Diagnosis and treatment of hormonal, metabolic and gonadal disorders
• Diagnosis and treatment of lipid-disorders
• Comprehensive Adult Endocrinology care
• Reproductive endocrine disorders ( including PCOS )
• Assessment of vitamin-D-deficiency (Bone mineral density test (DXA)) and osteoporosis, diagnosis and treatment

C. Other services

• Bariatric (Obesity) management  including support from Bariatric surgery department
• Psychological counselling for obese and diabetic patients
• Nutritional counselling and planning
• Patient education