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Endocrinology & Diabetes

Endocrinology & Diabetes

Endocrinology & Diabetology Department offers expert care for various metabolic, pituitary, thyroid and diabetes-related conditions. Hospital gives access to a multi-disciplinary team including endocrinologists, diabetic educators, dietitians and a nurse practitioner. The treatment of disorders such as diabetes, obesity, thyroid, PCOS, osteoporosis, as well as less common, and highly complex hormonal disorders is given in concurrence with renowned specialists who are often involved in diabetes care, such as cardiologists, ophthalmologists, nephrologists, and dermatologists as well as primary care physicians.

  • Diabetes
  • Thyroid Disorder
  • Polycystic Ovarian Disease
  • Vitamin Deficiency

Diabetes mellitus (commonly known just as diabetes) is a metabolic disorder. When food is eaten, it is mostly transformed into glucose (sugar). This glucose becomes a prime source of energy when absorbed by cells. Insulin is required for this glucose to be absorbed. When the insulin levels in the blood drop, sugar cannot be absorbed by the cells and instead builds up in the bloodstream. This can be either due to inadequate production of insulin or the cells’ inability to absorb it. This condition is known as diabetes and there are different kinds of it.

Type 1 Diabetes:

When the body does not produce insulin it is known as Type 1 diabetes. This tends to manifest before the age of forty and often even in teenagers and young adults. It accounts for only 5% to 10% of all diabetes cases. It is progressive although the rate at which it progresses varies from person to person.

Type 2 Diabetes:

Type 2 diabetes is the most commonly occurring form of diabetes, affecting 90% to 95% of all patients. In it, either the body cannot produce enough insulin or the cells may not react to that which is produced (insulin resistance). Improper diet with excess sugar is the major contributor and obesity is a major cause. It is clearly a disease of civilisation although there is also a significant genetic factor as evidenced by it being far more common in people of African, South Asian and Middle Eastern descent.

Gestational Diabetes:

This form of diabetes is contracted by women during pregnancy during which time blood glucose levels are substantially high. Between 2% and 10% of all pregnant women suffer from it. The condition may disappear completely after pregnancy although a small percentage do contract diabetes mellitus (mostly of Type 2) later.

Prediabetes:

Prediabetes is a state where the body has higher glucose levels than normal but not high enough to classify as diabetes. It is a state which can last for years before transitioning to full blown diabetes.

The thyroid gland is located at the front of the neck and is responsible for producing the hormones thyroxine and triiodothyronine (the thyroid hormones) which control metabolism, heart rate, breathing, the nervous system, body temperature, weight and many other functions. Hyperthyroidism is a condition wherein the thyroid gland is overactive and results in the increased production of the thyroid hormones.

Symptoms of the condition can include:

  • weakness of muscle
  • tremors
  • mood swings
  • anxiety
  • heartbeats which are rapid
  • palpitations
  • dryness of skin
  • loss of weight
  • disturbed sleep

Hyperthyroidism is most commonly caused by an autoimmune disorder called Grave's disease. Some of the other causes are nodules in the thyroid gland, inflammation of the thyroid gland (from a virus or trouble with the immune system), excessive consumption of iodine in food or medication and pregnancy. It is diagnosed based on symptoms, physical examination and blood tests.

 

Hypothyroidism is a condition where the thyroid gland is underactive and produces less of the important hormones than the body requires. It is more likely to affect women, particularly those over the age of 60. This causes an upset in the balance of reactions in the body. While it rarely shows symptoms in the early stages, untreated hypothyroidism can result in a host of conditions ranging from obesity and infertility to joint pain and heart disease.

Symptoms of hypothyroidism are many and varied but they may include:

  • increased sensitivity to cold
  • dry skin
  • constipation
  • fatigue
  • weakness of muscle
  • high blood cholesterol levels
  • puffy face
  • pain and stiffness in the joints
  • depression
  • menstrual periods which are heavier than normal or irregular
  • mood swings

Diagnosis is through thyroid functions tests which are very accurate. Treatment can be synthetic thyroid hormone which has been found to be very effective.

PCOS is increasingly common in the modern age and is sometimes referred to as the ‘pre diabetes’ state. It is a disorder of the endocrine system in women of the reproductive age. Those afflicted by it have enlarged ovaries where fluid has collected in small deposits called follicles. These are located in each of the ovaries and are visible in an ultrasound. In a lot of cases, symptoms of PCOS begin to show soon after a woman begins having her periods while in some cases it may develop later. While they affect women differently, doctors look for at least two of the following symptoms.

  • Irregular periods: These may include menstrual cycles of more than 35 days, failure menstruate for more than four months and extended periods which are scant or heavy.
  •  Excessive androgen: Higher than normal levels of androgens (male hormones) which can result in hirsuteness (excessive facial and body hair), acne and male pattern baldness.
  • Polycystic ovaries: Ovaries which are enlarged and contain sacs filled with fluid, surrounding the ovaries.

The exact cause for PCOS remains elusive but it is thought to be linked to excessive insulin in the body, low-grade inflammation and heredity. A lot of other conditions can mimic PCOS, so diagnosis requires careful hormone work-up.

This is a condition which affects children and their bone development. Bones become soft and weak and it leads to deformities. It causes bowed legs, curved spines and thick ankles. It can also lead to fractures. Lack of Vitamin D or calcium is the primary cause of rickets. The body’s Vitamin D mostly comes from exposure to sunlight apart from a few foods. Lack of enough sunlight and the proper diet can lead to inadequate stores of Vitamin D. In some rare cases it can also be genetic.

Symptoms of Rickets (Severe Vitamin D deficiency) would be :-

  • Deformities the skeleton(skull,legs,ribcage,breastbone,spine,pelvis)
  • Tenderness in the arms,legs, pelvis and spine
  • Shortness of stature
  • Easily fractured bones
  • Cramping of muscle
  • Deformities of the teeth

Cushing Syndrome

Cushing’s syndrome is a condition where there is too much cortisol present in the body. There are many reasons for it. Cortisol is produced by the adrenal glands when they are stimulated by ACTH which is produced by the pituitary gland. Excess ACTH therefore causes Cushing’s syndrome. It can be the result of a pituitary tumour. Cushing’s can also be caused by excessive intake of steroids. In addition, an adrenal tumour can also result in Cushing’s. High levels of cortisol can have a host of complications. It causes excessive weight gain in the centre of the body. The patient experiences high levels of fatigue, is easily bruised, suffers from hirsuteness (excessive hair growth) is prone to infection, can suffer from erectile dysfunction (men), depression, osteoporosis and so on. Not everyone who has some of these symptoms has Cushing’s. The good news is that it is a condition which can be cured through various interventions.

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