Type 1 Diabetes:
We manage glycaemic control, complications, annual screening, driving licence certification, Insulin pump (new start and ongoing management)
For new diagnosis of a suspected Type 1 Diabetes, please Call Dr Nandi or Dr Sinha, directly for their immediate attention.
Type 2 Diabetes
We manage glycaemic control, Insulin and other non-Insulin medication management, complications, annual screening, driving licence certification, weight management
Diabetes in Pregnancy
Gestational Diabetes, Type 1 & type 2 Diabetes
A tight glycemic control is required in order to have a successful uncomplicated pregnancy. Blood glucose target: Fasting <5.5 mmol/L, 2 hurs post meals < 7 mmol/L
Whereever appropriate, a consultation with the diabetes educator is arranged at no additional cost
Hypothyroidism:
Useful investigations: TSH, T4, Anti TPO/TG antibody, fasting lipids with HDL/LDL, B12, Celiac serology with IgA level, FBC eLFT
Hyperthyroidism:
Useful investigations: T4, T3, TSH, ESR, TSH receptor antibody, FBC, eLFT, B12, anti-transglutaminase Ab, IgA, Thyroid nuclear scan Technetium scan (if done. Please ask you patient to bring the scans)
Thyroid nodules:
Useful investigations: Thyroid ultrasound(s), thyroid nuclear scan, TSH, T4, FBC, eLFT, CT Neck if symptoms of neck pressure, barium swallow if concerns of swallowing problems, Flow-Loop ventilation tests if symptoms of shortness of breath
Osteoporosis:
Risk assessment, pharmacological and non-pharmacological management, future fracture prevention strategies
Weight loss and Obesity
Risk assessment, management of comorbidities associated with obesity, sustainable non-pharmacological and pharmacological management and referral to bariatric surgeon where appropriate.
Hypercalcaemia:
Investigation, management and referral to specialist endocrine surgeon where appropriate
ELFT, ionised calcium, PTH, Vit D, activated Vitamin D, spot urine Ca:Cr (paired with eLFT) BMD (if done) ESR sEPP, serum ACE, FBC
Androgen insufficiency:
8-9am testosterone and free testosterone levels, FSH, LH, Prolactin, TSH, T4, sleep study (if done), FBC ELFT, fasting lipids with HDL LDL
Pituitary disorders
Investigation, management and referral to specialist endocrine surgeon where appropriate, for wide range under or over secretion of Pituitary hormones including Prolactin, Growth Hormone, ACTH & cortisol, ADH (Diabetes insipidus/SIADH)
Adrenal Disorders
Adrenal insufficiency: Investigation, management including arranging short synacthen test (SST)
Cortisol excess (Cushing's syndrome): Investigations to confirm diagnosis & etiology as well as management
Useful screening test: Late night salivary cortisol, 24 hour urinary cortisol, 1 mg dexamethasone suppression test, paired ACTH
Hyponatremia
Useful test: Paired serum and urine electrolytes, TSH, Glucose/HbA1c
Endocrine Disorders in Pregnancy
Pre-conception counselling, antenatal management, peri partum management including inpatient management, post-partum and long term care