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Endocrinology and Diabetes

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Nature of the work

The specialty of endocrinology and diabetes is concerned with conditions where there is perturbation of specific hormone action. Diabetes mellitus is very common, affecting at least three to four percent of the population. Thyroid disease is also common, as is polycystic ovarian syndrome – one of the commonest causes of infertility. Most other endocrine conditions are relatively rare, but require specialised expertise and facilities to manage effectively.

Working in endocrinology and diabetes

The specialty is a busy one, reflecting the growth of diabetes and its complications as the population ages and the prevalence of obesity increases. Much of the workload in endocrinology and diabetes is outpatient based, but a significant number of patients require hospital admission for complex investigations or the management of complications. Furthermore, at least ten percent of hospital inpatients have diabetes or other endocrine conditions. Increasingly, diabetes is managed jointly with colleagues in primary care. In the future, hospital-based specialists are likely to make a significant direct contribution to patients in the primary care setting. This move necessitates a new component of training in the management of diabetes.

In addition, endocrinologists are gradually enhancing services for obesity management and management of lipid disorders and osteoporosis. These advances are broadening the impact of the specialty, and opportunities for career development and multidisciplinary team working. Increasingly, complex endocrine diseases, and especially endocrine tumours are being managed in large referral centres. Medical management of endocrine diseases is also progressively being delivered in large referral centres, reflecting the specialist nature of this specialty.

Common procedures / interventions

These include:

  • Programmed investigations for complex endocrine disorders.
  • Post-operative management of endocrine and diabetic patients.
  • Management of diabetic and endocrine emergencies such as ketoacidosis and hypercalcaemia.
  • Management of diabetes and endocrine conditions during pregnancy.

 

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