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