Osteoporosis is a silent but serious medical condition. It is silent since it does not cause any symptoms till the first fracture. It is serious since people who get a hip fracture become significantly disabled and 30 % die within 1 year.
Being a silent disease, most people with osteoporosis are never get diagnosed on time. Some people develop vertebral
fractures which may again go unnoticed. Many people who have suffered a fracture will never get identified as osteoporosis or get treatment.
Osteoporosis is a medical condition where there is thinning of bone. Bone is made up of
minerals (calcium, phosphorus), proteins and cells like osteoclasts and osteoblasts. In osteoporosis, bone becomes less dense and is liable to break easily.
Osteoporosis is not painful. Osteoarthritis is not the same as osteoporosis. Osteoarthritis damages the cartilage in the bones leading to pain and reduced joint movements.
Although patients with diabetes can have cataracts or glaucoma, the most important complication is diabetic retinopathy. Diabetic retinopathy progresses through various stages that include mild, moderate and severe retinopathy. If untreated and uncared for, it can result in macular oedema, retinal bleeding and retinal detachment.
Diabetic retinopathy in early stages can be quite silent with no significant visual disturbances. But diagnosing at this stage can help tighten up diabetes control, blood pressure control and lipid control and prevent further progression of the disease. Get your eyes checked for retinopathy at least annually if you don’t have any symptoms and more frequently if you have any disease. Ophthalmology services in Providence (Monday and Friday 9:30 AM-1:00 PM)
Excessive hair growth in areas like face, chest and abdomen in women is called hirsutism. When someone has hirsutism, it is important first to find a reason for the same. It could be very simple problems like idiopathic hirsutism or it could even be quite sinister like an ovarian or adrenal tumour. In women with polycystic ovary syndrome, we will need to evaluate and manage your metabolic problems also. Once a diagnosis is made, we can decide on the right treatment. There are medicines which can reduce the speed of hair growth and thickness of hair so that it is much easier to manage hirsutism. It is high time that always make a diagnosis before we start treatment.
Our endocrinologists can help patients with hirsutism by making a diagnosis by clinical and hormone testing. We can start and adjust medicines monitoring for possible adverse effects. Being experts in endocrinology, our team can help in care of medical therapy even while undergoing LASERS, so that your outcomes are optimal. For appointments call 0471-6662880
Craniopharyngioma is a brain tumour which is common in children. All children with craniopharyngiomas undergo surgery following which some children require radiation to prevent recurrence. Since the tumour is located in areas which are quite close to the pituitary and hypothalamus, many of these children suffer from deficiency of pituitary hormones. If these hormones are not appropriately replaced, these kids suffer various problems including short stature, tiredness and lack of pubertal development. Some of these kids also suffer from diabetes insipidus, a condition causing increased thirst and urination.
Our endocrinologists can help patients with craniopharyngiomas asses their pituitary function and give age appropriate treatment to improve their outcomes. Being experts in both paediatric and adult endocrinology, our team can help in care during transition period. For appointments call 0471-6662880
In patients with type 2 diabetes, the beta cells of pancreas slowly become dysfunctional and reduce insulin production. It was believed that these cells die as diabetes progresses. It was once believed that the beta cells of pancreas do not have the ability to regenerate once they become dysfunctional. It is now known from animal experiments that beta cells of the pancreas become dysfunctional by changing themselves to immature cells or alfa cells. It is also now known that alfa cells can change their face and become fully functional beta cells. Alfa cells in the pancreas can modify themselves to produce GLP-1 which can stimulate multiplication of beta cells. Certain other cells in the pancreas can also generate beta cells. We believe that in the future there will be therapies which can help beta cell regeneration. For appointments call 0471-6662880
It was traditionally thought that diabetes affected only the eyes, nerves, kidney and the blood vessels. By affecting the blood vessels, it affects the heart causing heart attacks and the brain causing strokes (cerebrovascular accidents). But of late we have realised that patients with diabetes have an increased risk of liver disease. In fact, liver disease has become one of the major causes of death in subjects with diabetes. Most of these patients have non-alcoholic steatohepatitis (#NASH) which progresses to cirrhosis. Liver disease is not something that is easy to diagnose especially in the early stages. It is important to prevent liver disease in diabetes by these measures
1.Control blood sugars strictly
2.Reduce consumption of carbohydrates and fat
3.Reduce weight
4.Regular exercise
5.Selectively use drugs for diabetes which have a favourable profile in liver disease.
Drugs belonging to SGLT2 inhibitors class (Canagliflozin, Dapagliflozin and Empagliflozin) are well known to reduce the risk of heart disease and death in patients with diabetes. The same class of drugs are now known to reduce the risk of kidney disease progression in patients with diabetes, especially if they have proteinuria (condition of having more protein in urine). Large studies together involving more than 34000 patients have substantiated these claims.
In a new research called CREDENCE, Canagliflozin has been found to reduce progression of kidney disease in subjects with diabetic kidney disease. However, not all patients can use these drugs. Your doctor can help you understand the benefits and risks of these drugs.
You might have come across a news that there is now an oral drug that has been approved for use in subjects with type 1 diabetes.
You Should understand the following facts about this drug and its approval.
Insulin is essential for survival of patients with type 1 diabetes. The aim of treatment has changed from just helping patients survive the disease to having children live longer without any complications. Insulin is preferably given by 4 or more injections. The aim is to adjust the doses according to food and activity so as to keep the blood sugars on target. Most children will require short acting insulin with every meal and a long acting insulin once daily.
Developments in the insulin technology has resulted in long acting insulins like Glargine (20-24 hours action) and Degludec (more than 24 hours) action. These insulins have revolutionized the way we manage children with diabetes. This has resulted in lower risk of night time hypoglycemia.
