Diabetology

OP SERVICE

• Except for Sundays, all days of the week are used for the outpatient services. More than 600 to 700 patients visit it each day.
• In addition to facilities for early detection, evaluation, and treatment of other metabolic lifestyle disorders like hypertension, dyslipidemia, etc., it offers everyday insulin injections, laboratory testing, anti-diabetic medication supplies for all diabetic patients, and free insulin vials for Type 1 diabetic patients for the necessary duration.

IP SERVICE

• In order to provide inpatient care for diabetes patients, the Institute has a sanctioned bed strength of 30 (20 for males and 10 for females). The Institute also provides consulting services to the Government General Hospital's numerous other specialist departments, including neurology, cardiology, gastroenterology, nephrology, and other surgical specialties.

CARDIO – KIDNEY - METABOLIC

• A "cardio-kidney-metabolic syndrome clinic" is a specialized healthcare setting that focuses on diagnosing, managing, and treating individuals with conditions where the cardiovascular system, kidneys, and metabolic processes are affected.
• These clinics provide comprehensive care for the interconnectedness of these systems, recognizing that conditions like obesity, diabetes, and kidney disease often co-exist and influence each other.

TYPE 1 DIABETES CLINIC

• Type 1 Diabetes patients are issued insulin free of cost in all Government Hospitals all over Tamil Nadu since 1997. The Institute of Diabetology caters to more than 300 patients with Type 1 Diabetes and we dispense free insulin vials for all these patients.
• Apart from regular and intermediate acting insulin, insulin Analogues are also available to treat these Type 1 Diabetic Patients.

PREGNANCY DIABETES SERVICES

• The Institute's unique focus in the field of pregnancy diabetes is reflected in its pregnancy diabetes services. During 1979–1980, these services were initially offered at the Institute of Obstetrics and Gynecology and Hospital for Women and Children in Egmore, Chennai.
• In 1995, they were expanded to include the Government Kasturba Gandhi Hospital for Women.
• Additionally, Pregnancy Diabetes Services are offered daily in the OPD by the Institute of Diabetology. Patients who have been diagnosed with gestational diabetes mellitus are treated appropriately after being checked for the condition throughout pregnancy.
• In order to regulate their glycemic condition, individuals with GDM are also admitted to the ward.

LABORATORY

• The Laboratory Services of the Institute is one of the most modern and well equipped. The Institute Laboratory was chosen as one of the centres for carrying out Quality Control Assessment by the working group of the First WHO/International Diabetes Federation International Seminar on Laboratory Technology in Diabetes Mellitus at Zagreb, Yugoslavia way back in 1976.
• The following blood and urine tests are offered in our lab
  • FBS/PPBS/RBS
  • BLOOD UREA/CREATININE
  • TOTAL CHOLESTEROL/TRIGLYCERIDES/HDL CHOLESTEROL
  • TOTAL BILIRUBIN/DIRECT BILIRUBIN/SGOT/SGPT/SAP/TOTAL PROTEIN/ALBUMIN
  • HbA1C
  • URINE PCR/24 HOURS URINARY PROTEIN/URINE ALBUMIN/URINE ACETONE
  • The Laboratory of the Institute of Diabetology maintains quality of the highest standards as assessed by EQAS assessment done by CMC, Vellore, Tamil Nadu, India on regular basis.
  • For diabetic patients who visit the Diabetology Outpatient Department, biothesiometry (a vibration perception test) is performed in addition to the clinical evaluation of neuropathy. With our cutting-edge CANS detection method, cardiac autonomic neuropathy can be identified. The sole CANS detection system in the government sector and one of the very few in India is at our institute.

NEURO DIABETOLOGY SERVICES

• Diabetic neuropathy is a common microvascular consequence, and its morbidity and mortality might be decreased by early identification.
• For diabetic patients who visit the Diabetology Outpatient Department, biothesiometry (a vibration perception test) is performed in addition to the clinical evaluation of neuropathy. With our cutting-edge CANS detection method, cardiac autonomic neuropathy can be identified.
• The sole CANS detection system in the government sector and one of the very few in India is at our institute.

DIABETES FOOT CARE SERVICES

• Foot examination is a must for all diabetic patients to prevent amputations. Keeping this in mind, the Institute has established a diabetic preventive foot care clinic where the feet and footwear of the patients are examined and appropriate instructions and foot care education are provided to the patients.
• Vascular Doppler is also available and done for selected patients according to the clinical scenario.

DIABETES EYECARE SERVICES

• Recognizing the importance of Diabetic Retinopathy as one of the most important morbid complications of diabetes, the Institute runs the Diabetic Eye Care Services under a full time Ophthalmologist. The Institute also collaborates with the Regional Institute of Ophthalmology & Government Ophthalmic Hospital, Madras Medical College, Chennai, the second oldest Eye Hospital in the World.

PULSED ELECTROMAGNRTIC FIELD

• Pulsed Electromagnetic Field (PEMF) therapy shows promise as a non-pharmacological approach for managing pain and potentially improving nerve function in diabetic neuropathy. Studies suggest it can reduce pain intensity, improve nerve conduction velocity, and enhance skin perfusion pressure. PEMF therapy has been shown to reduce pain intensity in patients with diabetic neuropathy.
• PEMF therapy holds promise as a non-invasive treatment option for managing the pain and potentially improving nerve function in diabetic neuropathy.we have a separate device for PEMF where diabetic neuropathic patients are recieving pemf services on daily basis for 2 weeks to 3 weeks based on their improvement and having positive outcome in their symptoms.

NERVE CONDUCTION STUDY

• A Nerve Conduction Study (NCS) is a diagnostic test used to evaluate the function of peripheral nerves by measuring how quickly and well they can transmit electrical signals. It helps identify nerve damage and distinguish between nerve and muscle disorders.
• They can help healthcare providers determine the cause, severity and prognosis of these conditions. It is being performed in our out patients for cases suffering from diabetic neuropathy

SARCOPENIA

• Sarcopenia is characterized by a progressive and generalized loss of skeletal muscle mass and strength, is a significant contributor to frailty, disability, and decreased quality of life in older adults. Screening for sarcopenia is carried out on regular basis in our opd with muscle strength assessment using hand grip dynamometer , simple tests like calf circumference measurements for measuring muscle mass , physical performance assessment using chair stand tests are also done for diabetic patients.

DIET COUNSELLING

• Diet and exercise is very important aspect of management of diabetes and other metabolic disorders. The institute has a qualified and registered dietician who advises all the diabetic patients about diet and exercise. Apart from group counselling, tailor made diet advice according to the individual patient profile is also provided.
• A Certificate course in Clinical Therapeutic Nutrition and food service Management is conducted in the Institute of Diabetology and so far 30 students has been trained. The Institute also conducts a B.Sc (Clinical Nutrition) course in which 20 students are admitted each year and trained. These students are utilised in the assessment and maintenance of nutritional health of all inpatients admitted in Institute of Diabetology and other speciality departments of RGGGH.

YOGA

• Yoga can be beneficial tool for managing diabetes, particularly type 2, by improving insulin sensitivity, reducing blood sugar levels, and potentially lowering cholesterol. our op includes a dedicated yoga specialist for teaching yogas to Diabetic patients.

PHARMACY

• The Institute of Diabetology has its own Pharmacy with a qualified pharmacist The Institute gives all the required medicines including that of latest DPP 4 Inhibitors and SGLT 2 Inhibitors apart from anti-lipid and other drugs free of cost to all patients.

• Ms.XXX , a 9 year old girl child a case of hyperinsulinism , homebound due to recurrent episodes of hypoglycaemic seizures was referred to our department. Genetic screening tests for hypoglycaemia were found to be negative. She is on regular follow up, was started on tab.Diazoxide and is now seizure free for more than a month ,leading a near normal life.

• Master.YYY, a 21 year old male with type I diabetes on regular follow up in our department underwent a complicated abdominal surgery (double barrel jejunostomy and later ostomy reversal for traumatic jejunal perforation) in RGGGH. We assisted the surgical department in the management of diabetes. We managed to provide good glycemic control throughout his hospital stay(6-8 weeks) and was discharged later after complete recovery.

• Ms.ZZZ , a 18 year old female with type I diabetes underwent amputation surgery for infected diabetic foot ulcer. She was closely followed up and was managed by our department .She had an uneventful perioperative period and hospital stay.

• Continuous subcutaneous insulin infusion [CSII] pumps were initiated for four type 1 diabetes mellitus children who were earlier on multiple dose subcutaneous insulin, in collaboration with Idayangal trust ,Coimbatore. They were on close follow up and two weeks after starting the pump therapy ,the children informed that they are happy to be free of frequent injections and are under good glycemic control. They feel really independent and thankful for being given the pump and consumables free.

• The Department of Diabetology conducted a health camp for doctors for 2 days duration from 27/6/2022 to 29/6/2022 at RGGGH in collaboration with dept of Cardiology, Dept of Internal Medicine, Barnard Institute of Radiology, Regional Institute of Ophthalmology, Dept of Cardiology, Dept of Biochemistry ,Dept of Community Medicine ,MMC.
• The following tests were done: Plasma Glucose Fasting, HbA1C,Haemogram ,Urea, Creatinine, Sr.Uric Acid, Lipid Profile (F),SGOT, SGPT, Free T4 & TSH, Urine Routine ,ECG,ECHO, USG Abdomen, BMD, Fundus Examination. Around 169 doctors were screened during the 2 day program.