Diabetes

Diabetes mellitus is characterised by high levels of blood sugar (glucose) resulting from defects in either insulin secretion or insulin action, or both.

If not closely monitored and controlled, the condition can lead to a host of acute and chronic complications eg. heart attack, stroke, blindness, kidney failure, nerve damage, impotence in men, increased risk of infection or blood vessel disease that may eventually require amputation.

There are two types of diabetes – namely Type I and Type II. Patients with Type I Diabetes suffer from an absolute insulin deficiency, meaning that their body does not produce enough insulin to lower the blood sugar.

Patients with Type II Diabetes usually show some level of insulin resistance although there is an element of insulin deficiency as well. Type II Diabetes typically occurs among those in the older age group who are usually overweight and / or obese.

However, with good management and close monitoring of blood sugar levels, the risk of developing these complications can be reduced substantially.

Our Services:

• Diagnosis of condition followed by complications screening for the eyes, kidneys, feet and heart
• Treatment and management of the condition
• Counseling and education by diabetes nurse educator and dietician
• Foot screening performed by podiatrist

Thyroid Disorders

The thyroid is a small gland located in your neck that produces hormones that regulate your metabolism and growth. Hyperthyroidism (production of excessive hormones by the thyroid gland) and hypothyroidism (a lack of thyroid hormone) are examples of thyroid disorders. Other conditions include thyroid nodules and thyroid cancers.

Treatment

We offer complementary medical and surgical management of a spectrum of benign and malignant thyroid conditions including:

• Ultrasound guided biopsies for lumps in thyroid gland
• Diagnosis and management of hypo and hyperthyroidism
• Treatment and management of thyroid cancer

Obesity & Related Disorders

Obesity is one of the fastest growing health problems in the world ─ one that Singapore also faces. Defined as a problem of chronic positive calorie imbalance in a genetically predisposed individual, obesity puts individuals at a higher risk of medical, surgical, orthopaedic and psychological illnesses. Those with morbid obesity have a substantially shortened life expectancy due to complications resulting from their obesity. Several studies have found that a modest reduction of 5% to 10% of body weight can mitigate risk factors for heart disease including lipid levels, glycemic control and blood pressure.

We provide comprehensive multi-disciplinary programs to assist patients in controlling their diabetes and help overweight and obese patients reduce their weight by:

• Investigating potential causes of obesity e.g. hypothyroidism, Cushing’s disease, etc.
• Prescribing treatment and management of these conditions including medical (diet, exercise, behavioural modification, drugs) and surgical therapies (bariatric surgery).

Lipid Disorders

Lipid disorders are a group of inherited metabolic disorders in which there are abnormalities of cholesterol and triglycerides.

Lipid abnormalities are usually associated with an increased risk for vascular disease as well as heart attacks and strokes. They are a combination of genetic predisposition and dietary intake. We see individuals with hypercholesterolemia, suspected familial cause of hypercholesterolemia in addition to hypertriglyceridemia.

Treatment

• Investigation and diagnosis of lipid disorders affecting patients eg. hypercholesterolemia, hypertriglyceridemia, etc.
• Treatment and management of these conditions

Calcium & Bone Disorders

Common calcium disorders that we treat include osteoporosis, hypercalcemia, hypocalcemia, suspected cases of osteomalacia and Paget's Disease.

Pituitary Disorders

Pituitary disorders are conditions brought about either by an excess or lack of hormones produced by the pituitary gland. Examples include hypopituitarism, pituitary tumours, Cushing’s Disease, acromegaly and prolactinomas.

Adrenal Disorders

We treat patients with adrenal insufficiency, primary aldosteronism, pheochromocytoma, adrenal tumors, adrenal insufficiency as well as Cushing’s Disease and congenital adrenal hyperplasia.

Endocrine Hypertension

Endocrine hypertension occurs when individuals suffer from high blood pressure caused by excess hormone production.

Using Insulin

Why Insulin

Your doctor may have recommended that you start on insulin.

If you have Type 1 diabetes, you will need insulin therapy to replace the insulin that your body is unable to produce.

Insulin is sometimes prescribed for people with Type 2 diabetes or gestational diabetes. You need the insulin therapy if other treatment have not been able to keep your blood glucose levels within the desired range.

How to inject Insulin

• Watch a video on how to inject insulin from a vial or insulin pen here
  (Video credits to Health Promotion Board)

• Download step-by-step guide on the administration of insulin therapy:
• How to draw and inject insulin from a single vial (PDF, 711KB)
• How to draw and do mixed insulin injection (PDF, 1.1MB)
• How to use an insulin pen (PDF, 193KB)

Storage of insulin

• Store your unopened insulin in the fridge, not freezer.
  
• Write the date on the vial or pen once you open a vial of insulin or pen.
  
• Keep opened vials and pens at room temperature. Do not expose them under hot sun.
• Discard open vials and pens 28 days after opening.
• If you are using the cloudy insulin pen (e.g. Novomix), discard and use a new pen when you have less then 12 units left in the pen.
  

Rotation of injection site

• Do not re-use needle. Use a new needle for each injection.
• Rotate your injection spots regularly. Ensure that there are no bruises or lumps at your injection site. If there are bruises or lumps, pick another area for insulin injection.

Important points

To contact your healthcare team for a refill prescription at least 2 weeks before you run out of medications.