SW Thames Prospectus - South Thames Diabetes and Endocrinology

antenatal service, joint diabetes complication clinics for nephropathy,
neuropathy and retinopathy, paediatric and adolescent diabetic
clinics, a patient education programme.
Intensive management of type 1 patients is based around the DAFNE
programme (Dose Adjustment for Normal Eating) which provides
structured education for patients in the form of a one week intensive
course which is run at 4 times a year.
The Diabetic Foot Clinic provides a comprehensive service for the
management of the diabetic foot and has a very large caseload of
complex patients with neuropathic and ischaemic ulceration and
Charcot arthropathy. There is a rolling audit programme including
management of diabetic emergencies and diabetic pregnancy in which
SpRs are encouraged to participate.
Endocrinology Services
The Department of Endocrinology provides a local and tertiary referral
service for all aspects of Endocrinology, with particular strengths in
pituitary disorders, thyroid disorders and specialist clinics for genetic
endocrine disorders and Obesity.
There is a busy programmed Endocrine Investigation Unit staffed by a
full time endocrine specialist nurse and this provides excellent
opportunities for training in Endocrine investigations.
Pituitary Disorders: St George’s is a regional neurosurgical centre
and is now amongst the busiest centres for pituitary surgery in the
UK. Close collaboration exists between the endocrine and
neurosurgical departments, with monthly joint meetings. Both pre-
and post-operative assessment of patients with pituitary disease is coordinated
through the Endocrine Investigation Unit.
Thyroid disorders and thyroid cancer: The department hosts weekly
thyroid clinics for management of general thyroid disorders. In
addition, thyroid cancer management is currently undertaken in the
setting of a joint multidisciplinary meeting in conjunction with
consultant endocrine and ENT surgeons.
Obesity: St George’s is an important referral centre for obesity
surgery, and the endocrine department provides medical input to the
preoperative evaluation and management of patients, working closely
with the surgical and psychiatric teams.
Genetic Endocrine disorders: A large cohort of patients is followed in
clinics designated for rare patients with genetic conditions including
von Hippel-Lindau, Multiple Endocrine Neoplasia and monogeneic
forms of diabetes.
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