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| Services Offered |
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 Diabetes Care Programme |
The Diabetes Care Programme provides intensive management of diabetes and diabetes related problems
- Retinopathy
- Nephropathy
- Neuropathy
- Ischaemic Heart Disease
The Programme also offers
- Management of gestational diabetes
- Paediatric diabetes clinics
- Psychological and social worker consultations
- Assessment of family risks of developing diabetes
The Diabetes Care team includes a Clinical Psychologist, experienced Dieticians and Physiotherapists. Nurse-clinicians, under the supervision of a Diabetologist, provide training in prevention and management of diabetic emergencies as well as the prevention and treatment of complications of diabetes.
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| The Podiatry Centre |
| The Podiatry Centre provides a comprehensive treatment approach to all foot problems in diabetic patients. The service is run by a doctor trained in the treatment of chronic, diabetic foot ulcers, a chiropodist, and vascular surgeons who provide services such as angioplasty and by-pass surgery for patients with blocked arteries in their feet. Regular preventive care classes are also held.
Today in India there are over 45 million diabetes patients and an estimated 50,000 amputations occurring per year due to diabetes related foot problems. In the diabetic patients, due to nerve damage and poor blood supply of the foot, various deformities of the toes and feet occur. This causes areas of raised pressures in the soles of the feet, where ulcers develop. These ulcers act as portals for the entry for bacteria leading to serious infections, which can result in amputations or even death.
The concept of surgical correction for the diabetic foot and ankle deformity has recently evolved as a means to correct foot deformities secondary to long standing diabetes. These surgeries help to prevent the formation of callus and ulcers of the foot and thus, these surgeries can prevent amputations in diabetics.
- Over-riding of the big toe and crowding of toes can cause skin breakdown thus resulting in ulcers and infection.
- Scarf Surgery is the corrective surgery to bring the toes to their normal position. If the foot is not properly aligned, then again high pressures build-up in the soles causing ulceration.
- Tendon Transfer surgery will correct the alignment and prevent ulcers, and eventually amputations.
- Charcots Foot is a severe complication of diabetes, which leads to erosions, and collapse of the foot and ankle bones, which in turn lead to marked deformities and ulcerations. Surgical corrections such as Triple Arthrodhesis and Plate Fixation of fractured foot bones in Charcots Foot are performed so as to normalize the shape and function of grossly deformed feet.
The Centre for Endocrinology and Diabetes at AIMS Hospital is the only programme in Asia where these corrective surgeries are being performed exclusively in high risk diabetic foot patients. By employing these novel surgical techniques a large number of amputations in patients with diabetic foot ulcers and deformed diabetic feet can be prevented. |
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| Diabetic Foot Care Programme and Vascular Clinic |
| The Department of Endocrinology at AIMS is the most comprehensive one stop centre for the evaluation, treatment and rehabilitation of preventive and therapeutic aspects of diabetic foot. The diabetic foot division of the Department of Endocrinology is fully equipped with the most modern equipment to assess the function of nerves and blood vessels. The Department provides all services, including special customized foot wear under one roof. The Podiatry Division also provides home dressing kits for dressing of diabetic foot wounds. So far, over 3000 foot surgeries have been carried out by the department with a high limb salvage rate. The department is equipped to carry out the latest and the best procedures for care of diabetic foot patients, including negative-pressure wound therapy. The foot care program is the only one in Asia to carry out reconstructive surgery in deformed diabetic foot, an emerging strategy for preventing diabetic foot-related amputations. Other facilities available include MRI-based lower limb angiography and treatment-planning, biothesiometry, sensitometry, TcPO2, pedopodography and customized footwear. |
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| Paediatric and Adolescent Endocrine Clinic |
| This clinic is held monthly on the second and fourth Thursdays in conjunction with the Paediatric Department in order to provide specialized care for children and adolescents with growth disorders, early or delayed puberty, thyroid diseases, bone diseases, diabetes, or other endocrine disorders. |
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| Lipic Clinic |
| The Lipid Clinic is devoted exclusively to treating patients with high cholesterol and high triglyceride levels. |
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| Impotence Clinic |
| The only clinic of its kind in India, an endocrinologist, a urologist, and a psychologist work as a team to provide quality care to men with erectile dysfunction. |
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| Exercise and Dietary Programme |
| The Exercise and Dietary Programme is aimed at full-fitness utilizing treadmills, exercise bicycles, and other equipment under the guidance of a trained physiotherapist. The amount of exertion is gradually increased depending on each individual's capability.
A structured yoga program under the supervision of a trained yoga teacher is also available offering specific yogasanas that help in controlling diabetes. Patients participate in weekly sessions for a period of one month and then are encouraged to continue the yoga exercises at home. |
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| Metabolic bone disease clinic |
| : The department is fully equipped to assess and treat metabolic bone diseases like osteoporosis and osteomalacia. Assessment of bone mineral density (bone densitometry) by DEXA (Dual Energy X-ray Absorptiometry) and evaluation of metabolic parameters are performed for patients suspected to have low bone mass (osteopenia) and/or bone thinning (osteoporosis). The Department has been the first endocrinology center to acquire a Bone Densitometer in Kerala, and has the longest experience in the diagnosis and treatment of low bone density. The Densitometer machine measures Bone Mineral Density, a simple and cost effective technique to diagnose loss of bone mass at an early stage. Bone loss or osteoporosis is a condition that can cause fragility fractures. In India, osteoporosis is an underdiagnosed disease especially in postmenopausal women. This is due to the lack of proper awareness about the disease among the public and lack of sensitive diagnostic tools. So far, over 1000 people have been screened for this disease. |
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| Comprehensive diabetes care |
| In addition to the routine out-patient based care of diabetic patient, the department has also initiated comprehensive diabetic care program, focused on providing an annual diabetes check up to patients. Diabetes is known as a silent killer, and if left untreated, diabetes can cause kidney, nerve, eye, heart and foot problems. The annual check up assesses the degree of glucose control and also measures the presence of diabetic complications. If detected early, many of these complications can be treated, and their progression stopped. The Diabetes Care team includes a clinical psychologist, experienced dieticians and a physiotherapist. Nurse-clinicians, under the supervision of a diabetologist, provide training in the prevention and management of diabetic emergencies, as well as the prevention and treatment of complications of diabetes. The department is also experienced in handling cases of pregnancy-related diabetes as well as juvenile (type 1 diabetes). The department has been running a successful insulin pump program for children with type 1 diabetes. Indeed, the department was the first in the country to use insulin pump in diabetic pregnancy. |
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