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Subspecialty Clinics

Diabetes

Diabetes in Pregnancy Clinic

Run conjointly by endocrinologists and obstetricians, this clinic manages patients with gestational diabetes, as well as pregnant patients with pre-existing diabetes. This clinic is currently conducted in the O&G Centre.

Young Adult Diabetes / Transition Clinic

This is a multidisciplinary clinic serving adolescents and young adults with diabetes, who are transitioning from the pediatric endocrine service to adult care. It is run by a team comprising specialist diabetes physicians, nurse educators, dieticians, and medical social workers.

Insulin pump Clinic 

This clinic serves patients who require continuous subcutaneous insulin infusions (ie: insulin pumps).

Obesity

Obesity and weight management Clinic

The Obesity and Metabolic Unit provides medical and surgical obesity management programs for the treatment of obesity and hyperlipidemia. This multi-disciplinary clinic is run by endocrinologists, bariatric surgeons, dieticians, physiotherapists and psychologists. This clinic operates from the LIFE Centre.

Thyroid fine needle aspiration Clinic

This clinic, run by specialist thyroid physicians, offers ultrasound guided fine needle aspiration (FNA) of thyroid nodules.

Osteoporosis

Osteoporosis and Bone Metabolism Clinic

This clinic is run concurrently by a specialist osteoporosis physician and specialist care nurses. It aims to provide state-of-the-art, comprehensive care for patients with osteopenia, osteoporosis and other disorders of bone metabolism. It is supported by allied health services including dietitians with a special interest in osteoporosis, and osteoporosis exercise classes run by experienced physiotherapists. This clinic operates from the LIFE Centre.

Transplant endocrinology Clinic

This clinic serves patients with transplant-related diabetes and metabolic issues. This clinic is currently conducted in either the Transplant Centre or the Diabetes and Metabolism Centre.

Obstetric Medicine (Endocrinology)

Pre-existing or new onset medical conditions in pregnancy have a significant impact on maternal, fetal and neonatal morbidity and mortality. The prevalence of medical conditions in pregnancy is rising because of increasing maternal age, with women more likely to have acquired medical disorders such as diabetes mellitus, and hypertension. 

It is important to manage endocrine conditions (such as diabetes mellitus, obesity, thyroid disorders, pituitary and adrenal disorders, and calcium disorders) well to mitigate maternal, fetal and neonatal risks. Treating pregnant mothers require a unique approach, with special consideration about the safety of investigations and drug therapy during pregnancy and breastfeeding. There is a need for collaboration with the obstetricians during the course of pregnancy for optimal medical management. 

Endocrine conditions in pregnancy:

  1. Gestational Diabetes Mellitus (Refer to section on Gestational Diabetes Mellitus)
    • Pre-existing diabetes mellitus and gestational diabetes mellitus are increasing in prevalence in Singapore. Mothers are managed in a joint gestational diabetes mellitus clinic with the obstetricians.
    • Pre-conception counselling and care is available.

  2. Thyroid disease (Thyrotoxicosis/ Hypothyroidism/ Thyroid nodules)
    Thyroid disorders are common in women of reproductive age. Careful management and monitoring of thyroid function status will be carried out during the course of pregnancy.

  3. Obesity
    Obesity is affecting more women of reproductive age group. In pregnancy, the implications include metabolic conditions like diabetes mellitus, high blood pressure, and requirement of special anesthetic considerations. Multi-disciplinary care will be provided for by endocrinologist, dietitian, physiotherapist, bariatric surgeon and anesthetist in the pre-conception and during pregnancy.

  4. Pituitary and Adrenal disease
    Pituitary and adrenal disorders are generally uncommon in pregnancy. Some cases may require surgery in the second trimester of pregnancy. Coordinated multidisciplinary care can be arranged with endocrinologist, neurosurgeon, general surgeon, and obstetrician.

  5. Parathyroid disease/ Calcium disorders
    Calcium physiology changes significantly during pregnancy and lactation. Calcium disorders can be managed by multidisciplinary care with endocrinologist, head and neck surgeon, and obstetrician.

Men's Health

Men’s Health Clinic (Endocrinology)

Men’s Health Clinic is a subspecialty clinic within SGH Endocrinology that focuses on the evaluation and management of testosterone related conditions. 

Men across lifespan may face health issues that are driven by or associated with abnormal testosterone production. 

These may be related to reproductive disorders, including delay or incomplete puberty (in adolescents or young adults), impaired sexual function, subfertility, and late-onset hypogonadism (popularly labelled as andropause in older men). 

Affected men may also experience a myriad of non-reproductive symptoms resulting in a poor quality of life, in particular mood swings, low energy level, inability to concentrate, sleep disturbances, and decrease in muscle bulk and strength.

Furthermore, metabolic disorders are closely linked to testosterone deficiency (hypogonadism). As such, affected men may suffer from abnormal blood glucose (diabetes), a greater fat-to-lean mass body composition (increased adiposity and sarcopenia) and low bone mineral density (osteoporosis). 

Specialised clinical evaluation is therefore necessary to establish the diagnosis of hypogonadism and its underlying cause, as well as the presence of any other hormonal disorders (e.g. thyroid, prolactin), associated medical conditions and complications. 

Treatment of hypogonadism and associated conditions is multi-faceted due to its complexity. In selected patients, multidisciplinary care is delivered together with physicians and health care providers from other specialities. 

Testosterone replacement therapy (TRT) plays a central role in addressing the symptoms and complications. The mode of TRT may differ between individuals depending on the etiology and goals of treatment.

In general, TRT aims to replace blood testosterone level to within that of normal physiological range, along with personalised titration according to age and co-existing medical conditions. Regular monitoring during treatment further ensures the safety of patients.

Diabetes and metabolism-related clinical services:

Patients with diabetes mellitus and diabetes-related disorders are seen at the Diabetes and Metabolism Centre, which provides the essential range of related services under one roof.

1) Personalised diabetes consultation


2) Dedicated podiatry service for diabetes-related foot problems


3) Fundal photography for early detection of diabetic retinopathy


4) Nurse educators for one-on-one diabetes counselling


5) Dietary counselling


6) Exercise Programme (with the Rehabilitation Department)
7) Continuous glucose monitoring
8) Regular self-management courses for patients with type 1 DM (Dose Adjustment for Normal Eating – DAFNE)
9)  Dental services for periodontal disorders

Endocrinology-related clinical services:

1) On-site blood and urinary testing
2) Specialised endocrine testing
3) Osteoporosis exercise program