::Departments : Clinical : Diabetology
DEPARTMENT OF DIABETOLOGY 
 
Introduction
 
            Diabetology department was started separately in July 2000 identifying the need for one from the wealth of cases collected in the Diabetic clinic which was attached to medicine department and late to the endocrine department. This department is fully sponsored and administered under the Director of Medical Education, of the Government of Tamilnadu. Within a short period the Diabetology department has made an impact in every aspect. Till date about 51,353 cases have been registered and patients getting drugs regularly which amounts to about 1000 patients per out patient day. The activities of the department are discussed under the following heads.
 
 

         1. Topography,      2. Academic,        3. Patients care,     4. Patient Education,  
         5. Research,           6. Epidemiology.  7. Deficiencies      8. The Future
 
  1. Topography 
This department is located at the fag end of the hospital building just on the road facilitating diabetic patients in general and diabetic foot patients in particulars to come in rickshaws and two wheelers and have their treatment and insulin injection and push off without any inconvenience.
           
    The out patient room with appointed tables for the assistants and chief aids to dispose the patients in a comfortable manner.
 A  separate room for Insulin injection administration is manned by two staff nurses with proper bio medical waste disposal of the needles and syringes.
 
     
This is the patient waiting hall where new patients and referral patients wait before being disposed. This is surrounded by education charts to impart the  knowledge about diabetes in a simple way.

              This is an exclusive foot care room where in, the foot complication of diabetes is identified by three instrument and thus helps to prevent loss of toes, foot and even loss of life.
          
     The dietician room serves as a place for one to one discussion about diabetes and the diet plan.
 
 
A separate pharmacy counter to issue all the medications is also attached with the department so that patient need not go to a different place to get the medications. Each time the medications are given for 28 days.
 
 
            A separate lab for blood sampling is functioning and results are issued the same day and drug titration is also done and issued. Case records are stored from the first case till date and could be retrieved within minutes.
 
            A small seminar A/c hall with LCD projection system, TV and CD player is subserving the function of diabetes patient education and other academic activities.
 
            The professor’s room A/c is also used for intra departmental discussions and departmental audit.
            On the whole it is a small, sweet home for diabetics and Diabetologist.
 
  1. Academic 
 
 
  1. Undergraduate students (MBBS) : fifteen day crash course on basic and clinical Diabetology is conducted during their first clinical year posting for all the batches of students.
  2. Diabetes daily discovery : A quiz programme in diabetes in the form of multiple choice questions is displayed daily and answers on the next day. The student who answers the maximum questions correctly in a month gets a prize and a certificate.
  3. M.D. (General Medicine) Post Graduates : Discussions along with case presentation and lectures and regular phenomenon during their fifteen days postings.
  4. M.S (Ophthalmology) Post Graduates : A complete synopsis of diabetes along with relevance to eye involvement in diabetes are discussed and evaluation done at the end.
  5. M.S. (Ophthalmology) Post Graduates (from Aravind Hospital) : These students also join for a fifteen day posting and a similar program is conducted for them also.
  6. Nurses Education Program : Investigatory techniques like urine sugar and acetone estimation and insulin injection technique are demonstrated and supervised.
  7. Weekly physicians’ conference : Interesting cases are presented frequently with the view of highlighting rarer problems and important concepts.
  8. Diabetes update : An annual program organized by this department targeted towards recent development every year was held recently.
  9. Compulsory Rotatory Resident Internees : CRRIs are posted in Diabetology Department during their community Medicine posting and there has been a practice oriented, entrance exam oriented useful education which is offered here for them.
 
  1. Patient  care 
The ultimate aim of this department is to deliver the best patient care. This specialized care is on par with any corporate private hospital in the country.

Department Routine :

Every new patient is completely evaluated for the extent of diabetes and its complications. Ophthalmology opinion, complete blood test, x-rays, ECG etc are obtained and registered in the department. Each patient is given a follow up book, identity card, and a diet sheet. Every patient is also counselled personally by the dietician  regarding diet. We also get the help of TB specialist, Cardiologist, Surgeon, Nephrologist, Orthopaedic Surgeon, Physiotherapy departments for our patients who require additional workup. A separate pharmacy counter in the department has releaved the plight of patients in procuring medications.  Insulin is issued for all type 1 diabetes patients. Gestational diabetics are taken special care by our diabetes pregnancy clinic with the help of our Obstetrics department.
  1. Patient Education  
  • Video education program is played everyday which consists of the routines of the department as well as diabetes education in the form of cartoons and also in the form of a skit by renowned actors, which is very helpful in imparting diabetes knowledge to all patients.
  • Small group discussion conducted for patients and their attenders are well attended by one and all headed by dietician, assistant professor and professor.
  • Mass education programs organized by the department is conducted for the benefit of the patients and guest speakers are also invited during such meetings.
 
  1. Research Work 
Clinical research is conducted since inception of the department. Some of the most important works are the following.
  1. Role of dietary fiber in glycaemic control
  2. Fate of IGT
  3. Evaluation of stress hyperglycaemia
  4. Auditory function in Diabetes
  5. Trace element levels in diabetes
  6. GAD antibodies in lean young diabetes
  7. Fibrinogen levels in diabetes
  8. Madurai Community screening 10,104 persons.
 
  1. Epidemiology Survery  
This was done in small way inside the hospital. Every category of the employees of our own institution were screened and it is surprising to know that the prevalence is very high.
  1. Last grade servants              -           16%
  2. Luskers                                -           10%
  3. Ministerial Staff                   -           20%
  4. MNA & FNA                      -           18%
  5. Staff Nurses                         -           20%
This has given us the lead and vision to upgrade the department with a epidemiological survey team which would be useful to get a real prevalence of diabetes.
 
7. The Future 
  • Being the prestigious institution next to Madras Medical College, Chennai, this department should be raised to the level of an institute.
  • Diploma Diabetology courses should be started here also.
  • More facilities for patients in the form of space, wards, food and purchase of insulin at Government rates as in Kilpauk Medical College, Chennai should be feasible.
  • Lastly Research assistants and adequate staff is to be posted to enhance Diabetes research.        
  • We Indians, more so the south Indians have the highest incidence of Diabetes. Hence we are the right persons to plan research and protocols to prevent Diabetes in the Society.
 
 

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