Patients referred for diabetes will be seen at the Diabetes Clinics - please refer to the Diabetes Service for more information. Diabetes is a disease that affects the way your body deals with sugar. The amount of sugar in the blood is controlled by insulin which is a hormone produced by the pancreas (an organ that lies near your stomach). Patients with diabetes have too much sugar in their blood. Lowering the blood sugar is important for the prevention of serious complications. Some indications that you may have diabetes include: change in your weight feeling thirsty excessive passing of urine blurred vision slow healing of sores tingling in hands and feet. If you experience any of these symptoms please see your doctor. In most people there are hardly any symptoms early in the disease. You are more likely to develop diabetes if you are overweight or have a family history of diabetes. Tests There are two types of tests in diabetes. Some are to diagnose if you have the condition and others are to monitor your treatment and manage the disease to prevent complications. Diagnosis testing The first test you will have had is a blood glucose (sugar) test. This is most sensitive if it is taken when you have an empty stomach so is usually done first thing in the morning before breakfast. If there is some question as to whether or not you have diabetes you will have a glucose tolerance test. For this test you have a blood test, then drink a very sweet drink and 2 hours later have another blood test. Monitoring testing Finger prick test. A very quick test where your finger is pricked, a drop of blood is collected on a strip and examined by a small hand-held machine. It takes less than a minute to do. Depending on the type of diabetes you have, you may have one of these machines at home and do your own test a few times a week or day. Glycosylated haemoglobin test (HbA1c). This is a test that is used to keep track of how your diabetes has being managed over the last 2 to 3 months. You might have 2 to 4 of these tests a year arranged by your doctor or diabetes nurse. Other tests Because diabetes can affect many other organs you will, over time, have other blood and urine tests as well as tests for your heart and eyes. Treatment Diabetes is treated with a combination of diet, exercise and medications. You may also be referred to a: dietitian, to advise you on healthy eating podiatrist, for foot care dentist, to ensure your gums and teeth are well maintained nurse, to help with day-to-day management of your diabetes ophthalmologist, to monitor your eyes. The amount of sugar in the blood varies throughout the day but normally remains within a narrow range (usually 4 – 6 mmol/L). Even with medication it tends to be slightly higher in people with diabetes but you will learn what level is your best target. You will receive lots of information about what you can do to manage your diabetes when, and after, you attend the clinic.

Osteoporosis is a disease that weakens your bones. Osteoporosis is not painful but it makes your bones more prone to breaking (fracture). Women are more likely than men to suffer from osteoporosis and as you get older you are more likely to have it. Tests Osteoporosis can be diagnosed by measuring bone mineral density (BMD). This test involves taking x-rays or a computer tomography (CT) scan of the bones in your spine, wrist, arm or leg. You may be asked to have a blood test to look for reasons why you might have osteoporosis. Treatment There is no cure for osteoporosis, but there are treatments that can improve bone strength and reduce your chances of breaking a bone. If you are diagnosed with osteoporosis you may be prescribed several medications to improve your bone strength. You will have follow-up either with your GP or specialist to make sure that the medication suits you. You will be given some more detailed reading about things you can do to help manage your osteoporosis and about the type of medication you are on.

The thyroid is a gland that sits in the front, and towards the bottom of, your neck. It is responsible for producing a hormone called thyroxine. Thyroxine has an important role in the body as it affects many organs including the heart, muscles and bones. Diseases that affect the thyroid can make it either overactive (producing too much thyroxine), underactive (not producing enough thyroxine) or enlarged (goitre). Endocrinologists specialise in these diseases as well as cancer of the thyroid. Tests Thyroid problems are usually picked up with a blood test but there are other tests you may have to work out why the problem has occurred. These include: an ultrasound scan. This is where a hand-held scanner head is passed over your thyroid gland and pictures are taken a nuclear medicine scan. This is where you are given something to drink that contains a substance that only goes to the thyroid gland. Although it is radioactive it does not damage you or anyone else. Pictures are then taken of the thyroid gland that give the doctor information about what might be causing the problem fine needle aspirate (FNA). This is where the doctor puts a very fine needle (smaller than for a blood test) into the thyroid gland to take some cells to look at under the microscope.

The pituitary gland is in your brain. It controls most of the endocrine (hormone) system in your body. When disorders occur in this gland a variety of problems can appear. If your doctor thinks you have problems in this area (usually discovered with a series of blood tests) they will refer you to a specialist endocrinologist.

Polycystic ovary syndrome (PCOS) is a hormonal disorder that can cause you to have a variety of symptoms including: no periods or irregular periods, increased hair growth on the face and body, acne (pimples) and increased bodyweight. PCOS is also one of the main causes of infertility in women. The ovaries of women with PCOS often contain many small cysts (fluid-filled sacs), but this does not seem to be the cause of the condition. For women who have not reached menopause, the most common treatment is the birth control pill, which will regulate your periods. There are also other medicines that can help control the symptoms.