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Diabetes and Endocrinology Service

Diabetes and Endocrinology Service

Diabetes service

At the L&D the Multi-Disciplinary Diabetes Specialist Team offers a comprehensive range of diabetes services for in-patients and out-patients of all age groups, including Children and Young Persons (CYP). There are dedicated Diabetes Specialist Nurses (for adults and CYP), Specialist Dieticians, Specialist Podiatrists, and Consultant led consultations. For out-patients, most of the multi-disciplinary team specialist clinics are held in the dedicated Diabetes Centre or in the paediatric out-patient department.

CYPs with suspected diabetes are seen on the day of referral in the Paediatric Assessment Unit (PAU) and have open access to the unit with 24 hour expert advice for diabetes related issues. The Paediatric Diabetes Nurse Specialist, following diagnosis and when needed, support the family/child in the community setting and at their school. The team provide support and education for the staff at school to support the diabetes.

There is a close working link with both the Luton and Bedfordshire Integrated Community Diabetes Services.

A free diabetes information and advice website has been developed in conjunction with Bedford Hospital Diabetes Specialist Team, for health care professionals in primary care.

In addition to general diabetes clinics, the team can offer a wide range of specialist clinics and services: 

Clinics

  • Diabetes in the Elderly (over 65s)
  • Paediatric (Children)
  • Young Adult / Adolescent
  • Insulin Pump Clinic
  • Adult General Diabetes Clinic (new and follow up)
  • High HbA1c Clinic (Paediatric Diabetes Nurse led)
  • Joint Diabetes Antenatal Clinic
  • Joint Gestational Diabetes Clinic
  • Pre-Conception Counselling Clinic
  • Diabetic Foot Clinic
  • Procedures and services
Procedures and services
  • Assessment and management of complex diabetes
  • Assessment and management of acute and chronic diabetes complications
  • Insulin and injectable therapies initiation
  • Continuous home blood glucose monitoring
  • Structured education programs for patients
  • Assessment and initiation of subcutaneous insulin infusion pump therapy
  • Group educational services
  • Rapid assessment and management of acute diabetic foot ulcers
  • Support from Clinical Psychologist
  • 1:1 Teaching on carbohydrate counting

Endocrinology Service 

The L&D is one of the few hospitals providing a comprehensive endocrine service, encompassing common and uncommon endocrine disorders. We work in close collaboration with endocrine surgery, paediatric endocrinology and clinical biochemistry and the endocrine team in Cambridge, Oxford and Great Ormond Street Hospital.

The endocrine team runs out-patient clinics at the L&D to see new referrals and for follow-up of patients with complicated disorders. A high percentage of patients are discharged from their clinic follow-up after their acute problems have settled, but some of the complicated problems receive life long follow-up. The team also runs a consultation service for in-patients with endocrine disorders and endocrine emergencies. There is an Adult and Paediatric Endocrine Nurse Specialist, who run nurse led follow up clinics, provides endocrine counselling to patient, pastoral care, and facilities endocrine function tests. There is also a joint endocrine adolescent clinic and outreach clinic from Great Ormond Street Hospital.

Any condition which indicates a hormonal dysfunction (thyroid, pituitary, adrenal, ovaries/testes) are seen in clinic. Other conditions seen are: 

  • Electrolyte and metabolic disorders
  • Secondary hypertension
  • Other rare disorders with a strong suspicion of endocrine cause
  • Pregnant patients with endocrine problems can be seen at the request of a GP or obstetrics team

A good system of tests (requiring day admission) has reduced the need for patients travelling to Cambridge, Oxford, or Great Ormond Street Hospital for investigations or after their surgery in those centres.

Consultants

  • Consultant Dr Auditi NaziatAuditi NaziatSecond nameNaziatBiographyTrained in Diabetes and Endocrinology in Oxford. Joined the L&D in 2014 as a Consultant Physician. Leads the Ambulatory Care Service, Hyponatramia Service and Secondary Hypertension Clinic; and chairs the Diabetes and Endocrinology Academic meeting.
  • Kah Fai WongSecond nameWongBiographyMBChB, MRCP(UK) Consultant Physician in Diabetes & Endocrinology. Undergraduate training in Aberdeen, completed higher specialist training in West Midlands and Cambridge. Specialty interests include young adult diabetes, insulin pump and Endocrinology.
  • Nisha NathwaniSecond nameNathwaniBiographyConsultant
  • Ritwik BanerjeeSecond nameBanerjeeBiographyConsultant
  • Ronald MisquithSecond nameMisquithBiographyMBBS, MD, MRCPCH Consultant Paediatrician and Clinical Director. Graduated in India, completed higher specialist training in Paediatrics in London. Special interests: Diabetes, Endocrine and High Dependency Care. Joined the L&D in 2009 as a Consultant Paediatrician.
  • Shiu-Ching SooSecond nameSooBiographyMBBCh, MA (Cantab), FRCP Trained in Cambridge and London. Consultant Physician at the L&D since 2001, Clinical Director in Diabetes & Endocrinology since 2015. Special interests includes diabetes in pregnancy and in-patient diabetes.
  • Tariq RehmanSecond nameRehmanBiographyMB, MD, FRCP Consultant Diabetes and Bariatric Physician. Undergraduate training in Karachi. Postgraduate training and NHS practice in UK since early 1980s. Key interest in managing young people with diabetes and those with kidney disease, obesity and related problems.
  • Usha NiranjanSecond nameNiranjanBiographyM.B;B.S, MRCPCH Consultant Paediatrician at the L&D since 2016. Graduated in India and underwent Paediatric Specialist training in Sheffield. Acute Paediatrics Consultant with special interest in Diabetes and Endocrinology. Specialised clinics include Diabetes, Thyroid, Bone and Obesity.