Diabetes & Metabolism
Type 1 Diabetes
An autoimmune condition needing insulin from diagnosis. With modern regimens, monitoring and carbohydrate counting, children and adults with type 1 diabetes lead entirely unrestricted lives.
Symptoms that bring people in
- Rapid weight loss
- Excessive thirst and frequent urination
- Profound tiredness
- Bedwetting in a child who was previously dry
- Abdominal pain, vomiting, or breath that smells fruity
Having one of these does not mean you have this condition — several overlap with far more common problems. It means the question is worth asking properly.
In type 1 diabetes the immune system destroys the insulin-producing beta cells of the pancreas. It most often appears in childhood or adolescence but can begin at any age, and it is not caused by diet or lifestyle. Insulin is required from the outset and for life — this is replacement of a missing hormone, not a treatment of last resort.
The regimen
Care is usually built on a basal–bolus regimen: a long-acting insulin covering background needs, with rapid-acting doses matched to the carbohydrate in each meal. Insulin pump therapy is an option for those who want it and can manage it. What determines how well any regimen works is less the choice of insulin than the education around it — recognising and treating hypoglycaemia, adjusting for illness, exercise, fasting and travel, and rotating injection sites to prevent lipohypertrophy.
Monitoring
Self-monitoring by fingerprick remains the foundation. Continuous glucose monitoring, where affordable, adds something a fingerprick cannot: the shape of the curve overnight and between meals, and therefore the ability to correct patterns rather than react to single readings. Time-in-range is now as useful a target as HbA1c.
Living with it
Practical questions get practical answers — school and examinations, sport, fasting during religious observance, driving, and eventually pregnancy, which needs planning well before conception. Screening for associated autoimmune conditions, particularly thyroid disease and coeliac disease, is part of routine follow-up, alongside annual checks of eyes, kidneys and feet once the recommended interval from diagnosis has passed.
Diabetic ketoacidosis
Vomiting, abdominal pain, rapid deep breathing or drowsiness in someone with type 1 diabetes is a medical emergency. Insulin must never be stopped during illness, even when eating little — that is exactly when ketoacidosis develops.
This page is general information. Doses and treatment choices in endocrinology are individual, and are decided at a consultation with your reports in front of us. Please do not start, stop or change a medicine based on this page.
Common questions
Before your first visit
How do I book an appointment?
Use the appointment form on this website and the clinic will telephone you to confirm a time, usually within one working day. For a same-day or urgent request, please ring the number in the page header instead — a phone call is always faster than a form.
Hospital OPDs at CMRI and Narayana Memorial are booked through the hospital's own reception. For district chambers, it is worth calling the chamber number listed on its page before travelling.
Which chamber should I choose?
Whichever is easiest for you to reach and return to. Endocrine conditions need review over months and years rather than a single visit, so the chamber you can get to comfortably every few months is nearly always the better choice than the one that seems most impressive.
That said: if your problem needs same-day tests, an ultrasound, or admission, a hospital OPD is the better setting. The Chambers page lists every location with its days and timings, and the weekly timetable shows them all side by side.
Do chamber timings ever change?
Yes — and this is worth taking seriously if you are travelling any distance. Several district visits run on a monthly rotation, such as the 1st and 3rd Saturday, and a hospital OPD can be rescheduled at short notice. Timings shown on this website are kept up to date and any known cancellation appears on the chamber's page, but please telephone ahead before a long journey.
What should I bring to the first consultation?
Bring everything you have, even if it seems old or irrelevant:
- all previous prescriptions, including from other doctors
- every blood report and scan you hold, in date order if possible
- the actual strips or boxes of the medicines you take, or a written list with doses
- your home blood sugar or blood pressure diary, if you keep one
- for a child, the growth chart and immunisation record
Old reports are genuinely useful. A five-year-old thyroid result or an earlier scan often changes the plan, because what matters in endocrinology is frequently the trend rather than today's number.
Consultation
Request an appointment
Tell us which chamber suits you and when. We will confirm your slot by phone.