Listen to Professor John AH Wass, professor of endocrinology at Oxford University, and Dr Ioannis Spiliotis, clinical research fellow and honorary specialty registrar in diabetes and endocrinology at Oxford University, discuss their specialty and give advice on how to get into it.
Introduction to endocrinology and diabetes
Endocrinology and diabetes is one of the most challenging, rewarding and wide-ranging of the medical specialties. As diabetologists our role requires a complex interplay of education, behaviour change and the use of cutting-edge technology. As diabetes is a common long-term condition a career in endocrinology and diabetes will let you build up long-term patient relationships. At times this can be rewarding, such as sharing the joy of a mother with diabetes in the safe delivery of a baby; at other times challenging, such as trying to encourage people into lifestyle changes which they do not necessarily want to follow!
The diversity of the specialty means many consultants sub-specialise. Within diabetes there is the opportunity to sub-specialise in inpatient care, renal disease, vascular problems, genetics, technology (insulin pumps), transplants, HIV – areas in which many physicians are involved in cutting-edge research. Working closely as part of a multidisciplinary team, alongside other hospital specialties and with primary care, is an essential and enjoyable part of the job.
As endocrinologists we treat the dysregulation of hormonal control. When these controls go wrong there can be profound effects on a person’s life. These range from changes in physical appearance and psychological wellbeing, through important functions such as sex and reproduction, to life-threatening emergencies.
As endocrinologists and diabetologists, we are privileged to share the most intimate aspects of our patients’ lives and, by correcting the underlying hormonal issues, relieve their problems.
Endocrinology and diabetes resources
- Society for Endocrinology
- Young Diabetologists & Endocrinologists
- Diabetes UK
- BBC documentary The Fantastical World of Hormones with Professor John Wass.
- Consultant physicians working with patients – endocrinology and diabetes mellitus chapter (p91)
- Clinical Medicine articles:
- Chowdhury TA, Grant P. Drug therapies in type 2 diabetes: an era of personalised medicine. Clin Med 2016;16:441–7.
- Varma R, Karim M. Lesson of the month 1: Diabetic ketoacidosis in established renal failure. Clin Med 2016; 4:392–3.
- Brooks A, Chong J, Schpira et al. Type-1 diabetes revisited and lessons learned. Clin Med 2016;16:s6.
- Loh S, Spoon D, Singh M. Cause of long-term mortality among diabetics undergoing percutaneous coronary intervention. Clin Med 2016;15:s9.
- Bennett K. Diabetes in older people. Clin Med 2015;15:465–7.
- Winocour PH. Care of adolescents and young adults with diabetes – much more than transitional care: a personal view. Clin Med 2014;14:274–8.
- Paterson F, Theodoraki A, Amajuoyi A et al. Radiology reporting of adrenal incidentalomas – who requires further testing? Clin Med 2014;14:16–21.
- Grant P. Management of diabetes in resource-poor settings. Clin Med 2013;13:27–31.
- Kamath C, Govindan J, Premawardhana AD et al. Nephrogenic diabetes insipidus partially responsive to oral desmopressin in a subject with lithium-induced multiple endocrinopathy (lesson of the month). Clin Med 2013;13:407–10.
- Owen KR. Monogenic diabetes: old and new approaches to diagnosis. Clin Med 2013;13:278–81.
- Cheer K, George JT, Grant R et al. One-third of doctors completing specialist training in diabetes fail to secure a substantive consultant post: Young Diabetologists’ Forum survey 2010. Clin Med 2012;12:244–7.
- Bailey SL, Grant P. ‘The tubercular diabetic’: the impact of diabetes mellitus on tuberculosis and its threat to global tuberculosis control. Clin Med 2011;11:344–7.
- Lumb A, Wass J. Expanding boundaries of endocrinology. Clin Med 2010;10:238–41.
- Grant P, Lipscomb D. 21st century endocrinology. Clin Med 2009;9:459–62.
- Monson JP. Advances in endocrinology. Clin Med 2009;9:358–65.
- Evans KM, Flanaga DE, Wilkin TJ. Chronic fatigue: is it endocrinology? Clin Med 2009;9:34–38.
- Winocour PH, Gosden C, Walton C et al. The conflict between specialist diabetes services and acute-general internal medicine for consultant diabetologists in the UK in 2006. Clin Med 2008;8:377–80.
- Clinical Medicine CME section on diabetes (2014):
- Lamb A. Diabetes and exercise. Clin Med 2014;14:673–6.
- Wilmot EG, Mansell P. Diabetes and pregnancy. Clin Med 2014;14:677–80.
- Garrett C, Doherty A. Diabetes and mental health. Clin Med 2014;14:669–72.
- Grant P, Velusamy A, Thomas E, Chakera AJ. When to suspect ‘funny’ diabetes. Clin Med 2014;14:663–6.
- Quin J. Diabetes and HIV. Clin Med 2014;14:667–9.
- Grant P, George J. CME Diabetes SAQs (91577): self-assessment questionnaire. Clin Med 2014;14:681–2.
- Clinical Medicine CME section endocrinology (2013):
- Rogers A, Thakker RV. Clinically relevant genetic advances in endocrinology. Clin Med 2013;13:299–305.
- Koulouri O, Gurnell M. How to interpret thyroid function tests. Clin Med 2013;13:282–6.
- Crowley R, Gittoes. How to approach hypercalcaemia. Clin Med 2013;13:287–90.
- Bevan JS. Pituitary incidentaloma. Clin Med 2013;13:296–8.
- Ball SG. How I approach hyponatraemia. Clin Med 2013;13:291–5.
- Future Hospital Journal articles:
- Simmons D, Yu D, Bunn C. Hospitalisation among patients with diabetes associated with a Diabetes Integrated Care Initiative: a mixed methods case study. FHJ 2015;2:92–8.
- Solomon A, George S, Al-Sabbagh S et al. A seven-day diabetes service for inpatients and the emergency department in an acute hospital setting – the East and North Herts Diabetes Outreach Team (DOT). FHJ 2014;1:100–2.
Historical highlights from the library, archive and museum collection
The introduction of insulin treatment in the 20th century transformed type 1 diabetes from a death sentence to a long-term condition, inspiring some early recipients to dedicate their lives to diabetes care. The absence of effective remedy did not stop physicians in centuries past from diagnosing and attempting to treat diabetes. You can read more historical perspectives on the study and treatment of diabetes on the library, archive and museum blog.