Low Bone Mineral Density in Osteoporosis

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Osteoporosis is rapidly increasing in Asia and with the advancing age of its population, Singapore is not spared this phenomenon. About 55,000 women above the age of 50 were found to have osteoporosis.1  The hip fracture rates have increased by 1.5 and five times respectively in men and women aged over 50 years in Singapore.2 […]

Bariatric Surgery for Type 2 Diabetes

Before and after pictures of man with 16 months nutrition and exercise changes and losing 180 lbs.

The global prevalence of type 2 diabetes is rising dramatically, driven by an ‘obesogenic’ environment that favours increasing sedentary behaviour and easier access to attractive calorie-dense foods acting on susceptible genotypes.1 The most recent global predictions by the International Diabetes Federation (IDF) suggest that there are 285 million people with diabetes currently worldwide. This is […]

Management of Type 2 Diabetes Mellitus

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Defining the role of DPP-IV inhibitors and metformin combination therapy Type 2 Diabetes Mellitus (T2DM) is a heterogeneous group of diseases defined by the presence of hyperglycaemia. With rising numbers of individuals affected by this condition, the associated complications are well known. DM significantly increases the risk of coronary heart disease, kidney disease, amputation and […]

Diabetes and Peripheral Arterial Disease

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Preserving limbs, saving lives A seldom known fact: a major lower limb amputation due to complications from diabetes occurs once every 30 seconds worldwide. In Singapore, it is estimated that about 700 major lower limb amputations take place a year (approximately two per day). These sobering numbers reflect the grim outcomes that diabetics with peripheral […]

Obesity and Metabolism

women with overweight on scales

Looking beyond the link Introduction The causes of obesity are complex and despite breakthroughs in scientific efforts, have not been fully uncovered. The relationship between an individual’s metabolism and body weight is both an active area of interest and controversy for researchers, healthcare providers and patients alike. This article aims to provide an overview of […]

Primary Aldosteronism

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A potentially curable cause of hypertension Primary aldosteronism (PA) is the autonomous production of aldosterone by the adrenal glands. Table 11 shows the possible causes of this. The most reliable and at times, only sign of PA is hypertension due to the excess aldosterone. It is a myth that PA is invariably associated with hypokalaemia, which […]

Can Cushing’s Syndrome Co-exist with Adrenal Insufficiency?

Figure 1: Classical purplish broad striae that is characteristic of Cushing’s

Cushing’s syndrome refers to a constellation of signs and symptoms which reflect excess glucocorticoids in the body (Table 1).1 Many of them are non-specific and the most specific ones include easy bruising and proximal myopathy. Figure 1 shows classical purplish broad striae more than one cm in width that is characteristic of Cushing’s. It is […]

Diabetes Management

Test for determination level sugar and fresh pastry in backgroun

Since the discovery of the Islets of Langerhans in 1869, followed by breakthrough efforts by Banting and Best in 1921 in treating diabetes in dogs with injectable pancreatic extracts, the last decade has seen technology in diabetes management advance by leaps and bounds. Insulin pharmacodynamic profiles have improved through manipulation of native insulin structure; delivery […]

Type 2 Diabetes Mellitus

Medical diabetes insulin syringe injection shot

Type 2 Diabetes Mellitus (T2DM) is increasing in epidemic proportions across Singapore. The 2010 National Health Survey in Singapore reported the prevalence of T2DM in Singapore as 11.3% among the age group of 18 to 69 years. This was a significant rise from the previous survey results of 8.3% in 2004. The health risks are […]

Injection Rather Than Implantation of Tissue Works Better for Restoration of Parathyroid Function

When non-surgical methods fail, patients with secondary or renal hyperparathyroidism have their parathyroid glands removed as part of the treatment. Now, they can have their parathyroid function restored at the Singapore General Hospital (SGH) using an innovative method that is simple, effective and non-invasive. Patients also walk away scar free. A team of surgeons from […]

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