Endocrinology

The Endocrinology Department at KIMS-Arete Hospital strives to consistently deliver superior clinical outcomes through comprehensive care solutions for hormonal problems affecting all age groups. We treat all types of diabetes, short stature, thyroid diseases including thyroid malignancy, rickets, obesity, disorders of sexual development and puberty development, bone disease including osteoporosis, metabolic bone diseases, etc., premature ovarian failure, polycystic ovary disease and syndrome, pituitary or adrenal or parathyroid disorders, metabolic syndrome, male hypogonadism, and atypical genitalia, among various others. 

KIMS-Arete Hospital is the best hospital in Hyderabad for endocrinology since it employs cherry-picked expert endocrinologists who specialize in the treatment of not just hormonal issues but also various other complications of endocrine diseases extending up to endocrine oncology. The endocrinology department acquired state-of-the-art diagnostic facilities and developed treatments to help patients recover from a wide range of medical issues.

From Continuous Glucose Monitoring Systems with Insulin Pumps to specialized endocrinology tests like OGTT, mixed meal C-peptide test, and growth hormone suppression test, the endocrinology department at KIMS-Arete Hospital utilizes advanced tools to gather valuable insights for informed decision-making. Our endocrinologists, with excellent clinical skills, integrate cutting-edge treatment approaches while providing personalized and compassionate care to our patients. 

KIMS-Arete Hospital, being the best endocrinology hospital in Hyderabad, redefines healthcare by leveraging state-of-the-art technology to establish trust, assurance, and confidence. Our spacious and best-in-class infrastructure ensures a premium and comfortable healthcare journey for patients. To cultivate a serene and calm environment in our endocrinology department to enhance positivity, we prioritize delivering a seamless healthcare experience. The enhanced efficiency approach of KIMS-Arete Hospital is rooted in a commitment to fostering excellence in every aspect of patient care.

Endocrinological Symptoms 

1. High blood sugar levels (also called hyperglycaemia): Hyperglycaemia is seen in various conditions but from an endocrine point of view, it could be due to diabetes, menstrual cycle disorders, etc. The other general factors which could cause or worsen hyperglycaemia include physical stress, illness, infections, steroids, etc.
2. Obesity: increased fat in body is associated with several endocrine diseases such as hypothyroidism, Cushing’s disease, hypogonadism, and growth hormone deficiency.
3. Fatigue: Endocrine dysfunction is a common cause of fatigue especially seen in thyroid disfunctions. Fatigue due to endocrine disorder is often accompanied with abnormalities, such as hyper- or hypoglycaemia, dyslipidaemia, and gonadal dysfunction etc.
4. Bone fractures: Hormonal regulation determines the bone mass. Endocrine defects such as diabetes and thyroid, parathyroid, sex steroid, and growth hormone disorders can cause low bone mass.
5. Changes in vision: Various endocrinopathies (endocrinology diseases) are commonly presented with distinct disturbances in vision. Recognizing ophthalmic manifestations of endocrine disorders is critical not only for rapid diagnosis and treatment, but also to prevent significant morbidity and mortality. Ophthalmic disturbances are seen in disorders of the pancreas, thyroid gland, and hypothalamic-pituitary axis, diabetes mellitus, Graves’ disease, pituitary tumours, etc.
6. Changes in heart rate: The manifestation of endocrine disorders could disturb various organ systems. Being one of the directly affected organ systems, the cardiovascular system could be altered through various endocrine disorders such as hyperthyroidism, hypothyroidism, hypoparathyroidism, acromegaly, hypercortisolism, etc. 
7. Changes in the skin: Skin alterations, hair alterations, alterations in nails, and mucosal surfaces could be due to various endocrine diseases like thyroidism, diabetes, Cushing’s syndrome etc.

Endocrinology Test List 

1. 24-Hour urine collection test: This is necessary to check renal function. Urine is collected in a special container over a period of 24-hours. It is necessary for diabetic nephropathy, hypertension (high blood pressure), kidney damage, lupus nephritis, etc. 
2. ACTH stimulation test: Stress should make the body release cortisol from adrenal glands. In adrenal insufficiency the production of cortisol levels to stress factors is impaired. The ACTH stimulation test is a reliable tool to diagnose secondary adrenal insufficiency.
3. Bone density test: Various tools and techniques such as X-rays, dual-energy X-ray absorptiometry (DEXA or DXA) are used to measure the bone mineral content and thus find its density. These tests can help diagnose diseases such as osteoporosis through bone brittleness. 
4. CRH stimulation test: The characters of pseudo-Cushing's syndrome and mild Cushing's syndrome often overlap, confusing the endocrinologists. As a tool to rule the differential diagnosis of Cushing's syndrome the dexamethasone-corticotropin-releasing hormone (CRH) test is utilized so that proper medication can be prescribed. 
5. Dexamethasone suppression test: Through this test, the doctors can understand if the suppression of cortisol secretion by the adrenal gland can be done. Abnormal results could be due to adrenal tumors, pituitary tumors, etc.
6. Fine-needle aspiration biopsy: Fine needle aspiration (FNA), uses a slender, hollow needle, to extract sample necessary for cancer diagnosis. In endocrinology, it is usually used for the diagnosis of thyroid malignancy.

Key Endocrinology Subspecialities

• Pediatric Endocrinology: Our specialists provide tailored care for hormone-related disorders in children, including challenges related to growth, puberty, metabolism and diabetes. We offer a range of ultra-sophisticated diagnostic and treatment options for endocrine diseases such as short stature, rickets, disorders of sexual development, disorders of puberty development, Type 1 diabetes mellitus), etc. KIMS-Arete Hospital support the healthy development of the child, prioritizing their holistic well-being.
• Adult Endocrinology: Whether addressing challenges such as diabetes, thyroid malignancy, hormonal abnormalities affecting female reproductive conditions or dealing with resistant hypertension, we prioritize the health, ensuring a patient-centric approach to hormonal balance.
• Geriatric Endocrinology: In this unit, our proficient endocrinologists consistently achieve unparalleled excellence in diagnosing, managing, and treating age-related hormonal imbalances to enhance the overall well-being of older adults aged 65 and above.

Endocrine Diseases List

1. Type 1 DM (Diabetes Mellitus): Type 1 Diabetes, often developing in childhood or adolescence, requires specialized care due to the inability to produce insulin. Our team at KIMS-Arete Hospital is well-equipped to manage this condition, offering comprehensive support to regulate blood sugar levels through a personalized treatment plan.

2. Neonatal DM (Diabetes Mellitus): In our pediatric endocrinology unit, we address neonatal diabetes mellitus, a rare form that affects newborns and is characterized by severe hyperglycemia due to insufficient or no circulating insulin. Our medical experts understand the complexities of this condition and offer the best care to manage high blood sugar levels caused by genetic mutations affecting Insulin production or response.

3. Diabetes Mellitus: Diabetes mellitus, a condition affecting blood sugar regulation, demands meticulous care. India is recognized as the diabetes capital of the world, yet it is often undertreated or mismanaged due to gaps in specialist care. At KIMS-Arete Hospital, our esteemed endocrinologists provide holistic and comprehensive care for diabetes, aiming to prevent complications such as nerve damage, kidney issues, and vision problems.

4. Short Stature: Pediatric endocrinologist at KIMS-Arete Hospital diagnoses and evaluates children with growth disorders, mostly addressing short stature. These conditions may stem from various factors such as genetic conditions, nutrition, environmental factors, growth hormone deficiency, or chronic diseases affecting growth.

5. Rickets: We provide specialized care for children with rickets, a bone disorder usually caused by a deficiency of vitamin D, calcium, or phosphate. Our experts work closely with families to educate about optimal nutrition and development to manage rickets.

6. Disorders of Sexual Development: These conditions arise when a child's sexual anatomy or chromosomes deviate from the typical male or female pattern, potentially resulting in genital ambiguity. Our multidisciplinary specialists at KIMS-Arete Hospital are experienced in managing these cases with enhanced efficiency. 

7. Disorders of Puberty Development: For children encountering early (precocious) or delayed puberty, our experts conduct meticulous assessments to explore underlying endocrine causes. This thorough evaluation is crucial for determining effective management strategies tailored to the individual needs of each child.

8. Precocity: Precocity is defined as the occurrence of puberty related indicators before the normal age of onset. It need not be taken as an endocrine disorder, and in some cases these events could be normal. Nevertheless, in the case of major indicators of puberty before the normal age of onset, it could signal impaired endocrine activity.

9. Female Premature Ovarian Failure: Premature ovarian failure, marked by early cessation of ovarian function, is exponentially increasing in this modern era, probably secondary to endocrine disruptors. We manage hormonal imbalances, support fertility preservation, and address increased risks of osteoporosis, autoimmune disorders, and ischemic heart disease. Case-dependent treatment options for restoring ovarian function may involve hormonal replacement therapy.

10. PCOS and PCOD (Polycystic Ovary Syndrome and Disease): Our endocrinologists are experienced in managing PCOD and PCOS, which are common endocrine disorders in women, manifesting with irregular periods and increased levels of male hormones leading to unwanted hair and severe acne. The customized treatment plan addresses hormonal imbalances, menstrual irregularities, and associated metabolic concerns with lifestyle changes and medication.

11. Hypo/Hyperthyroidism and Thyroid Malignancy: Through thyroid function tests and comprehensive blood tests, our services encompass the detailed evaluation of thyroid disorders, including hypo/hyperthyroidism and thyroid malignancies. KIMS-Arete Hospital utilize state-of-the-art diagnosis and treatment modalities to ensure early detection and effective management, including medication or in severe cases, surgical interventions, to optimize thyroid health for our patients.

12. Pituitary or Adrenal or Parathyroid Disorders: Specializing in the diagnosis and management of disorders impacting the pituitary, adrenal, and parathyroid glands, our expertise extends to crafting personalized treatment plans for conditions such as Cushing's Syndrome, Addison’s Disease (adrenal insufficiency), acromegaly, Sheehan's syndrome, and various parathyroid disorders.

13. Metabolic Syndrome, Obesity, and Hypertension: KIMS-Arete Hospital’ holistic approach for metabolic syndrome, obesity, and hypertension (either at young age or resistant hypertension) involves thorough assessments, including hormonal and metabolic profiling and cardiovascular evaluations. Young hypertension workup includes diagnosis of hormonal causes like thyrotoxicosis, pheochromocytoma, aldosterone or cortisol producing tumors and acromegaly. While employing patient-specific treatment, we integrate lifestyle interventions, targeted medications, and continuous support to optimize metabolic health and ensure cardiovascular well-being.

14. Osteoporosis/ Metabolic Bone Disease: In order to promote bone health and reduce the risk of fractures, our team specializes in the diagnosis and management of osteoporosis and other metabolic bone diseases, offering technology-enabling diagnostics and personalized treatment plans.

15. Male Hypogonadism: We provide high quality care for male hypogonadism, characterized by low testosterone levels. By addressing the impact on overall health, vitality, and well-being in older men, our comprehensive approach focuses on optimizing hormone levels with testosterone replacement therapies and managing associated symptoms, such as erectile dysfunction, decrease in muscle and bone mass.

16. Atypical genitalia: Formerly known as ambiguous genitalia, this rare condition is characterized by the presence of genitals that do not look either typically male or typically female. It occurs due to hormonal irregularities in pregnancy. Hormonal therapy or surgery is necessary for treatment.

17. Non-palpable testes: A testicle that cannot be detected during a physical examination is referred to as a "nonpalpable" testicle, which implies that it cannot be felt in the anatomical location (scrotum). In contrast, a "palpable" testis is one that can be felt, irrespective of its position; it may be located in the scrotum, groin, or other areas.

18. Thyrotoxicosis: This endocrine disease is associated with excess thyroid hormone production. The presentation could be asymptomatic (showing no signs and symptoms) to a life-threatening thyroid storm.

19. Pheochromocytoma: A neuroendocrine cancer which develops from chromaffin cells in the adrenal glands. About 80-85% of pheochromocytomas grow in the inner layer of the adrenal gland.

20. Acromegaly: A rare but serious medical condition of excess growth hormone in the body causing irregular growth. Treatments include surgery, medication and radiation therapy.

21. Cushing's syndrome: A disorder of persistent and excess cortisol (stress hormone). The adrenal glands are two small glands situated on top of the kidneys, producing cortisol.

22. Sheehan's syndrome: Also called postpartum pituitary necrosis, this disease refers to the death of the anterior pituitary gland, which may occur after heavy post-partum bleeding, hypovolemia (low blood level), and shock.

Endocrinology Treatment (Medical)

In recent years, significant progress has been made in the management of endocrine disorders. This progress includes the development of innovative pharmacological agents which comes from an enhanced understanding of the underlying pathophysiology of these conditions. Along with reducing endocrine disorders through advancements in endocrinology (pharmacotherapy), KIMS-Arete Hospital also administer advanced techniques for the already established medications. The mainstay of treatment in endocrinology relies on hormone hypersecretion control along with replacement of hormone deficiencies. 

The senior endocrinologists supported by a team of experienced endocrinologists and staff members at KIMS-Arete Hospital upholds the notion of risk-benefit ratio while prescribing the pharmacotherapeutic regimens, thus deriving the highest benefit from the prescription with least side effects. The appetite for learning enabled the endocrinologists to indulge in various educational ventures, thus getting familiarised with the latest advancements in endocrinology – both pharmacotherapeutic and procedural. KIMS-Arete Hospital incorporated the novel drugs that pushed the frontiers of endocrinology in its treatment regimens to provide patient centric treatment. Few of the drug classes which had produced recent novel drugs with extreme safety and tolerability profiles include: 

• The endocrinologists at KIMS-Arete Hospital abide by the doctrine of prescribing medicines according to the risk-benefit ratio. Somatostatin analogues thus are prescribed which helps in the treatment of Cushing's syndrome. It also inhibits growth hormone secretion which helps in the treatment of acromegaly.
• Growth hormone secretion receptor antagonists can improve fatigue, sweating, and acromegaly.
• Selenoproteins derived agents in combination with antithyroid drugs help in the treatment of Graves’ ophthalmopathy.
• Innovation in human monoclonal antibodies helps in the treatment of osteoporosis, which reduces the risk of fracture in postmenopausal women from the ailment. 
• Novel calcimimetics help in reducing serum calcium levels in most hyperparathyroidism patients. 
• Various tyrosine kinase inhibitors combined with vascular endothelial growth factors improved progression-free survival in patients suffering from advanced pancreatic neuroendocrine tumors and thyroid cancers.
• The US Food and Drug Administration (FDA) approved the use of growth hormone (GH) for the treatment of children with idiopathic short stature (ISS).
• Steroidogenesis inhibitors block the production of cortisol and other steroid hormones from the adrenal glands, thus treating Cushing disease. They are also used to treat pituitary tumors with the combination of somatostatin analogues and D2 agonists.
• Long-acting analogues of gonadotropin-releasing hormone (GnRH) have been established as the gold-standard treatment of central precocious puberty worldwide with reasonable safety. The endocrinologists at KIMS-Arete Hospital provide patient-centric treatment for longer-acting and sustained-release forms of GnRH analogues with a proper risk benefit ratio.
• A novel type of oral antihyperglycemic medicine, the class of sodium glucose co-transporter 2 (SGLT2) inhibitors can be coupled with insulin which demonstrated improved HbA1c levels and fasting plasma glucose. For additional precision and flexibility in the insulin dosage with fewer injections, our endocrinologists may prescribe the insulin pump.
• Also called incretin mimetics the glucagon-like peptide 1 (GLP-1) agonists, are being frequently prescribed in the treatment regimen of type 2 diabetes. These agents work by inducing pancreas to produce release greater levels of insulin after eating, thus maintaining blood glucose levels within the normal range. They also delay gastric emptying, reduce postprandial glucagon, thus reducing food intake. Since these mechanisms are also useful in regulating obesity levels, few GLP-1 agonists such as liraglutide, tirzepatide are also being prescribed to control obesity. Obesity‐related benefits include reduction in body weight, appetite, food cravings, and energy intake, along with increased satiety and improved eating control.
• The endocrinologists at KIMS-Arete Hospital take special care in the treatment of diabetic foot ulcers (one of the most serious complications of diabetes). It could occur in 19% to 34% of diabetics, and about 50% to 70% of patients with diabetic foot ulcers die within 5 years.  KIMS-Arete Hospital utilize various therapeutic strategies to treat the condition. Few of them include: 
  • Surgical debridement
  • Antibiotic regimen
  • Vascular assessment
  • Offloading
  • Amputation
  • Placental-derived products
  • Sucrose octasulfate-impregnated dressing
  • Leukocyte and platelet-rich fibrin patches
  • Hyperbaric oxygen therapy
  • Negative pressure wound therapy
• To ease the agony in the patients suffering from differentiated thyroid cancer despite undergoing thyroidectomy, our endocrinologists can treat it with radioactive iodine (RAI). The radioactive iodine therapy can deliver targeted radiation, destroying overactive thyroid tissue or residual cancer cells. The dosage of radioactive iodine is carefully calculated based on individual risk factors, considering risk-benefit ratio.

Endocrinology Treatment (Surgical) 

• Parathyroidectomy: This surgery results in the removal of parathyroid glands or tumors. It is usually done to treat hyperparathyroidism (excess parathyroid hormone production). 
• Thyroidectomy: This surgery is necessary for people suffering from thyroid tumors, thyroid nodules, or hyperthyroidism, (excess thyroid hormone production).
• Adrenalectomy: A surgical procedure to remove the cancerous adrenal gland or if it is producing excess hormone. It is usually done through small incisions (minimally invasive laparoscopic surgery).
• Pancreatectomy: This operation removes the entire or a part of the pancreas to treat pancreatic cancer or severe chronic pancreatitis. 
• Trans-sphenoidal surgery: This surgical modality is offered to all acromegaly patients suffering from a microadenoma or a macroadenoma (growth of tissues) which can be fully resectable, or if it is causing visual impairment.