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SPECIALTIES & SERVICES

Endocrinology


The endocrinology service provides tertiary level care in hormonal and metabolic disorders.  Our team comprises doctors with varied and complementary interests in different aspects of endocrinology.  We are committed to medical excellence and providing our patients with well-rounded care to ensure that their medical needs are taken care of.

Apart from multidisciplinary services for diabetes care at the Diabetes Clinic, we see a wide range of general and subspecialty endocrinological disorders, which are listed under our services list. 


We provide a comprehensive range of inpatient and outpatient services for patients with endocrine disorders. Examples of our services include:

  • Diabetes

Patients with diabetes related disorders are seen at the Diabetes Centre which provides a comprehensive range of services.

  • Lipid Disorders

Hypercholesterolemia, suspected familial causes of hypercholesterolemia and hypertriglyceridemia and usage of statins in patients with transaminitis.

  • Thyroid Disorders

Hyperthyroidism, hypothyroidism, thyroid nodules and thyroid cancers

  •  Calcium and Bone Disorders

Osteoporosis, hypercalcemia, hypocalcemia, suspected cases of osteomalacia and hyperparathyroidism

  • Pituitary Disorders

Hypopituitarism, pituitary tumours such as incidentally discovered pituitary tumours, Cushing’s disease, acromegaly, prolactinomas, hyperprolactinemia

  • Adrenal Disorders

Suspected primary aldosteronism, pheochromocytoma, incidentally discovered adrenal tumours, hypocortisolism, Cushing’s syndrome

  • Female Reproductive Endocrinology

Premature menopause, amenorrhoea, thyroid dysfunction in pregnancy, hirsutism

  • Male Hormonal Disorders

Hypogonadism, gynaecomastia

  • Endocrine Hypertension

Hypertensive patients suspected of having a secondary endocrinological cause of hypertension

  • Water and Electrolyte Imbalance

Hyponatraemia, hypokalaemia

  • Other general hormonal and metabolic disorders

Our unit places a strong emphasis on medical education and training. We regularly offer training posts for medical students, internal medicine residents, medical officers and advanced specialty trainees. Clinical teaching takes place in the clinics and wards, where our trainees are exposed to a wide spectrum of endocrine diseases. In addition, they are rotated through the various allied health services and education programmes in the Diabetes Centre to obtain a holistic appreciation of diabetes management.

Sample Weekly Schedule for Medical Officer Endocrinology Posting

Week

Mon

Tue

Wed

Thur

Fri

8-11am

Diabetes Clinic

 

Diabetes Clinic

 

Project Work

 

Diabetes & Endocrine Clinic

 

Departmental

Meeting (7.30–8.30am)

11am-1pm

Inpatient Diabetes Management & Blue Letter Consultations

Inpatient Diabetes Management & Blue Letter Consultations

Inpatient Diabetes Management & Blue Letter Consultations

Thyroid FNAC Clinic (Alternate Fridays)

 

1-2pm

Professorial Clinical Tutorials

 

 

 

Clinical Approaches Tutorials 

Data Interpretation Tutorials

2-4pm

Weeks 1, 3, 5

Carousal Clinic 

 

Weeks 2, 4

Diabetes Clinic

Diabetes Centre Staff Teaching

Endocrine Clinic 

Weeks 1, 3, 5

Diabetes Clinic

 

Weeks 2, 4

Diabetic Kidney Disease Clinic  

Dietitian/DNE/Podiatrist

4-5pm

Endocrine Journal Club


Teaching Curriculum for Advanced Specialty Trainees in Endocrinology
New Case Tutorial
Endocrine-Radiology Meeting
Journal Club
Topic Review and Case Discussion
Diabetes Centre Staff Teaching
Combined Renal-Endocrine Journal Club

 AHPL Residency and Senior Residency Programs

The division has a strong culture of research and is well-supported by a team of research technicians, including post-doctoral fellows. Our endocrinologists and trainees are regular recipients of national grants and collaborate with other national centres and institutions. Research interests range from basic science research in genetics and cell signaling to principal investigator (PI) initiated clinical trials.

Click to watch video

Funding Bodies
National Medical Research Council
National Kidney Foundation
Endocrine and Metabolic Society of Singapore

Key Publications

Adrenals

Gangopadhyay K, Baskar V, Toogood AA. A case of exclusive Dopamine secreting paraganglioma. Clinical Endocrinology 2008; 68: 494-5.

Calcium and Osteoporosis

Vivien Lim, Bart L Clarke. Co-existing primary hyperparathyroidism and sarcoidosis cause increased angiotensin converting enzyme and decreased parathyroid hormone and phosphate levels. J Clin Endocrinol Metab. 2013 May;98(5):1939-45

Lee MC, Gupta V. Premenopausal osteoporosis. Indian J Endocrinol Metab. 2013 Mar;17(2):240-4.

Vivien Lim, Bart L Clarke. New Therapeutic Targets for Osteoporosis: Beyond Denosumab: Maturitas 2012;73:269-72.

Diabetes

Manjunatha RS, Manjunatha NP, Baskar V, Headon MP, Singh BM, Viswanath AK. Quality assurance in diabetic retinopathy screening: evaluating benefit of universal regarding of normal primary grade. Diabet Med 2012 Feb;29(2):287-8.

Nayak AU, Baskar V. An unusual cause for deterioration of glycaemia in diabetes. Pract Diab Int 2011; 1584: 163.

Nayak US, Govindan J, Baskar V, Kalupahana D, Singh BM. Exenatide therapy in insulin-treated type 2 diabetes and obesity. Quarterly Journal of Medicine 2010; 103: 687-94.

Wright J, Ruck K, Rabbitts R, Charlton M, De P, Barrett T, Baskar V, Kotonya C, Saraf S, Narendran P. Diabetic Ketoacidosis in Birmingham, UK, 2000-2009: an evaluation of risk factors for recurrence and mortality. The British Journal of Diabetes & Vascular Disease 2009; 9: 278-282.

Manley SE, Sikaris KA, Lu ZX, Nightingale PG, Stratton IM, Round RA, Baskar V, Gough SC, Smith JM. Validation of an algorithm combining HbA1c and FPG for diagnosis of DM in UK and Australian populations. Diabet Med 2009; 26: 115-21.

Poh ZX, Goh KP. A current update on the use of alpha lipoic acid in the management of type 2 diabetes mellitus. Endocr Metab Immune Disord Drug Targets. 2009 Dec;9(4):392-8.

Tavintharan S, Chi LS, Fang SC, Arunmozhiarasi A, Jeyaseelan K. Riboregulators and metabolic disorders: getting closer towards understanding the pathogenesis of diabetes mellitus? Curr Mol Med. 2009 Apr;9(3):281-6.

Mahto R, Venugopal H, Vibhuti VS, Mukherjee A, Cherukuri V, Healey B, Baskar V, Buch HN, Singh BM. The effectiveness of a hospital diabetes outreach service in supporting care for acutely admitted patients with diabetes. QJM. 2009 Mar;102(3):203-7.

Stahl D, Sum CF, Lum SS, Liow PH, Chan YH, Verma S, Chua HC, Chong SA. Screening for depressive symptoms: validation of the center for epidemiologic studies depression scale (CES-D) in a multiethnic group of patients with diabetes in Singapore. Diabetes Care. 2008 Jun;31(6):1118-9.

Lim SC, Lekshminarayanan R, Goh SK, Ong YY, Subramaniam T, Sum CF, Ong CN, Lee BL. The Effect of Coenzyme Q10 on Microcirculatory Endothelial Function of subjects with Type 2 Diabetes Mellitus. Atherosclerosis. 2008 Feb;196(2):966-9.

Lim SC, Morgenthaler NG, Subramaniam T, Wu YS, Goh SK, Sum CF. The relationship between Adrenomedullin, Metabolic Factors and Vascular Function in Individuals with Type 2 Diabetes. Diabetes Care. 2007 Jun;30(6):1513-9.

Lim VC, Sum CF, Chan ES, Yeoh LY, Lee YM, Lim SC. Lactate Levels in Asian Patients with Type 2 Diabetes Mellitus on Metformin and its Association with Dose of Metformin and Renal Function. Int J Clin Pract. 2007 Nov; 61(11):1829-33.

Baskar V, Kamalakannan D, Holland MR, Singh BM. Does ethnic origin have an independent impact on hypertension and diabetic complications? Diabetes Obesity and Metabolism 2006; 8: 214-219.

Kamalakannan D, Baskar V, Singh BM. Severe and disabling diabetic autonomic neuropathy – a case report. Journal of diabetes and its complications 2004; 18: 126-28.

Baskar V, Kamalakannan D, Holland MR, Singh BM. Hypertension in diabetes: is there a place for age-adjusted centile cut-offs in those aged <50 years? QJM. 2004 Nov;97(11):747-53.

Kamalakannan D, Baskar V, Barton DM, Abdu TA. Diabetic ketoacidosis in pregnancy. Postgraduate medical journal 2003; 79: 454-57.

Barton DM, Baskar V, Kamalakannan D, Buch HN, Gone K, Wilson E, Anderson J, Abdu TA. An assessment of care of paediatric and adolescent patients with diabetes in a large district general hospital. Diabetic Medicine 2003; 20: 394-98.

Baskar V, Kamalakannan D, Holland MR, Singh BM. The prevalence of hypertension and utilisation of anti-hypertensive therapy amongst a diabetes population. Diabetes Care 2002; 25: 2107-2108.

Buch HN, Baskar V, Barton DM, Kamalakannan D, Acarza C, Singh BM. Combination of insulin and thiazolidinedione therapy in massively obese patients with type 2 diabetes. Diabetic Medicine 2002; 19: 572-4.

Diabetic Foot

Tavintharan S, Nang EEK, Lim SC, Wu Y, Khoo CM, Lee J, Heng D, Chew SK, Wong TY, Tai ES. Distribution of ankle brachial index and the risk factors of peripheral artery disease in a multi-ethnic Asian population. Vascular Medicine 2011; in press

Lekshmi Narayanan RM, Koh WP, Phang J, Subramaniam T. Peripheral arterial disease in community-based patients with diabetes in Singapore: Results from a Primary Healthcare Study. Ann Acad Med Singapore. 2010 Jul;39(7):525-7.

Tavintharan S, Ning Cheung, Su Chi Lim, Tay W, Shankar A, Shyong Tai E, Wong TY. Prevalence and risk factors for peripheral artery disease in an Asian population with diabetes mellitus. Diab Vasc Dis Res. 2009 Apr;6(2):80-6.

Kamalakannan D, Baskar V, Usher J, Singh BM. Remember shoes. British Medical Journal 2002; 324(7331): 248.

Manjunatha R, Huddart S, Baskar V. Acute Charcot arthropathy following thermal trauma BMJ 2010; 341: c6455

Diabetic Nephropathy

Lim SC, Liu JJ, Low HQ, Morgenthaler NG, Li Y, Yeoh LY, Wu YS, Goh SK, Chionh CY, Tan SH, Kon YC, Soon PC, Bee YM, Subramaniam T, Sum CF, Chia KS. Microarray analysis of multiple candidate genes and associated plasma proteins for nephropathy secondary to type 2 diabetes among Chinese individuals. Diabetologia 2009; 52: 1343 – 1351.

Vivien CC Lim, CF Sum, Edwin SY Chan, LY Yeoh, YM Lee, SC Lim. Lactate levels in Asian patients with type 2 diabetes mellitus on metformin and its association with dose of metformin and renal function. International Journal of Clinical Practice 2007; 61(11):1829-33.

Lim SC, Koh AF, Goh SK, Chua CL, Heng BL, Subramaniam T, Sum CF. Angiotensin receptor antagonist vs. angiotensin-converting enzyme inhibitor in Asian subjects with type2 diabetes and albuminuria - a randomized crossover study. Diabetes, Obesity and Metabolism. 2007 Jul;9(4):477-82.

Baskar V, Venugopal H, Holland MR, Singh BM. Clinical utility of estimated glomerular filtration rates in predicting renal risk in a district diabetes population. Diabetic Medicine 2006; 23: 1057-60.

Lim SC, Goh SK, Lai YR, Tee WW, Koh A, Xu XH, Wu YS, Yap E, Subramaniam T, Sum CF. Relationship between common functional polymorphisms of the p22phox gene (-930A>G and +242C>T) and nephropathy as a result of Type 2 diabetes in a Chinese population. Diabet Med. 2006 Sep;23(9):1037-41.

Baskar V, Kamalakannan D, Kiberd B, Holland MR, Singh BM. Hypertension-based clinical risk strategies for detecting microalbuminuria in diabetes. QJM. 2005 Jun;98(6):427-33.

Baskar V, Kamalakannan D, Holland MR, Catchpole CR, Singh BM. Uncertain clinical utility of contemporary strategies for microalbuminuria testing. Diabetes Obesity and Metabolism 2003; 5: 262-6.

Electrolyte Disorders

Gangopadhyay KK, Gupta R, Baskar V, Gautam N, Toogood AA. With a pinch of salt. Clin Med 2010; 10: 86-7. Erratum 2010; 10: 300.

Goh KP. Management of hyponatremia. Am Fam Physician. 2004 May 15;69(10):2387-94.

Baskar V, Kamalakannan D, Singh BM. Carbamazepine-induced rapid and severe hyponatremia. The Pharmaceutical Journal 2002; 268: 690.

Exercise Metabolism

Goh KP, Lee HY, Lau DP, Supaat W, Chan YH, Koh A FY. Effects of Resveratrol in Patients With Type 2 Diabetes Mellitus on Skeletal Muscle SIRT1 Expression and Energy Expenditure. Int J Sport Nutr Exerc Metab. 2013 Aug 5.

Goh KP, Sum CF. Connecting the dots: molecular and epigenetic mechanisms in type 2 diabetes. Curr Diabetes Rev. 2010 Jul 1;6(4):255-65.

Goh KP, Chew K, Koh A, Guan M, Wong Y S, Sum CF (2009) The relationship between ACE gene ID polymorphism and aerobic capacity in Asian rugby players. Singapore Med J. 2009; 50(10): 997-1003.

Lipidology and Atherosclerosis

Weston N, Fernando U, Baskar V. Hypertriglyceridaemia-induced pancreatitis. BMJ Case Rep. 2013 Feb 27;2013.

Tavintharan S, K Woon, LT Pek, X Dong, N Jauhar, Lim SC, Sum CF. Niacin results in reduced monocyte adhesion in patients with type 2 diabetes mellitus. Atherosclerosis (doi.org/10.1016/j.atherosclerosis.2010.12.020)

Tavintharan S, Lim SC, Sum CF. The effects of niacin on cell adhesion and early atherogenesis: biochemical and functional findings in endothelial cells. Basic Clin Pharmacol Toxicol. 2009 Mar;104(3):206-10.

Tavintharan S, Ong CN, Jeyaseelan K, Sivakumar M, Lim SC, Sum CF. Reduced mitochondrial coenzyme Q10 levels in HepG2 cells treated with high-dose simvastatin: a possible role in statin-induced hepatotoxicity? Toxicol Appl Pharmacol. 2007 Sep 1;223(2):173-9.

Tavintharan S, Sivakumar M, Lim SC, Sum CF. Niacin affects cell adhesion molecules and plasminogen actiator inhibitor-1 in HepG2 cells. Clin Chim Acta. 2007 Feb;376(1-2):41-4.

Tavintharan S, Lim SC, Chan YH, Sum CF. Apolipoprotein E genotype affects the response to lipid-lowering therapy in Chinese patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2007 Jan;9(1):81-6.

Ganji SH, Tavintharan S, Zhu D, Xing Y, Kamanna VS, Kashyap ML. Niacin non-competitively inhibits diacylglycerol acyltransferase-2 (DGAT2) but not DGAT1 activity in HepG2 cells. J. Lipid Res.2004; 45: 1835–1845.

Moti L Kashyap, Tavintharan S, Kamanna VJ Optimal therapy of low levels of HDL Cholesterol Am J Cardiovasc Drugs 2003, 3(1): 53-64

Non-Diabetic Hypoglycemia

Kao SL, Chan CL, Tan B, Lim CC, Dalan R, Gardner D, Pratt E, Lee M, Lee KO. An unusual outbreak of hypoglycemia.N Engl J Med. 2009 Feb 12;360(7):734-6.

Pancreatic and Islet Cell Transplant

Peter A. Senior, Tatsuya Kin, James Shapiro, Angela Koh. Islet Transplantation at the University of Alberta: Status Update and Review of Progress over the Last Decade. Can J Diabetes 36 (2012) 32-37.

Gala-Lopez BL, Senior PA, Koh A, Kashkoush SM, Kawahara T, Kin T, Humar A, Shapiro AM. Late Cytomegalovirus Transmission and Impact of T-Depletion in Clinical Islet Transplantation. Am J Transplant. 2011.

Senior PA, Koh A, Shapiro AM. Remission of Alopecia Universalis Following Successful Clinical Islet Transplantation. Am J Transplant. 2011:11: 2536-7.

A. Jermendy, E. Toschi, T. Aye, A. Koh, C. Aguayo-Mazzucato, A. Sharma, G. C. Weir, D. Sgroi, S. Bonner-Weir. Rat neonatal beta cells lack the specialised metabolic phenotype of mature beta cells. Diabetologia. 2011;54(3):594-604.

D. M. Zuk, A. Koh, S. Imes, A. M. J. Shapiro and P. A. Senior. Three Cases of Alopecia Following Clinical Islet Transplantation. American Journal of Transplantation 2011; 11: 163–168.

C. Aguayo-Mazzucato, A. Koh, I. El Khattabi, W.-C. Li, E. Toschi, A. Jermendy, K. Juhl, K. Mao, G. C. Weir, A. Sharma & S. Bonner-Weir. Mafa expression enhances glucose-responsive insulin secretion in neonatal rat beta cells. Diabetologia . 2011;54(3):583-93.

Angela Koh, Sharleen Imes, Tatsuya Kin, Parastoo Dinyari, Andrew Malcolm, Christian Toso, AM James Shapiro, Peter Senior. Supplemental islet infusions restores insulin independence after graft dysfunction in islet transplant recipients. Transplantation 2010 Feb 15;89(3):361-5.

Angela Koh, Sharleen Imes, Tatsuya Kin, Parastoo Dinyari, Andrew Malcolm, Christian Toso, AM James Shapiro, Peter Senior. Insulin-Heparin infusions peri-transplant improve single donor clinical islet transplant success. Transplantation. 2010 Feb 27;89(4):465-71.

*Eman Alfadhli, *Angela Koh, Waleed Albaker, Ravi Bhargava, Thomas Ackerman, Charlotte McDonald, Edmond A.Ryan, A.M. James Shapiro, Peter A. Senior. High prevalence of ovarian cysts in pre-menopausal women receiving sirolimus and tacrolimus after clinical islet transplantation. Transplant Int 2009 , 22:622- 625. (*co-1st authors)

Angela Koh, Tatsuya Kin, Sharleen Imes, A.M. James Shapiro, Peter Senior. Islets isolated from donors with elevated HbA1c can be successfully transplanted. Transplantation 2008; 86(11):1622-4.

Krishnamurthy J, Ramsey MR, Ligon KL, Torrice C, Koh A, Bonner-Weir S, Sharpless NE. p16INK4a induces an age-dependent decline in islet regenerative potential. Nature. 2006 Sep 28; 443(7110): 404-5

Pituitary

Gupta V, Lee M. Growth hormone in chronic renal disease Indian J Endocrinol Metab.2012; 16: 195-203.

Foo SS, Lee M, Yap P, Tang T, Tan L.An unusual case of asthenia and anorexia in an elderly chinese man. J Am Geriatr Soc. 2009 Dec;57(12):2364-5.

Goh KP, Lee HY, Rajasoorya RC. Triple jeopardy in the pituitary. Pituitary. 2008;11(3):331-6.

Siddique H, Baskar V, Chakraborthy A, Clayton RN, Hanna F. Spontaneous pregnancy in a patient with previous Lymphocytic hypophysitis treated by hypophysectomy. Clin Endocrinol 2007; 66: 454-55.

Baskar V, Kamalakannan D, Singh BM, Odum J. Spontaneous resolution of hypercalcemia in a patient with primary hyperparathyroidism and prolactinoma. Journal of Endocrinological Investigation 2004; 27: 462-64

Holdaway IM, Rajasoorya RC, Gamble GD. Factors influencing mortality in acromegaly. J Clin Endocrinol Metab. 2004 Feb;89(2):667-74.

Holdaway IM, Rajasoorya CR, Gamble GD, Stewart AW. Long-term treatment outcome in acromegaly. Growth Horm IGF Res. 2003 Aug;13(4):185-92.

Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary. 1999 Jun;2(1):29-41.

Wrightson P, Rajasoorya C, Holdaway IM, Scott DJ. Acromegaly: factors affecting the long term outcome after surgical treatment. J Clin Neurosci. 1994 Jul;1(3):164-72.

Rajasoorya C, Holdaway IM, Wrightson P, Scott DJ, Ibbertson HK. Determinants of clinical outcome and survival in acromegaly. Clin Endocrinol (Oxf). 1994 Jul;41(1):95-102.

Reproductive Endocrinology

Lee MC, Conway GS. Liver dysfunction in Turner syndrome and its relationship to exogenous oestrogen. Eur J Gastroenterol Hepatol. 2013 Oct;25(10):1141-5.

Thyroidology

ECK Yeoh, JR Claude, C Rajasoorya. Paradox of rising TSH despite increasing thyroxine dose in hypothyroidism and its association with nephritic syndrome. Nephrology 2013, 18(9): 647-648.

Khalid Y, Buch H, Baskar V. Watch what you lick! Clin Endocrinol 2012 Feb;76(2):314.

Khalid Y, Sulaiman R, Zahir R, Baskar V, Buch HN.An unusual complication in a patient with Graves’ disease.NZMJ 2011; 124 (1341): 69-71.

Khalid Y, Barton DM, Baskar V, Kumar H, Jones P, West TET, Buch H. Efficacy of fixed high dose radioiodine therapy for hyperthyroidism – a 14y experience.
BJMP 2011; 4; a435

Gupta V, Lee M. Central Hypothyroidism. Indian J Endocrinol Metab. 2011 Jul;15(Suppl 2):S99-S106.



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