DAY IN THE LIFE OF A DOCTOR: Diabetes Clinic (Endocrinology Rotation)


Morning guys. I’m Siobhan, a 3rd year medical resident. I’m currently on my endocrinology rotation. So the specialists that deal with hormones. So this morning is a diabetes clinic and then this afternoon we’ll be going and covering all the hospitals in the city, doing consults about anything to do with hormone abnormalities. So it’s going to be an exciting day! Diabetes is a disease that causes high blood sugars. This can happen if your body doesn’t make insulin or if it doesn’t really know how to use insulin properly. And insulin is a really important hormone that helps to move glucose, sugar, from your blood into your cells. And over time these high blood sugars causes a huge amount of damage to blood vessels and nerves in the body. And that’s why diabetes leads to kidney failure, heart attacks and even blindness. So it’s a really serious issue. This first patient that I’ve seen is a type 1 diabetic. Type 1 meaning that it was an autoimmune disease that attacked and destroyed her pancreas. So since a very young age she just doesn’t make insulin, so she always has to be giving it to herself. She happens to be using an insulin pump. So it’s attached to her all the time and she’s able to input how much insulin she needs, depending on what she eats and how much activity she has. So she’s incredibly aware of her body and what’s going on and she’s doing an amazing job. I mean… Can you imagine checking your sugars, poking your finger at least 6 times a day? Doing mental math, figuring out how many carbs you can be eating and what to do when you have a low sugar or a high sugar, while you’re working or going to school. It’s, yeah, really impressive! Okay, so this next patient has type 2 diabetes. So different from type 1 diabetes, because it normally happens later in life and it’s really strongly linked to obesity. There are some genetic factors, environmental factors, medications that can make it worse. But overall what I think is exciting about this disease, is that it’s something we can prevent with good exercise, keeping a normal body weight. Those things can prevent the disease and all the complications that come with it. Because diabetes can affect so many different organ systems, I like to take a super systematic approach with each patient, so that I don’t forget anything. For each visit I ask about acute events like a low blood sugar or getting admitted to the hospital. Then I think about damage to the large blood vessels, like a heart attack or stroke. Then I think about the small blood vessels. So asking if there’s numbness in the feet or if their stomach is emptying slowly. If they’re getting their eyes checked regularly, or even if they get lightheaded when they stand up. Then I move on to the physical exams and that always includes checking for numbness in the feet. So we use a special wire called a monofilament to apply pressure and basically poke the patient’s foot. The cool thing is that the wire is designed to bend under a specific amount of force. So that makes the test standardized and then we can compare it and the results from one appointment to the next. There’s no doubt that diabetes is difficult. It’s difficult to treat, difficult for patients to manage and what’s so wonderful about this clinic is that you can have regular follow-up appointments. We have nurse clinicians and get education from the dieticians and even work through barriers with the psychologists and social workers. So there are lots of supports to help people succeed. Alright, so it’s just after noon and I guess you guys don’t see that every time I see a patient I then go and review with my staff physician and we kind of work on the plan together and then go back and see the patient. Now that doesn’t leave me with a lot of time to do my dictations and notes between patients. So now I’m left with a pile of dictations to do, just part of the reality of medicine. And then we’re gonna get to go and see some of the inpatients. Okay, done. Now I’m gonna text the endocrinology fellow who will know what’s up in the hospital system and tell me where we need to go. There are 4 different hospitals in the city and we could be called to any of them to see consults. So we never know. Okay, so we’ve been called to go to a different hospital and see a patient who just had brain surgery. So they have a pituitary tumor that was removed and we’ll see how they’re doing. This is a really interesting surgery. They go up the nose, through the skull and into the brain. It’s the easiest way to access the pituitary gland, which is inside the brain and just behind the eyes. So the pituitary controls many really important hormones like the thyroid hormone, growth hormone, estrogen, testosterone and lots of others. So after the surgery it’s our job to check all the hormone levels, to make sure they’re working properly. And if they aren’t, we need to really carefully replace them. Alright, so got out early today and now I’ve got an extra 30 minutes of my day, which feels amazing! So I’ve just come home and I’m gonna play a little bit of violin before I have to go back to the hospital for my Royal College study group tonight. But we’ve got this holiday party/ talent show coming up this weekend. So I’ve got some some fun duets on the go. Back to the hospital. This time for my Royal College study group, not for work. So I guess that’s different, but it kind of feels like a deja-vu from this morning. And because we’re talking about diabetes, I want to remind you guys that so much of your health is in your hands. Not all of it, I know that. But try to get out there, do something fun and active, because you’re gonna feel great in your mind in your body. And if you’re super busy and you feel like you can’t do anything, then do a couple of stairs, walk to go and get groceries or walk to work, but try to get those steps in. Alright guys, I’m probably not gonna see you until 2020. It’s crazy to think of! So for now: Happy holidays, Merry Christmas, Happy Hanukkah. I hope you have wonderful times with your friends and family. I’ll see you guys in the next video, in the new year. Bye for now!

100 thoughts on “DAY IN THE LIFE OF A DOCTOR: Diabetes Clinic (Endocrinology Rotation)

  1. I’ve had a Bariatric Bypass and my type 2 diabetes has literally turned around. No more insulin. But I still have a watch my sugars which is why I still take my BSLs between 8-20 times a day. I don’t drive when sugars r less that 5. Ty to the fabulous drs that gave me the chance to turn it around with having the BB. Ty for ur education. Very informed. Why I’ve subbed and will continue to watch.

  2. Hi Siobhan I hope you're doing great, I'm preparing a Bachelor degree in Cytopathology in France do you think I can apply for Med school in Canada once I finish my Degree ?
    Thank you
    I love your vlogs, the way you record and edit them is amazing !

  3. Happy early christmas ! Glad to see you happy and positive 🙂 , it would make my decade if you would follow me on Instagram because who doesn’t want a doctor friend haha . Yadan_Gonzalez is my instagram

  4. Hey..just a random q ..Are sulphonylureas (glimipride, gliclazide etc) still used as routine meds in the west? What's usually the preferred 2nd line drug in case if ASVD risk is present?

  5. Back in college I had a teacher with diabetes and a service dog for it. I never really understood the reason for her having the dog when most diabetic people don't. If anyone has experience with this I'd be super interested to know:)

  6. Endocrinology is a very interesting part of medecine. I have Turner Syndrome and so I have visited with an Endrocrinologist every year for a check up. i

  7. I am type two diabetic. I am going to be having bariatric surgery in a couple of weeks. I am hoping that this will help reduce my blood sugars. Wish me luck!

  8. Just want to say, thank you for your videos. Not only are they educational, but it also gives people a small window into what goes on behind the curtains. Keep it up!

  9. Great video. I love your approach to type 1 diabetes and how you do a consult. I've had type 1 since the age of 3 (dx in 1979) and have seen Al advances in technology. Currently using a Medtronic 640G insulin pump and a Libre sensor. A1C is 5,6%. Unfortunately I have got some complications from the days control wasn't that good. I love to see medical students and residents approach a disease like diabetes differently than it used to by doctors and nurses. And people in general. That really helps. Thank you for sharing. Merry Christmas and a happy new year to you and the ones you love from the Netherlands. Frederike.

  10. I have secondary hypopituitarism. After two transphenoidal surgeries I am doing ok three years later. I take all hormone replacements but it has taken a long time to get the balance right. Thanks for sharing Dr 😊 for anyone who has been affected by pituitary disorders or wants more information on hormones check out www.pituitary.org.uk they are a UK based charity with lots of helpful information

  11. I was diagnosed with t1d in the summer. It’s been a bit challenging to manage as I have important exams this year and so sometimes I don’t want to deal with it when I’m studying but I’m trying to keep positive as I’m getting used to it and hopefully there will be a cure one day

  12. Beautiful sweater!! Gorgeous colour on you!
    BTW – was so nice to see/hear you play the violin! It is definitely my favourite instrument. In fact, at our wedding, we had a violinist and cellist play instead of a dj/band 🙂

  13. You honestly are an amazing human type. You inspire me to look at situations when it comes to medical stuff differently. I’m like a non nonsense person lol 😝 so I say things as they are and don’t always get a good response. You have a way of saying things without making the person feel bad. That in it self is a gift. 🙏🤗

  14. This was interesting to watch because I’m actually a type2 diabetic and I have gastroparesis. I was diagnosed with gastroparesis a year or so before I was with diabetes. I’m also male to female transgender so I’m on Hrt right now.

  15. What about all the other types of diabetes…? I have MODY 3 (hnf1a) diabetes. It's a genetic form- which for me, varies so much from day to day. I use an insulin pump and a dexcom. There arent just two types, and it is so important that people learn this.

  16. As a type two I'm a little heart broken about your video. You aren't inaccurate, there are a lot of preventative measures, but having doctor's who believe that I did this to myself means I get really terrible care despite having 'normal' test results and currently having zero complications. Because I'm type two diabetic the GP misdiagnosed my bronchitis as a heart problem. Because I'm type two diabetic everyone assumes I have a sedentary lifestyle regardless of what I say or any proof. Because my GP and the clinics case worker's attitude I now have ptsd and white coat syndrome. There are so many problems with how people perceive those of us with type two, the stigma is extremely detrimental, and I'm just a little bit sad.

  17. I'm so happy you filmed your endo rotation! I'm a first year med student and I'm interested in endocrinology so it was great to see what it's like for this specialty in the hospital. Love your content, looking forward to more! ❤🔥

  18. hi. enjoy your videos, i learned a lot from watching them, thank you. Can you help ? maybe yes, i has a question that if you answer it i appreciate it so much in advance. please and thank you. the question is "why do i shiver all of a sudden?" hope you can help me. thank you

  19. I love watching your video because I want to become a ER or and ICU doctor also it makes me prepared for what I am going to see and do in the future. Keep it up 👍

  20. I was diagnosed with type 2 a month ago. I ended up having to see a specialist at first because my family doctor thought that there might be a small chance that it was type 1. Needless to say it's forced me to completely change how I eat, exercise far more often and so on. Apparently I'm the youngest person in my family doctors practice (I'm 33) with type 2 so that's why he had me see the specialist.

    He started to suspect that I might have diabetes because it runs on my mothers side of the family, I occasionally have instances of Nystagmus (Horizontal) – basically my vision starts "moving" side to side for a couple of minutes (but my eyes don't always move when it's happening which is the weird part) and obviously I'm overweight.

  21. The last violin music was epic😍😍😍😍😍😍😍😍
    I use to play violin too
    I should probably start playing soon

  22. People with type 1 amaze me! I’m a middle school cheer coach and one of my girls has T1 and she is incredible! She has a pump but monitors close and knows her body so well. It’s so impressive to see a 13 year old have so much awareness of her body’s needs

  23. Hey Siobhan! Do you have any input on PCOS? I’ve been told I have to be on the pill the rest of my life which is probably damaging my body one way or another. Thanks!!

  24. Thank you for this video, I am a type 2 diabetic who is still struggling to balance everything out and manage my blood sugar, the words of encouragement were well needed. This video also answered my other question and that was: do you still find time to play your violin. glad to see that you are!! See you next year!!

  25. As the older sister of a Type I diabetic, endocrinologists are a special kind of wonderful. Extra special shoutout to Dr. Scott at Children's Hospital of Alabama for taking care of my baby sister along her whole journey.

  26. Hey Doc, I been an avid watcher for a while but just subscribed recently. I took the hands off approach with Youtube since 2010, but something about your video logs compelled me to hit the "Red" button! Also, I would have been graduating class of 2003 for Nursing until I switched majors, I do miss the Medical field though.

  27. I wish all doctors had a handwriting like you have. Me being a nurse would love to have more doctors like you. You are kind, think about the rest of the staff on the floor, and you have a good handwriting🥰

  28. Being a type 1 diabetic for almost 19 years now, I have been waiting to see if you would ever do a video on an endocrinology rotation. What a cool christmas present!

  29. Type 2 question: Wondering if you've ever noticed that if your patients can eat "bread," e.g., does not have Celiac, eating English muffins, specifically English muffins, doesn't cause a blood sugar spike at 1/2 hour, 1 hour, 2 hours, 3 hours, 4 hours after eating English muffins, in particular?

  30. Hi Siobhan! Just want to tell you that i love your channel. I request you please please do more of such vlog/informative videos!! They really help medical students (productive procrastination lol). I really appreciate you trying to explain everything so simply that even common man can understand what you're saying. Also love your medical case discussion videos!! <3 please dont ever stop mkaing videos

  31. I love how you gave a little shout out to the dietitian. I am currently going to school to become one and it’s so exciting when physicians acknowledge our presence in the medical field and appreciate it

  32. I was diagnosed with diabetes type 2 at 17yrs old. Now I am 28 and I hate taking my medicine so I try to eat healthy and workout to control it

  33. ughh she’s my fave and when i saw her do a diabetes video i got so excited because i have type one diabetes :)))

  34. This is such a stupid question but do you have to pay for residency? From my understanding it sounds like a training program for doctors….but you also work long hours? I’m so uneducated I’m sorry 😂

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