METABOLIC CLINIC – A new service started for liver patients at the PGI, Chandigarh
“Alcohol use disorder (AUD) is the biggest problem affecting not only the patients but also their families, so quite alcohol intake,” Dr Vivek Lal.
The Department of Hepatology in collaboration with the Department of Endocrinology and Dietetics, PGIMER, Chandigarh has started a new service for the patients attending the Liver Clinic in the New OPD complex on Monday and Friday at PGIMER, Chandigarh.
The service of ‘Metabolic Clinic’ was inaugurated on Monday, 22nd April 2024 by the Director PGI, Chandigarh, Prof Vivek Lal in the presence of Medical Suptd, Prof Vipin Koushal, Prof Ashok Kumar, Additional Medical Suptd, Prof Ajay Duseja, Head of Hepatology, Prof Sanjay Bhadada, Head of Endocrinology, other faculty members of Hepatology, Endocrinology, Dietetics and other departments, nursing staff and other staff members of the institute.
Dr Duseja explained that the purpose of starting the Metabolic Clinic within the Liver Clinic is to provide integrated, one-stop care under one roof to patients with chronic liver disease; many of whom have metabolic risk factors like overweight/obesity, diabetes mellitus, hypertension, and dyslipidemia. A lot of metabolic changes happen in the body with the onset of chronic liver disease and the development of hepatic fibrosis (scarring in the liver). In fact, many patients develop diabetes mellitus (blood sugar) after the development of cirrhosis liver. Patients with metabolic dysfunction associated steatotic liver disease (MASLD) earlier called nonalcoholic fatty liver disease (NAFLD) typically occur in patients who have these metabolic risk factors of obesity, diabetes, hypertension, and lipid disorders. Patients undergoing liver transplantation tend to gain body weight, increase in blood sugar, blood pressure and derangement of blood lipids after the transplant. In general, these patients after being seen in the Liver Clinic are referred to the Department of Endocrinology and Dietetics for the management of these metabolic risk factors. Because of the tertiary care set of the hospital, endocrinology OPD being on different days and many patients coming from outstation, a significant number are not able to reach these specialty clinics. Having an integrated ‘Metabolic Clinic’ within the Liver Clinic will facilitate these patients to have a consultation on the same day from the endocrinologist and dietitian who would be managing the ‘Metabolic Clinic’.
On the occasion, the Director PGI elaborated that integrated clinics like these are the need of the hour and congratulated the department of Hepatology for this endeavor. He complimented the department in taking the similar lead last year for starting another integrated clinic, the Alcohol Use Disorder (AUD) Counselling Clinic in collaboration with Psychiatry department which has shown positive outcomes in last one year. He stressed that alcohol use disorder (AUD) is the biggest problem responsible for not only alcohol associated liver disease but many other disease in the body. He further stressed that AUD not only affect the patients but also their families and urged everyone to quit alcohol intake.
Dr Bhadada, head of endocrinology spoke about the importance of integrated metabolic clinic and point-of-care services within the liver clinic. He said that initially these services will be provided once a week (on every Monday) and can be increased to both the days of the liver clinic (Monday and Friday).
The inauguration ‘Metabolic Clinic’ on Monday coincides with the World Liver Day which is observed every year on 19th April all over the world. Globally, the activities are organized on this health awareness day to spread awareness about liver diseases amongst the general public. Three most common causes of chronic liver disease in our country and worldwide are non-alcoholic fatty liver disease, alcohol associated liver disease and chronic viral hepatitis. These diseases are associated with significant complications and can go on to develop end stage liver disease and primary liver cancer if not detected and treated early. Fortunately, most of these diseases are preventable and controllable and ‘Metabolic Clinic’ started by the department of Hepatology is a step in that direction which will help in in better management of patients with chronic liver disease.
