SURMOUNT-1: Tirzepatide for obesity management

29th July 2022, Dr Chee L Khoo

12 months ago, at GPVoice, we announced the arrival of drug LY3298176, which now has a name, tirzepatide, as the first in its class of “twincretins” in the management of type 2 diabetes. We briefly explored the 4 Phase 3 trials looking at the efficacy and safety of trizepatide in comparison with placebo, semaglutide, insulin degludec and insulin glargine.…

PCSK9 inhibitors in dyslipidaemia – where is the evidence?

13th July 2022, Dr Chee L Khoo

Meta-analysis

In the last issue of GPVoice, we looked at the up-to-date guidelines in the management of dyslipidaemia in primary and secondary prevention. We looked at how complex those guidelines are. We also touched on the fact not all the evidence behind the guidelines is Level A evidence. The PCSK9 inhibitors, in particular, are a relatively new class of lipid lowering agents and the data is still coming in.…

Universal definition of HF – it’s here

13th July 2022, Dr Chee L Khoo

Definition of HF

Have you noticed we don’t hear about congestive cardiac failure (CCF) anymore? Its’ just plain heart failure (HF) now. It makes sense because not all heart failures are congestive in nature. Of course, you are aware of the new terms – heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).…

Fibroscan for NAFLD

13th July 2022, NIA Diagnostic Imaging

NAFLD

Last month we explored the many treatment options in the pipeline for the treatment of non-alcoholic fatty liver disease (NAFLD). We have to first diagnose NAFLD. The gold standard for diagnosis of NAFLD involves a thorough clinical history with pathological correlations. This is then confirmed through the detection of steatosis on liver biopsy and the exclusion of all other causes, including alcohol consumption.…

Spectrum Bankstown Now Open

30th June 2022, Spectrum Medical Imaging

We are used to quality radiology services from Spectrum Medical Imaging. First, we had expanded services in Liverpool with Spectrum Medical Imaging opening further rooms at Sydney Southwest Private Hospital.

Spectrum is now open at

402-410 Chapel Road Bankstown

Spectrum Bankstown offers full service radiology including CT, Ultrasound, Cardiac CT, interventional radiology and OPG.

T2D Lipid Management – are you up-to-date

ASCVD

26th June 2022, Dr Chee L Khoo

I was recently tasked with preparing a lecture on the current guidelines for lipid management in patients with diabetes. I thought it was quite straight forward. We have known for some years now that the targets are tighter than patients without diabetes. Thus, it can’t be that hard. As I looked into national and international guidelines, they started to get more and more complicated.…

Time to get together as GPs

26th June 2022, Dr Chee L Khoo

Tell me, what time did you get home last night? When did you last work a Saturday or a Sunday? When did you last truly spend time with the whole family? I bet you still fly economy class when you last went overseas. I am not telling you anything you don’t already know. Our rebates have not gone up for > 20 years.…

Fenofibrate and retinopathy – when should we use it?

13th June 2022, Dr Chee L Khoo

retinopathy

Fenofibrate is a commonly-used lipid lowering agent. In particular, it is recommended for patients with high triglycerides. Two previous studies have demonstrated that fenofibrate reduces the progression of diabetic retinopathy (DR) in patients who already have DR. Despite the benefits of fenofibrate, we don’t see recommendations for its use featured prominently in guidelines.…

NAFLD – the many treatment options in the pipeline

12th June 2022, Dr Chee L Khoo

NAFLD

Non-alcoholic fatty liver disease (NAFLD) is the most common liver condition in the western world. A significant proportion of these patients developed inflammation and progressed to non-alcoholic steato-hepatitis (NASH). Further and persistent inflammation can lead to cirrhosis and ultimately, to liver failure or liver cancer. Management till recently is primarily targeted towards lifestyle measures to reduce liver fat.…

Diabetic retinopathy in pregnancy – real bad news!

11th June 2022, Dr Chee L Khoo

Diabetic retinopathy

Diabetic retinopathy (DR) will affect at least 1 in 3 of our patients with diabetes. Did you know that DR is the leading cause of irreversible blindness in women of reproductive age? Further, the progression continues up to 12 months postpartum. Type 1 diabetes is on the increase and young type 2 diabetes is definitely on the rise.…

Personalised breast cancer risk assessment is here

31st May 2022, Spectrum Medical Imaging

We know that different women have different breast types. Some breasts are more dense than others. Some breasts have more adipose tissues than others. Obviously, with age, those features will change. Thus, the ideal imaging techniques will be different and will depend on the breast type, the age and the underlying risk of the woman, amongst many other things.…

Fibromyalgia – which drug for which symptom?

23rd May 2022, Dr Chee L Khoo

Fibromyalgia?

We all know that the term fibromyalgia is a wishy-washy term used to cover something rather imprecise. Don’t get me wrong. I am not doubting the syndrome but just the name used to refer to the constellation of symptoms of widespread chronic pain, easy physical exhaustion, cognitive difficulties, depressed mood, sleep problems and digestive problems.…