Creatine supplements – do they do anything?

22nd August 2025, A/Prof Chee L Khoo

Creatine

We always worry when athlete patients take supplements to improve their workout and performance. We don’t really know what these “supplements” are. We don’t really know whether they work or whether they are safe. One of the most commonly used supplements is creatine. Does it help muscle building and performance? Does it help to lose fat?…

Oral GLP1-RAs coming soon? – they are already here

13th August 2025, A/Prof Chee L Khoo

Oral GLP1-RA

We know the ongoing cost and availability of anti-obesity medications (AOM) the likes of Wegovy and Mounjaro although we have been assured that the supply issue is behind us now. Part of the problem with cost relate to the manufacturing cost of the devices. In fact, the rate limiting step to the production is the pen, which needs to be precisely manufactured and tested as it is a medical device.…

HFpEF – what else can we use in addition to an SGLT2 inhibitor?

28th July 2025, A/Prof Chee L Khoo

We are all aware of the four pillars of treatment in the guideline directed medical treatment (GDMT) of patients with heart failure with reduced ejection fraction (HFrEF) – SGLT2 inhibitors (SGLT2i), angiotensin receptor neprilysin inhibitor (ARNI), beta blockers and mineralocorticoid receptor antagonist (MRA). When we come to heart failure with preserved ejection fraction (HRpEF), the pillar of treatment is rather lonely – SGLT2i only.…

Who should not go vegan?

30th June 2025, A/Prof Chee L Khoo

There are many reasons why some of our patients go vegetarian. A primarily plant-based diet with less meat is supposed to lower the morbidity of chronic diseases, including cardiovascular diseases, type 2 diabetes, and certain cancers [1]. Some patients may choose to reduce their food-related ecological footprint. A transition to a diet that contains more plant-based products and less meat could increase food availability while releasing the burden on the environment [2].…

Type 5 diabetes mellitus – where did that come from?

27th May 2025, A/Prof Chee L Khoo

Classification of diabetes mellitus

We know about type 1 to type 3 diabetes mellitus. I didn’t know that there was a type 4 and now they tell us there is a type 5. For someone who has a special interest in things diabetes, this is definitely news to me. Actually, on further research, it’s actually not that new.…

Reducing LDL-C for brain health – how low do we need to go?

27th April 2025, A/Prof Chee L Khoo

how low should LDL-C be?

We recently looked at the LDL-C levels needed to stabilise plaque progression and the LDL-C levels needed to cause plaque regression. Plaque stabilisation and regression leads to reduction in cardiovascular events. Dyslipidaemia (especially LDL-C) is also associated with cognitive impairment and dementia and reducing those numbers with statin therapy reduces the risk.…

Prescribing exercise in T2D – when is a good time?

13th April 2025, A/Prof Chee L Khoo

Continuous glucose monitoring (CGM) was first shown to be beneficial in the management of patients with type 1 diabetes. Later on, patients with type 2 diabetes on insulin also found CGM beneficial in more ways than one. Of course, patients with T2D not on insulin also found CGM beneficial. What else can we use CGM for?…

GLP1-RA and thyroid cancers – is there a signal here?

24th February 2025, A/Prof Chee L Khoo

thyroid cancers

This is one of the most common questions asked at glucagon-like peptide 1 receptor agonist (GLP1-RA) CPD meetings. “What about the risk of thyroid cancer, doc?” As usual, the evidence is rather conflicting. The worry about the thyroid cancer risk with GLP1-RA is actually not without justification. The hypotheses is actually biologically plausible.…

Lancet Commission – what is clinical and preclinical obesity?

A/Prof Chee L Khoo, 26th January 2025

Obese or not?

Obesity was first recognised as a disease by WHO in 1948, and more recently also by several medical societies and countries (1–9). The current WHO International Classification of Disease labels obesity as “a chronic complex disease”. But obesity is a highly heterogenous condition and many people with excess adiposity have no signs of illness.…

Obstructive Sleep Apnoea Rx – is CPAP all we have?

8th January 2025, A/Prof Chee L Khoo

CPAP

Obstructive sleep apnoea (OSA) often (but not always) lead to daytime sleepiness and suboptimal daytime performance (including driving performance). It can also have a major effect on the quality of life (QOL) of the patient and the family. OSA is associated with a number important metabolic and cardiovascular conditions in a multidirectional manner.…