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.…

Serum magnesium – what is normal and why the fuss?

23rd December 2024, A/Prof Chee L Khoo

Serum magnesium

The reference values for serum magnesium (Mg2+) have been proposed to be somewhere between ~0.6 and ~1.2 mmol/L in healthy humans. That is a pretty wide range. Have you noticed that every second person discharged from hospital is recommended to take some Mg2+ supplement. Serum Mg2+ is often (or always) checked in hospitalised patients.…

Early GDM – what happens post partum?

29th November 2024, A/Prof Chee L Khoo

We have written a bit on the paradigm change in our diagnosis and management of GDM over the last couple of years. We have looked at the TOBOGM study at length about early GDM (eGDM). This is GDM diagnosed before 24-week gestation. The TOBOGM study demonstrated that it is important to diagnosed early GDM as early treatment significantly improve neonatal and maternal outcomes.…