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Diabetes & Obesity

Fournier’s gangrene & SGLT2i – how rare is it?

23rd March 2019, Dr Chee L Khoo You may remember receiving warnings recently from the Therapeutics Goods Administration (TGA) about a serious “rare” infection, called necrotising fasciitis of the perineum, also referred to as Fournier’s gangrene (FG). FG is reported to be associated with the…

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Maintaining weight loss in primary care – is it possible?

23rd March 2018, Dr Chee L Khoo The DiRECT trial is really a landmark study which shows that remission of type 2 diabetes (T2D) is possible with weight loss and more importantly, it can be achieved in primary care. The result from DiRECT was most…

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Insulin-GLP1 agonist combo – two heads better than one

23rd March 2019, Dr Chee L Khoo American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) suggest that if HbA1c targets are not achieved despite the addition of basal insulin in type 2 diabetes (T2D), treatment could also be further…

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Diabetes management after bariatric surgery – which medication to continue

14th March 2018, Dr Chee L Khoo Bariatric/metabolic surgery is an effective strategy to attain diabetes remission in obese patients. Significant and rapid weight loss by any means will improve insulin sensitivity, the internal glucotoxicity and lipotoxicity. Bariatric surgery, in particular, is thought to also…

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Continuous glucose monitoring FREE for T1D but not FREELY available

10th March 2019, Dr Chee L Khoo It makes sense that patients with type 1 diabetes (T1D) on insulin pump be fitted with continuous glucose monitoring (CGM) which facilitate insulin titration. It’s even better if the CGM sensor directly “talks” to the pump and adjust…

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Metformin in Pregnancy – first do no harm?

27th February 2019, Dr Chee L Khoo Primum non nocere (first do no harm) is quite an appropriate term when is comes to managing pregnant women who either have dysglycaemia or are at risk of dysglycaemia. While there is no question that hyperglycaemia during pregnancy…

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Can Vitamin C reduce plasma glucose?

22nd February 2019, Dr Chee L Khoo Increased oxidative stress appears to be a significant factor leading to insulin resistance, dyslipidaemia, β-cell dysfunction, impaired glucose tolerance and ultimately leading to type 2 diabetes (T2D). Ascorbic acid (AA) is a water soluble anti-oxidant that reduces oxidative…

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Losing weight: Different diets for different patients – are we there yet?

13th February 2019, Dr Chee L Khoo It’s all too confusing. It used to be low fat diet. It’s now low carbohydrate (carb) diet. Some studies show that low carb diet loses more weight than low fat diet while others show the opposite. Yet, other…

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The adipocyte – a very busy cell

27th January 2019, Dr Chee L Khoo Energy consumption, regulation and storage vital for the survival of the organism. We have specialised cells that manages the above but often, the cells do a bit of each depending on the energy needs of the organism at…

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Do all fat kids develop diabetes? If not, who does?

27th January 2019, Dr Chee L Khoo As GPs we often see little kids already carrying extra weight and we know that many of these will go on to become overweight or obese adults. Many overweight kids and overweight adults will go on to develop…

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Fasting glucose – is it still relevant when managing patients with T2D?

27th January 2019, Dr Chee L Khoo It’s tempting to rely too much on HbA1c when managing our patients with type 2 diabetes (T2D). It is not uncommon to come across patients with pretty optimal HbA1c (under 6.5-7.0%) and we pat them on the back…

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Cholecystokinin (CCK) – more than just a gallbladder hormone

4th January 2019, Dr Chee L Khoo When you treat a medical condition with an agent with known intended effects, it is not uncommon that we come across some of the unintended effects of the agent. Glucagon-like peptide 1 receptor antagonists (GLP1-RAs) are very useful…

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