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Diabetes & Obesity

At least 3 other reasons why you should use GLP1-RAs early in diabetes management

13th July 2019, Dr Chee L Khoo New anti-diabetic agents are coming thick and fast. It is easy to get confused as to which agent to use. For injectables, there are currently at least a dozen different insulin preparations and 5 GLP1 -Receptor Analogues (GLP1-RAs)…

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Cardiovascular health – are eggs in or out?

13th July 2019, Dr Chee L Khoo First, it’s not good, then it’s Ok and now we are not sure. Maybe it is, maybe it isn’t. We are talking about eggs and the association with cardiovascular disease and mortality. It’s stuck in many of our…

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Fasting or non-fasting lipid levels – doesn’t it really matter?

22nd June 2019, Dr Chee L Khoo It is standard to measure blood lipids after an 8-12 hour fast. Pretty much all our guidelines for management of cardiometabolic conditions are based on these fasting blood levels. The actual reading is important because it guides us…

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Diabetic peripheral neuropathy and serum cholesterol– is lower necessarily better?

22nd June 2019, Dr Chee L Khoo Distal polyneuropathy (DPN) is one of the more severe complications of diabetes. The exact pathologic metabolic process of DPN is still uncertain but it is more common in patients with type 2 diabetes (T2DM) than in patients with…

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Checkpoint inhibitor-induced T1D – a newly emerging syndrome

8th June 2019, Dr Chee L Khoo Checkpoint inhibitors are monoclonal antibodies that block checkpoint molecules, cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed death-1 (PD-1) and PD-1 ligand 1 (PD – L1). They have revolutionised cancer treatment because of their ability to improve survival in a…

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Early weight loss following T2DM diagnosis – does the body remember?

8th June 2019, Dr Chee L Khoo The majority of patients with type 2 diabetes (T2DM) are diagnosed and managed in primary in the early years. We know from the UKPDS that early tight glycaemic control have enduring legacy effects on cardiovascular morbidity and mortality….

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New faster acting insulin – how fast is faster?

6th June 2019, Dr Chee L Khoo I thought short acting insulin was fast acting until fast acting insulin came along. Just when you think fast acting is truly fast acting, along came faster acting. So, what is this faster acting insulin aspart (fiasp)? Is…

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SGLT2 inhibitors and the diabetic kidney – friend or foe?

26th May 2019, Dr Chee L Khoo Sometimes when a drug is contraindicated for patients with low eGFR, it may mean that usage of the drug may further damage the kidneys or increase the risk of certain adverse events. For example, the use of metformin…

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GP: The centre of type 2 diabetes care – are you up to the task?

26th May 2019, Dr Chee L Khoo GPs in south west Dydney (SWS) are increasingly overwhelmed by the numbers of patients with type 2 diabetes (T2DM) coming through the doors. We know that this cohort have a more “aggressive” disease and much higher and earlier…

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Implementing a successful low calorie diet in general practice – Part 2

23rd May, 2019. Dr Chee L Khoo How to implement a low calorie diet for weight loss in general practice In the last issue, we described our retrospective audit of all the patients at my practice who has a diagnosis of type 2 diabetes and…

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How to create a weight loss program for patients with T2D

13th May 2019, Dr Chee L Khoo Type 2 diabetes is strongly associated with obesity and abnormal fat distribution. Fat loss especially from the liver and pancreas have been shown to reduce insulin resistance and, in some cases, lead to diabetes remission. Bariatric surgery can…

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The young T2D – more trouble ahead than you think

13th May 2019, Dr Chee L Khoo You are already seeing the worrying trend of younger and younger patients being diagnosed with type 2 diabetes (T2D). My youngest is 25 years old when first diagnosed with T2D. I am sure many of you have patients…

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