Diabetes & Obesity

Diabetes risk according to family history – can we quantify the risk?

29th January 2020, Dr Chee L Khoo If you have someone in the family with type 2 diabetes (T2D), then your risk of developing diabetes significantly increases. How much is “significant” though? Is it 2 times, 3 times or is it 10 times? Does it matter how many members in the family have diabetes? Is […]

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New T2D hyperglycaemia management guidelines 2019 – what is new?

29th January 2020, Dr Chee L Khoo The major difference between the 2018 American Diabetes Association/ European Association for the Study of Diabetes (ADA/EASD) consensus guidelines compared to previous guidelines were that they were less glucose centric in determining which agent to use after metformin. We used to use the most potent agent to get […]

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Coronary artery calcification among endurance athletes – do we need to worry?

5th January 2020, Dr Chee L Khoo Athletes and highly active people are not immune to coronary artery disease. There are some studies which suggest that despite the high levels of physical activity, these individuals have a higher prevalence of coronary artery calcification (CAC) compared with controls with low atherosclerotic risks (1,2). Is this increased […]

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Pet ownership and cardiovascular mortality – is it the ownership or the walking?

4th January 2020, Dr Chee L Khoo Anecdotal evidence suggests that having a pet reduces cardiovascular mortality. Does it? You can imagine that trying to conduct a randomised control trial can be difficult. One has to consider the pre-existing risks profile of the pet owner, physical activity pre and post pet ownership, marital status of […]

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Heart failure in type 2 diabetes – who is most at risk?

12th December 2019, Dr Chee L Khoo Type 2 diabetes (T2D) and heart failure (HF) are common diseases with significant morbidity and mortality. Two out of three patients with T2D have evidence of ventricular dysfunction within 5 years of diabetes diagnosis (1). Data from both observational studies and clinical trial cohorts suggest that the development […]

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SGLT2 inhibitors and hospitalisation for heart failure – finally a real trial!

12th December 2019, Dr Chee L Khoo EMPA-REG, CANVAS, DECLARE-TIMI 58 and VERTIS-CV are cardiovascular outcome trials (CVOTs) originally designed to demonstrate non-inferiority of SGLT2 inhibitors versus placebo on major adverse cardiovascular events (MACE). These clinical trials involving a total of > 36,000 patients with type 2 diabetes (T2D) followed for 2–5 years. Patients treated with a […]

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Vitamin D and Omega 3 Oils – do they have a role in diabetic kidney disease?

24th November 2019, Dr Chee L Khoo It’s not often that we report on trials with negative results but this trial attracted my attention because of many issues it raised when the top-line results were announced in the Journal of American Medical Association a fortnight ago. The conclusion states “supplementation with vitamin D3 or omega-3 fatty acids, […]

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Oral therapy in type 2 diabetes – navigating the PBS maze

14th November 2019, Dr Chee L Khoo Oral therapy for T2D – navigating the PBS maze During our recent GP Diabetes Injectable Masterclass Workshop, I noted that there was a lot of uncertainty and confusion in relation to what oral agents can be combined under the PBS. This uncertainty and confusion can only lead to […]

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The complexity of managing T2D – a GP’s perspective

13th November 2019, Drs Chee Khoo & Sobhy Khalil We have a contribution from our GP colleague this week. Dr Sobhy Hakeem KHALIL who thoroughly studied the ADA/EASD Management of Hyperglycaemia In Type 2 Diabetes, 2018 Consensus Report and provided his take on the guidelines. I have added my comments to his take (in blue): […]

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Second generation basal insulins – are they truly better insulins?

27th October 2019. Dr Chee L Khoo In medicine, newer is usually better although sometimes, we can be sceptical whether “newer” means a sneaky way to extend patents. The newer, second generation insulins, Toujeo® (insulin glargine U300 or GLA-300)  and Degludec® are truly better insulins. Diabetes Therapy recently published a practical guide to the use […]

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Does bariatric surgery reduce major adverse cardiovascular events?

27th October 2019. Dr Chee L Khoo We often hear about cardiovascular outcomes trials (COVT) involving the new anti-diabetic agents – the SGLT2 inhibitors, the DPP4 inhibitors and the GLP1-RAs. The CVOTs were meant to ensure that the agents do not have significant major adverse cardiovascular outcomes (MACE) when we prescribed them for patients with […]

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Nut consumption and weight change – is it positive or negative?

11th October 2019. Dr Chee L Khoo We all know that weight management is not as simple as a calories in calories out equation. Increasing nut consumption in particular, in theory, can cause weight gain because of nuts’ energy density but it doesn’t always translate to weight gain. In fact, a recent study showed the […]

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