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Diabetes & Obesity

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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Weight loss – how to keep it off?

24th December 2018, Dr Chee L Khoo Losing weight is the second hardest thing to do. The hardest is keeping that weight off. With weight loss, hunger increases and energy expenditure decreases as the body adapts physiologically to the weight loss. The kilogram loss is…

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Another successful injectable workshop – DOMTRU at your service!

13th December 2018, Dr Chee L Khoo Three weeks ago, 25 of our GP and allied health professional (AHP) colleagues sacrificed their valuable Saturday and became engaged in a highly interactive session exploring the use of injectables in the management of our patients with type…

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Ertugliflozin – now we are three again

13th December 2018, Dr Chee L Khoo Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the latest therapeutic strategy in the treatment of type 2 diabetes mellitus (T2DM). They feature prominently in the latest international diabetes management guidelines. They not only improve glycaemic control but recent clinical…

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High dose fish oil and CV outcomes – another fishy tale?

10th December, 2018, Dr Chee L Khoo Elevated triglyceride  (TG) level serves as an independent marker for an increased risk of ischaemic events, as shown in epidemiologic and mendelian randomisation studies (1-5). However, in most of the statin trials, patients with high TG are generally…

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The Diabetic Heart – the dawn of the myocardium

27th November, 2018, Dr Chee L Khoo Of the patients with type 2 diabetes (T2D) who die from cardiovascular (CV) disease, 40% die from IHD, 15% die from heart failure and 15% die from strokes. Patients with T2D have greater atherosclerotic plaque burden, higher atheroma…

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Diabetes Management – GPs as good as Diabetes Centres!

13th November 2018, Dr Chee L Khoo 70-80% of patients with type 2 diabetes (T2D) are managed in primary care in Australia. Patients managed in hospital based outpatients have the advantage of multi-disciplinary team care. They have dietitians, credentialled diabetes educator (CDE), physiotherapists and of…

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Dapagliflozin more than DECLARE its CV benefits

13th November 2018, Dr Chee L Khoo It’s finally here. The Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction 58 (DECLARE–TIMI 58) trial finally released their results this week at the American Heart Association (AHA) Scientific Sessions 2018. The results were most impressive but this…

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GDM Diagnosis & Management – SWS leading the way

8th November 2018, Dr Chee L Khoo When there is so much talk about gestational diabetes (GDM), you can’t help but think that just about every pregnant woman has GDM in south west Sydney (SWS). After all, if you look at the “high risk” group…

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Twincretins – are two incretins better than one?

29th October 2018, Dr Chee L Khoo Incretins are hormones released when we eat. They augment the release of insulin from pancreatic beta cells. They not only lead to reduction in blood glucose levels via the secretion of insulin, they also inhibit glucagon release thereby…

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GLP1 agonists – are you up-to-date with them?

28th October 2018, Dr Chee L Khoo There are now 7 glucagon like peptide 1 (GLP 1) injectable analogues used to control hyperglycaemia in patients with type 2 diabetes (T2D). An eighth GLP1 analogue is now available as an oral form. Only four of them…

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Finally, what comes after metformin – the latest ADA/EASD guidelines made easy

11th October 2018, Dr Chee L Khoo Over the last 20 years, 5 classes of anti-diabetic agents are now available to choose from. This is great but which do you use after metformin? Guidelines after guidelines in Australia and internationally leave that decision up to…

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