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Diabetes & Obesity

Different types of type 2 diabetes – the more the merrier?

June 1, 2018, Dr Chee L Khoo Have you noticed that your patients with type 2 diabetes (T2D) are a heterogeneous group? Some T2D patients are more insulin resistant than others. Some T2D patients are more insulin deficient than others. These tend to be the…

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Hypoglycaemia is more than just an inconvenience

May 15, 2018, Dr Chee L Khoo Unless you have experienced a severe hypoglycaemia, you don’t actually appreciate the petrifying effects it has on your patients. In addition to increased morbidity and mortality, it is associated with a reduction in health-related quality of life, increased…

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Continuous Glucose Monitoring coming to general practice – are you ready?

May 15, 2018, Dr Chee L  Khoo You probably think that insulin pump (so-called continuous subcutaneous insulin infusion or CSII) and continuous glucose monitoring (CGM) are all to do with Type 1 diabetes (T1D) in diabetes centres and you probably don’t need to know about…

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SGLT2 inhibitor/DPP4 inhibitor combo under PBS – sorting out the confusion

May 1, 2018 Dr Chee L Khoo When I wrote the article last fortnight about new SLT2 inhibitor/DPP4 inhibitor combo now on the PBS, the situation was still very confused. Since that article, more information has  come to light. Yes, we are allowed to use…

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Getting T2D to target – two heads better than one

April 15, 2018, Dr Chee L Khoo To get our patients with type 2 diabetes (T2D) to glycaemic target using oral agents,  you can either use an SGLT2 inhibitor (SGLT2i) or a DPP4 inhibitor DPP4i) after metformin (with or without a sulphonylurea) but not both….

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Metformin in pregnancy – where are we now?

April 2018, Dr Chee L Khoo Another day, another study published on the good or bad about metformin use in pregnancy. There is a lot of confusion and unknowns about the benefit or safety of metformin to the mother-to-be or to the long-term outcome of…

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Multi-disciplinary care of T2D – does it work in primary care?

April 2018, Dr Chee L Khoo Multi-disciplinary care (MDC) is often hailed as THE comprehensive management for patients with type 2 diabetes (T2D). We refer these patients to podiatrists, exercise physios, dietitians, diabetes educators and sometimes, endocrinologists. Now, that is MDC, isn’t it? We are…

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Ketosis may improve glycaemic control – can we use it in T2D therapy?

April 2018, Dr Chee L Khoo Ketogenesis is the production of ketone bodies (KB) when glucose levels decline and the glucagon:insulin ratio is high. When the body is deprived of glucose, KB act as an alternative fuel source for brain, heart, kidneys and skeletal muscles….

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Statins and Muscles – worse than we think

March 15, 2018,  Dr Chee L Khoo “Doc, my muscles feels tired every time I try to exercise”. Are these patients just unfit or is it the statin or is that just another excuse? Between 7-29% of patients on statins report muscle complaints (depending on…

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Metformin during pregnancy – Goldilocks principle strikes again!

March 15, 2018 Dr Chee L Khoo Hyperglycaemia during pregnancy has significant metabolic consequences for the mother, the pregnancy as well as for the offspring’s future health. It is tempting to assume that keeping the glucose lower during pregnancy must be beneficial for both parties….

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VLCD may cause initial reduction in cardiac function

March 2018, Dr Chee L Khoo Several meta-analyses of randomised clinical trials showed that ketogenic diets induce a long-term significant improvement in body weight, diastolic blood pressure, triglycerides and HDL-cholesterol, when compared to low fat diets. However, rapid weight loss may cause a transient rise…

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Dasiglucagon – the new glucagon

February 2018, Dr Chee L Khoo Hypoglycaemia is one of the most common endocrine emergencies and the most feared complication of having diabetes. Treatment of severe hypoglycaemia in patients who are unable to take oral treatment is limited to either glucagon or glucose injections both…

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