Diabetes & Obesity

A patient with complex, advanced stage type 2 diabetes – where do we start?

14th September 2019. Dr Chee L Khoo We all have patients similar to this presenting to the practice not that infrequently. This is a real case that I came across just recently. Joanne was referred to the practice by a friend of a friend. She had just been discharged from the local hospital after three […]

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Double diabetes means double jeopardy

10th September 2019. Dr Chee L Khoo Have you noticed that most patients with type 1 diabetes (T1D) are not only small and petite but are often devoid of muscles when diagnosed. Insulin is a growth factor and without endogenous insulin, muscle growth is often stymied. We can’t push insulin therapy too hard because it […]

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Pancreatic cancer screening – why are we not there yet?

10th September, 2019. Dr Chee L Khoo Let’s face it. We all dread the diagnosis of pancreatic cancer in any of our patients. There aren’t too many red flags that we can rely on to warn us that something is not right with this deep seated abdominal organ. Many of the symptoms are either subtle […]

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DOMTRU GP Diabetes Injectable Workshop Masterclass 2019

It’s here again. The DOMTRU GP Diabetes Injectable Workshop Masterclass will be held at Mercure Hotel, Liverpool on Sunday 10th November with a totally new agenda. Over the last 12 months we have presented numerous articles detailing the multiple trials and guidelines surrounding the usage of the new GLP1-Ras and insulins. There are now 5 […]

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Lipid guidelines – what’s new in 2019?

23rd August 2019, Dr Chee L Khoo Remember we used to have lipid targets for patients with diabetes and patients with cardiovascular disease. Life was simple then. Just follow those numbers. Then the 2013 ACC/AHA guidelines told us to throw away those targets and put everyone with cardiovascular (CV) risk above a certain figure on […]

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Commercial drivers with diabetes – Do you know whose licence you can’t sign off!

12th August 2019, Dr Chee L Khoo A truck driver with type 2 diabetes (T2D) comes in for a “driving medical”. He’s had the forms for at least 6 weeks and he hands you the blue form. “It’s due today, doc”. You are in a bit of a bind. If you don’t sign off the […]

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SGLT2i, GLP1-RA and CVOTs – sorting out the confusion

11th August 2019, Dr Chee L Khoo All new anti-diabetic agents since 2008 have been mandated by the US FDA to conduct cardiovascular outcome trials (CVOT) to ensure that they are safe, or in statistical jargon, “non-inferior” to placebo in relation to major adverse cardiovascular events (MACE). 15 CVOTs assessing DPP‐4 inhibitors, GLP‐1 receptor agonists […]

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Visceral fat deposits – not all fat deposits carry the same risk

28th July 2018, Dr Chee L Khoo Visceral obesity is a better correlate with cardiometabolic risk, morbidity and mortality than general obesity. However, not all visceral fat depositions are the same. Some visceral fat depositions are worse than others in their contribution to atherosclerosis and cardiometabolic risk. The development of new imaging techniques has revolutionised […]

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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) available in Australia. Some are on the Pharmaceutical Benefits Scheme […]

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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 and our patients’ minds that eggs are no good. It […]

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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 to determine whether a patient is commenced on a statin […]

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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 type 1 diabetes (T1DM) even after adjusting for glucose levels. […]

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