13th April 2025, A/Prof Chee L Khoo
Continuous glucose monitoring (CGM) was first shown to be beneficial in the management of patients with type 1 diabetes. Later on, patients with type 2 diabetes on insulin also found CGM beneficial in more ways than one. Of course, patients with T2D not on insulin also found CGM beneficial. What else can we use CGM for?…
28th February 2025, A/Prof Chee L Khoo
Every so often you come across a study where the initial and immediate impression is that there must be more to the conclusion. The latest study which connects the use of anti-depressants with further cognitive decline in patients with dementia is just one of those studies. Now, many patients who have dementia also have depression and are on anti-depressants and we don’t think twice about whether the drugs might hasten the decline in cognitive function in these patients.…
24th February 2025, A/Prof Chee L Khoo
This is one of the most common questions asked at glucagon-like peptide 1 receptor agonist (GLP1-RA) CPD meetings. “What about the risk of thyroid cancer, doc?” As usual, the evidence is rather conflicting. The worry about the thyroid cancer risk with GLP1-RA is actually not without justification. The hypotheses is actually biologically plausible.…
10th February 2025, A/Prof Chee L Khoo
We perform cardiovascular (CV) risk assessments in our consulting rooms everyday. We assess lipid profiles, smoking history, family history and activity levels in our patients routinely and try to quantify the likelihood they may have a cardiovascular event. Over the years at GPVoice we have tried to expand beyond the traditional risk factors as more data come to hand.…
A/Prof Chee L Khoo, 26th January 2025
Obesity was first recognised as a disease by WHO in 1948, and more recently also by several medical societies and countries (1–9). The current WHO International Classification of Disease labels obesity as “a chronic complex disease”. But obesity is a highly heterogenous condition and many people with excess adiposity have no signs of illness.…
A/Prof Chee L Khoo, 23rd January 2025
We explored the benefits (or lack of) of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) back in early December 2024 when we look at the indications and criteria to initiate icosapent ethyl in patients with residual hypertriglyceridaemia for cardiovascular benefit. Now, omega-3 fatty acid (O3FA) supplements often contain a combination of EPA and DHA.…
8th January 2025, A/Prof Chee L Khoo
Obstructive sleep apnoea (OSA) often (but not always) lead to daytime sleepiness and suboptimal daytime performance (including driving performance). It can also have a major effect on the quality of life (QOL) of the patient and the family. OSA is associated with a number important metabolic and cardiovascular conditions in a multidirectional manner.…
23rd December 2024, A/Prof Chee L Khoo
Is this one of those “adverse events” related to the GLP1 agonist your patient saw on google one day? I can see you roll your eyes and I thought that way too initially. But upon further research, it seems to be a real thing as there was a study published in the JAMA Ophthalmology recently.…
12th December 2024, A/Prof Chee L Khoo
Back in August this year, when we last highlighted the benefits of the new pure eicosapentaenoic acid (EPA), icosapent ethyl (Vazkepa®), in reducing cardiovascular outcomes in patients with high triglycerides and high cardiovascular risk, we foreshadowed that it will be available on the PBS for patients with established cardiovascular disease. It is now on PBS Authority and there isn’t much of a launch of the drug which is a pity as many of our patients who may benefit from icosapent ethyl who should be on it aren’t because most of us (including me) are still confused as to who will benefit and who is eligible.…
29th November 2024, A/Prof Chee L Khoo
We have written a bit on the paradigm change in our diagnosis and management of GDM over the last couple of years. We have looked at the TOBOGM study at length about early GDM (eGDM). This is GDM diagnosed before 24-week gestation. The TOBOGM study demonstrated that it is important to diagnosed early GDM as early treatment significantly improve neonatal and maternal outcomes.…
18th November 2024, A/Prof Chee L Khoo
Amongst the many causes of heart failure with preserved ejection fraction (HFpEF) is obesity. This is not surprising because obesity is now considered an inflammatory chronic disease. Increase adiposity leads to increased released of pro-inflammatory cytokines which damages myocardial muscles. It would then follow that reducing that fat mass would reduce the pro-inflammatory environment and result in lower incidence of HFpEF as well as reducing complications of HF.…
9th November 2024, A/Prof Chee L Khoo
Metformin has been the first line treatment for patients with type diabetes for many years. It has many mechanisms of action with many more that we have yet to uncover. We know that it improves glucose control by improving insulin resistance. These days we have many other glucose lowering agents that are a lot more potent than metformin.…