12th July 2020, Dr Chee L Khoo
One month ago, we discussed Ozempic®(semaglutide) as the new GLP-1 agonist kid on the block in the treatment of hyperglycaemia in patients with type 2 diabetes (T2D). We foreshadowed that it will be coming real soon. Well, sooner than I thought. Ozempic® went on the PBS on the 1st July. What we didn’t know was what the restrictions will be when prescribing for patients with T2D.…
11th July 2020, Dr Chee L Khoo
Another month, another change to the immunisation schedule. You must have heard about the major changes to schedule from 1st July. There are changes to who should get the pneumonia vaccines and which pneumonia vaccine they should get under the National Immunisation Program (NIP). Oh, that is, if they don’t run out of stocks again.…
29th June 2020, Dr Chee L Khoo
One in three patients with diabetes will develop diabetic foot ulcers (DFU). This typically occurs in the setting of peripheral artery disease, peripheral neuropathy and trauma. Foot ulcers invariably leads to lower extremity amputation (LEA) and both are associated with significant morbidity and mortality. We know that poor glycaemic control contributes to the development of DFU and LEA.…
28th June 2020, Dr Chee L Khoo
In type 1 diabetes (T1D), the β-cell die rapidly from a massive immunological assault and practically all the β-cells are quickly lost and hence, there is an absolute deficiency of insulin secretion. Using auto-antibody screening, we can define T1D. Do you realise that we don’t actually have a definition for type 2 diabetes (T2D).…
13th June 2020, Dr Chee L Khoo
We are not talking about whether front line workers should wear a mask or not. We are talking about masks for the general public. Even as medical practitioners, we are confused. How does the average member of the public decide whether to wear masks or not? There are so many different opinions from numerous different quarters.…
12th June 2020, Dr Chee L Khoo
Whenever there are multiple brands of the same class of drugs on the market, one always wonder whether the new kid on the block is a “johnny-come-lately” trying to break into an already crowded market with yet another drug or it’s really a new kid with much better credentials. We already have 4 GLP-1 agonists in Australia and now a fifth one will be out real soon.…
12th June 2020, Dr Chee L Khoo
Like me, you probably have come across homocysteine, methionine and MTHFR gene polymorphism from time to time and are aware of some connection between those things and cardiovascular disease but not quite sure how to connect them together. Which patient should we be checking homocysteine levels in? What about the MTHFR gene polymorphism?…
24th May 2020, Dr Chee L Khoo
In primary care, we are frequently preventing disease or at least we try to. Apart from lifestyle measures, we prescribe statins, anti-hypertensive, aspirin and beta-blockers to reduce cardiovascular events. What about arthritis? In patients who do not have arthritis (yet) but are at high risk of degenerative osteoarthritis, is there something we can do to reduce the patients’ risk of progressing to full blown arthritis?…
22nd May 2020, Dr Chee L Khoo
Let’s imagine we have a pregnant woman who tested positive for β-thalassaemia trait (minor) on antenatal screening blood tests. If both partners carry the same thalassaemia trait, there is a 25% chance of having a baby with thalassaemia major. Thus, we are advised to screen her partner for thalassaemia as well. Say, the partner’s blood picture is normal with no microcytosis and high performance cation-exchange chromatography (HPLC) shows normal levels of HbA2 and HbF.…
13th May 2020, Dr Chee L Khoo
Covid-19 have exposed the numerous risks patients with type 2 diabetes (t2D) face when the two pandemics meet head on. We have seen that patients with diabetes are over-represented in patients hospitalised with Covid-19 in Wuhan. Patients with diabetes are also affected more severely if they contracted Covid-19 especially if glycaemic control is suboptimal.…
11th May 2020, Dr Chee L Khoo
Most of you would have run out of flu vaccines by now. The bad news is that we don’t know when new stocks will arrive. So much for the assurance from the government in mid-March that “there is enough vaccines for all who needs them” but “go to your GP now anyway”.…
28th April 2020, Dr Chee L Khoo
The incidence and mortality from coronary artery disease in Australia continue to decline. Coronary revascularisation consisting of percutaneous coronary intervention and coronary artery bypass graft (CABG) is rapidly increasing as the standard of care for coronary artery disease. There have been numerous trials comparing CABG with percutaneous coronary intervention (PCI) and so far, no studies have convincingly shown any overall difference between the two revascularisation strategies.…