26th April 2020, Dr Chee L Khoo
Although the Covid-19 pandemic seems to be under some control, we are still in danger of a second wave if we relaxed the social distancing rules too much too quickly. One of the big unknowns is what is the proportion of people with SARS-COV-2 who are asymptomatic? These are the people we are not testing.…
11th April 2020, Dr Chee L Khoo
You are probably overwhelmed by the whole Covid-19 saga. Just because we are dealing with Covid-19 “everywhere”, doesn’t mean existing chronic diseases can take a breather. Patients with chronic illness especially diabetes and hypertension are affected by the current Covid-19 chaos in more ways then one. GPs play a vital role in managing these patients during this difficult and challenging time especially when there is much emphasis on telehealth.…
10th April 2020, Dr Chee L Khoo
It’s amazing how quickly news travel during a pandemic. A bit of information came out a few weeks ago that suggests SARS-CoV-2 enters the body via the angiotensin converting enzyme receptor 2 (ACE2) present in abundance in pulmonary tissues. Initial reports out of Wuhan found that patients with chronic obstructive pulmonary disease (COPD), diabetes and hypertension were at higher risks of getting the infection as well as developing the severe form of Covid-19 if they do get the infection.…
We all have that warm fussy feeling inside every time they talk about the frontline “heroes”. You say “that’s me”. We all contribute towards the fight against the Covid-19 pandemic. The UK recently acknowledge the hardworking frontline health care workers (HCWs) with the “clap hands for frontline workers” campaign to acknowledge the dangerous work that we do. That’s what we sign up for – to save human lives.…
25th March 2020, Dr Chee L Khoo
They tell us that patients need to have 1) returned from overseas (any country will do now) OR been in contact with someone confirmed to have coronavirus infection AND 2) Flu symptoms with FEVER before we swab for Covid-19. Otherwise, we just reassure the patient that no they can’t have the swab and yes, they probably don’t have coronavirus infection.…
I told you last week that I am no expert and despite that I did write an article about the coronavirus. Well, I am doing that again this week but this time with a little more information and little bit more “expertise”. We have been getting oodles of feeds from many sources and I don’t know about you, but, all these bulletins really don’t help us working at the frontline.…
14th March 2020, Dr Chee L Khoo
I have been holding off writing about the coronavirus so far as I didn’t think that I have the expertise. I would be out of my depth. It’s been coming up to three months since the world woke up to Wuhan. It’s been 6 weeks since Australia banned all flights from China. It was only a matter of time before the virus run rampant in Australia causing mayhem.…
14th March 2020, Dr Chee L Khoo
It’s more than 100 years since insulin was first use for patients with type 1 diabetes (T1D). It’s been many decades now since we discovered that autoantibodies pre-dates the development of hyperglycaemia and theoretically, we should be able stop destruction of the beta cells before the onset of hyperglycaemia and “prevent” T1D. Unfortunately, strategies from preclinical and clinical studies thus fat, have not met their primary end points.…
14th March 2020, Dr Chee L Khoo
Despite significant reduction in cardiovascular events over the last 20 years in the general population, patients with diabetes still has 1.5-2 times the risk of cardiovascular events and cardiovascular mortality compared with the general population. It was pretty exciting when two classes of the new anti-diabetic medications have been shown in a number of landmark trials to reduce composite cardiovascular events patients with type 2 diabetes (T2D) and previous cardiovascular disease or patients with T2D with multiple cardiovascular risks.…
Lantus® or Insulin glargine U100 is a vital tool in a significant number of our patients with type 1 and type 2 diabetes. It is the only once a day basal insulin available in Australia until recently. From the 1st July, it will no longer be available on the PBS. It’s going to be chaotic unless you are prepared for D-day.…
The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive glucose lowering in patients with type 1 diabetes (T1D) reduce the risk of long term diabetes complications (1). Similar results were demonstrated in patients with type 2 diabetes (T2D) in the UK Prospective Diabetes Study (UKPDS). But intensive glucose control involves finger pricks at least 4-8 times a day and is not sustainable in the medium to long term in most patients.…
By now, you have heard that the continuous glucose monitoring “button” (Freestyle Libre) has finally been put on the NDSS. It was in the news and current affairs a few weeks ago with an interview of some politician to get their 5 minute of fame. You may even have a few patients come in asking for details. Of course, when you delve into the announcement a bit, you realise that it was a re hatching of some old news.…