GP Voice

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After Metformin, which agent is better?

1st August, 2018, Dr Chee L Khoo

After metformin and sulphonylurea, under the PBS we can choose between a DPP4 inhibitor, an SGLT2 inhibitor, a thiazolidinedione or a GLP1-RA injectable. Because of the potential adverse effects of cardiac failure with thiazolidinedione, realistically, it’s a three horse race. The cost effectiveness of each of the class of agents has not been explored thus far.…

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 the baby. When there is a lot of conflicting data coming our way, we need to sit back and look at the overall picture of hyperglycaemia in pregnancy and its management before we can make sense of these studies.…

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. Metformin has been used in women with PCOS, GDM and obesity during pregnancy in an attempt to improve pregnancy and foetal outcomes but this practice is not based on solid scientific evidence.…

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