all things to do with diabetes obesity and metabolism
27th May 2025, A/Prof Chee L Khoo
We know about type 1 to type 3 diabetes mellitus. I didn’t know that there was a type 4 and now they tell us there is a type 5. For someone who has a special interest in things diabetes, this is definitely news to me. Actually, on further research, it’s actually not that new.…
27th April 2025, A/Prof Chee L Khoo
We recently looked at the LDL-C levels needed to stabilise plaque progression and the LDL-C levels needed to cause plaque regression. Plaque stabilisation and regression leads to reduction in cardiovascular events. Dyslipidaemia (especially LDL-C) is also associated with cognitive impairment and dementia and reducing those numbers with statin therapy reduces the risk.…
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?…
23rd March 2025, A/Prof Chee L Khoo
I thought I read somewhere many years ago that we don’t have to advocate the traditional 72-hour carbohydrate (carb) loading prior to an oral glucose tolerance test (OGTT). I have not heard that issue being brought up of late. Well, does it increase or decrease the glucose levels of the OGTT.…
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.…
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.…
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
The reference values for serum magnesium (Mg2+) have been proposed to be somewhere between ~0.6 and ~1.2 mmol/L in healthy humans. That is a pretty wide range. Have you noticed that every second person discharged from hospital is recommended to take some Mg2+ supplement. Serum Mg2+ is often (or always) checked in hospitalised patients.…
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.…
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.…