all things to do with diabetes obesity and metabolism
29th March 2026, A/Prof Chee L Khoo
Just as we are getting used to the GLP1-RA and the bi-hormonal GLP1/GIP co-agonists in the management of type 2 diabetes (T2D) and obesity, the playground is about to get more crowded. Retatrutide is a once weekly triple hormone receptor agonist. It is a single molecule that can activate the receptors for glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1), and glucagon.…
28th March 2026, A/Prof Chee L Khoo
Not all women with gestational diabetes mellitus (GDM) are the same. There are three subtypes of GDM – isolated fasting hyperglycaemia, isolated post prandial hyperglycaemia or combination of both being abnormal. Similarly, not all women with GDM end up the same after delivery. Women with GDM are recommended to have an OGTT at the 6 weeks postpartum.…
13th March 2026, A/Prof Chee L Khoo
Diabetic complications are categorised as either microvascular or macrovascular. Microvascular complications are typically associated with suboptimal glycaemic control which damages the small capillaries that supply our retina, myocardium, kidneys and feet including the long nerves. The brain, in particular, is susceptible to damage by both big and small vessels. Thus, it is not surprising that patients with diabetic retinopathy (microvascular) are likely to have a higher risk of dementia.…
24th February 2026, A/Prof Chee L Khoo
We know that suboptimal glucose control is very associated with the incidence and progression of diabetic retinopathy. The duration of diabetes, high systolic BP, smoking, lack of exercise, poor diet and depression are the other risk factors which increase the incidence of diabetic retinopathy as well as the progression of retinopathy. Sleep disorders, which are commonly observed in people with type 2 diabetes (T2D), are also significant factors that influence the development of diabetic complications [1].…
24th February 2026, A/Prof Chee L Khoo
People on shift work are at higher risk of cardio-metabolic dysfunction including cardiovascular (CV) diseases. People on rotating day and night shifts are even worse because their body has to adapt to a new time clock every couple of weeks. These people include ambulance officers, police officers and hospital doctors! Some of us may not be shift workers but are late owls.…
12th February 2026, A/Prof Chee L Khoo
When we think about major complications in patients with type 2 diabetes (T2D), we automatically think of an atherosclerotic cardiovascular event. While diabetic kidney disease, diabetic foot disease and retinopathy makes the quality of life miserable the last 5-7 years of their shortened lifespan but it is ASCVD events that kills them.…
27th January 2026, A/Prof Chee L Khoo
We are very familiar with preventing the progression of prediabetes to type 2 diabetes (T2D). Achievement of remission involves multi-component interventions including dietary and physical activity measures and often, pharmacological intervention. Patients with T2D are at heightened cardiometabolic complications. You would think that preventing the progression from prediabetes to diabetes will prevent some of these complications.…
28th December 2025, A/Prof Chee L Khoo
We discussed the Lancet Commission’s clinical obesity 12 months ago. Clinical obesity is obesity in the presence of a clinical disease (whether complication or co-morbidity). This is why the PBS is funding semaglutide for patients with obesity and established cardiovascular (CV) disease and not obesity on its own. There are many other “diseases” associated with obesity which will be funded by the PBS in the very near future.…
11th December 2025, A/Prof Chee L Khoo
We all have a handful of patients witth idiopathic intracranial hypertension. It is often diagnosed by someone else incidentally. While the full pathophysiology of the condition is still not clear, we know enough about the condition to know who may be at highest risk and perhaps, diagnose the condition early to prevent visual loss. Medical treatment is possible in the early stages and cerebrospinal fluid (CSF) shunting is no longer the only surgical options. Headaches is the most common initial symptom but we see so many patients with headaches that we don’t find a cause for. Who may have IIH? Which patients with headaches should we be on the lookout for IIH?
Max Nonne, a German neurologist, described a syndrome of headache accompanied by swollen optic disks in patients with CSF pressure back in 1904 (1). He called the condition “pseudotumor cerebri,” because it behaves like a tumour but none of these patients have a tumour. He described a clinical syndrome of chronically elevated intracranial pressure of unknown aetiology.…
23rd November 2025, A/Prof Chee L Khoo
Patients used to be given tacit recommendations about lifestyle changes for metabolic dysfunction associated fatty liver disease (MAFLD) because it’s “just a little fat in the liver”. For those of us who have that few patients with those liver as well as non-liver complications, we will remember how horrible these patients fare moving forward.…
11th October 2025, A/Prof Chee L Khoo
Weekly semaglutide injectable has been around for some years now. Even with my special interest in diabetes and obesity, I am getting confused with all the clinical trials involving semaglutide in patients with obesity with or without diabetes. They all have very innovative acronyms most of them starting with “S” which makes them hard to keep track of.…
22nd August 2025, A/Prof Chee L Khoo
We always worry when athlete patients take supplements to improve their workout and performance. We don’t really know what these “supplements” are. We don’t really know whether they work or whether they are safe. One of the most commonly used supplements is creatine. Does it help muscle building and performance? Does it help to lose fat?…