all things to do with diabetes obesity and metabolism
13th June 2022, Dr Chee L Khoo
Fenofibrate is a commonly-used lipid lowering agent. In particular, it is recommended for patients with high triglycerides. Two previous studies have demonstrated that fenofibrate reduces the progression of diabetic retinopathy (DR) in patients who already have DR. Despite the benefits of fenofibrate, we don’t see recommendations for its use featured prominently in guidelines.…
12th June 2022, Dr Chee L Khoo
Non-alcoholic fatty liver disease (NAFLD) is the most common liver condition in the western world. A significant proportion of these patients developed inflammation and progressed to non-alcoholic steato-hepatitis (NASH). Further and persistent inflammation can lead to cirrhosis and ultimately, to liver failure or liver cancer. Management till recently is primarily targeted towards lifestyle measures to reduce liver fat.…
11th June 2022, Dr Chee L Khoo
Diabetic retinopathy (DR) will affect at least 1 in 3 of our patients with diabetes. Did you know that DR is the leading cause of irreversible blindness in women of reproductive age? Further, the progression continues up to 12 months postpartum. Type 1 diabetes is on the increase and young type 2 diabetes is definitely on the rise.…
22nd May 2022, Dr Chee L Khoo
The close association of inflammation and cardiovascular disease is well known for some time. Inflammation is an essential mediator of all stages of atherosclerosis, from initiation to progression and the development of thrombotic complications (1,2). Circulating immune cells play a critical role in the build-up of atherosclerotic plaques by adhering to activated endothelium and infiltrating the arterial wall to become lesional cells (3).…
13th May 2022, Dr Chee L Khoo
Another month, another commonly used class of drugs are implicated in either aggravating glucose control in patients with type 2 diabetes (T2D) or actually, increase the risk of developing T2D. This month, we a report suggesting the use of proton pump inhibitors (PPIs), as a class of agent, is associated with increased risk of developing T2D.…
12th May 2022, Dr Chee L Khoo
It’s been more than 4 years since we herald the arrival of the stable formulation of the new glucagon, dasiglucagon in a ready-to-use delivery device for the management of hypoglycaemia. If you think about how much time is wasted in the emergency treatment of hypoglycaemia. The existing glucagon emergency kits we currently have need reconstitution before administration.…
24th April 2022, Dr Chee L Khoo
There have many observational studies that have shown increased risks of a variety of cancers in patients with both type 1 and type 2 diabetes independent of body mass index (BMI). Cancer is also the second most common cause of death in patients with diabetes. Up to 18% of patients with cancers have diabetes.…
21st April 2022, Dr Chee L Khoo
We have discussed the two-way relationship between pancreatic cancer and diabetes. Patients with type 2 diabetes are at 1.5-2.0 times higher risk of developing pancreatic ductal adenocarcinoma (PDAC). In patients with T2D, the development of PDAC destabilises glucose homeostasis pretty much in all patients with T2D. In patients that do not have T2D, the development of PDAC pushes them across the threshold of T2D up to 6-12 months before the diagnosis.…
12th April 2022, Dr Chee L Khoo
It’s almost close to a wonder drug. It is widely used in type 2 diabetes (T2D) for management of hyperglycaemia when the HbA1c is >7.0%. For that indication, it is pretty potent and in clinical trials, can reduce the HbA1c by 1-1.5%. It also assists in weight reduction and thence, reduce the core problem of insulin resistance in these patients.…
22nd March 2022, Dr Chee L Khoo
If you don’t already know that SGLT2 inhibitors (SGLT2i) have significant cardiovascular (and renal) benefits over and above its glucose lowering action, you better catch up with our many, many past issues at GPVoice. You should also be as familiar with the similar benefits of the GLP1 receptor agonists (GLP-1RA), especially the newer weekly injectables.…
12th March 2022, Dr Chee L Khoo
When you look at the management of patients with type 2 diabetes (T2D), almost all the patients are on a statin for both primary and secondary prevention of cardiovascular complications. I suspect that those that are not already on a statin should be on as some doctors are not aware of the tightened lipid targets in the management of patients with T2D.…
7th March 2022, Dr Chee L Khoo
We are all familiar with various fixed dose combination of glucose lowering agents. We have DDP4 inhibitors + metformin, SGLT2 inhibitors + Metformin and SGLT2 inhibitors + DPP4 inhibitors. We also have combination insulins for some time – rapid acting insulin + long acting insulin (so-called pre-mix or co-formulations). Pharmacologically, they make sense as these combined agents either work via different mechanisms or have different pharmacokinetics.…