all things to do with diabetes obesity and metabolism
13th July 2022, Dr Chee L Khoo
Have you noticed we don’t hear about congestive cardiac failure (CCF) anymore? Its’ just plain heart failure (HF) now. It makes sense because not all heart failures are congestive in nature. Of course, you are aware of the new terms – heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).…
13th July 2022, NIA Diagnostic Imaging
Last month we explored the many treatment options in the pipeline for the treatment of non-alcoholic fatty liver disease (NAFLD). We have to first diagnose NAFLD. The gold standard for diagnosis of NAFLD involves a thorough clinical history with pathological correlations. This is then confirmed through the detection of steatosis on liver biopsy and the exclusion of all other causes, including alcohol consumption.…
26th June 2022, Dr Chee L Khoo
I was recently tasked with preparing a lecture on the current guidelines for lipid management in patients with diabetes. I thought it was quite straight forward. We have known for some years now that the targets are tighter than patients without diabetes. Thus, it can’t be that hard. As I looked into national and international guidelines, they started to get more and more complicated.…
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.…