Prefer to listen? Check out my podcast here! In a continued quest to employ dietary strategies to help people with type 2 diabetes achieve remission (ie make blood sugars go back to normal), the English National Health Services has established a real world 1-year behavioral support program, built on evidence from randomized controlled trials including […] The post Diabetes remission with lifestyle intervention – have we learned anything? appeared first on Dr Sue ..read more

Prefer to listen? Check out my podcast here! It came to attention a number of years ago that statins, a group of medications widely used to lower cholesterol and reduce heart attack and stroke risk, may increase the risk of developing diabetes (as blogged previously). However, we have been lacking some clarity on who is […] The post Could your statin cholesterol medication cause diabetes? appeared first on Dr Sue ..read more

GLP1 and/or GIP/GLP1 receptor agonists, used to treat obesity and diabetes, are known to slow the gastrointestinal tract. This includes semaglutide (Ozempic/Wegovy), tirzepatide (Mounjaro/Zepbound), dulaglutide (Trulicity), liraglutide (Victoza/Saxenda), exenatide (Bydureon/Byetta), and lixisenatide (Adlyxine). Since these medications have exploded in popularity and uptake in the last couple of years (particularly semaglutide and tirzepatide), case reports have emerged where patients having a surgery, or conscious sedation (eg before colonoscopy, or with sedation for an MRI), were found to ha ..read more

Prefer to listen? Check out my podcast here! We know that GLP1 receptor agonists have many health benefits in people with type 2 diabetes, including improvement in blood sugars, weight loss, and reduction in heart attack and stroke risk. We also know that GLP1 medications reduce protein in the urine in people with type 2 diabetes and kidney disease, but no study had ever been done to see whether GLP1 treatment could protect kidney function – until now. The FLOW study, just published in The New England Journal of Medicine, is the first dedicated kidney outcome trial in people with type 2 diab ..read more

Prefer to listen? Check out my audio recording of this post here: We know that some GLP1 receptor agonists reduce the risk of cardiovascular events in people with type 2 diabetes [including (as blogged previously) liraglutide (Victoza), dulaglutide (Trulicity), and semaglutide (Ozempic)]. We also know that in people with cardiovascular disease and obesity, without diabetes, semaglutide 2.4mg (Wegovy) reduces cardiovascular risk. GLP1 receptor agonists have many possible mechanisms by which they could reduce cardiovascular events. But what happens to risk of cardiovascular events if GLP1 recep ..read more

(my less-than-happy emoji face) Prefer to listen? Check out my podcast here! As the word about the efficacy of new and emerging obesity/diabetes medications continues to spread, the global shortages of these medications continues. The medications we are talking about here are semaglutide (Wegovy for weight management, Ozempic for diabetes) and tirzepatide (Zepbound for obesity, Mounjaro for diabetes). In many countries, Ozempic and Moujaro (diabetes brands) have been available but Wegovy and Zepbound (weight management brands) have not, so doctors have been prescribing Ozempic and/or Mounja ..read more

Prefer to listen? Check out my podcast here! As blogged previously, semaglutide 2.4mg (Wegovy) has been shown to markedly improve symptoms of heart failure in people with obesity (without diabetes) and heart failure with preserved ejection fraction (HFpEF for short), in a trial called the STEP HFpEF study. A new study was just published, showing similar results in people with obesity and diabetes and HFpEF. What do these new data teach us? The STEP HFpEF DM study included 616 adults with type 2 diabetes, HFpEF (left ventricular ejection fraction (LVEF) ≥45%), and a body mass index of 30 or h ..read more

Prefer to listen? Check out my podcast here! Articles have gone viral this week regarding women getting pregnant on diabetes/weight management GLP1-based medications, particularly semaglutide (Ozempic for diabetes, Wegovy for weight management) and tirzepatide (Mounjaro for diabetes, Zepbound for weight management). What do you need to know? Many women with elevated weight struggle with difficulty getting pregnant. This is most often related to polycystic ovary sydrome (PCOS), which can affect women of all shapes and sizes, is common in women with obesity, and is exacerbated by weight gain ..read more

Prefer to listen? Check out my podcast here! Fatty liver disease is very common, affecting about 70% of people with obesity or type 2 diabetes. Resmetirom (trade name Rezdiffra), a thyroid hormone receptor beta-selective agonist, is the first medication ever approved to treat fatty liver disease (approved a few days ago by the American FDA). Many other treatments are being investigated for fatty liver disease, including GLP1-based medications that are approved or in develoment for obesity and/or diabetes. Resmetirom is currently under investigation in the MAESTRO-NASH phase 3 trial, with the ..read more

Prefer to listen? Check out my podcast here! As blogged previously, with the emergence of medications that are very powerful for weight loss, some people may lose too much weight. The defintion of excessive weight loss goes beyond the numbers on the scale, and can include excessive loss of muscle mass, a condition called sarcopenia. Currently, there is no standardized guidance or consensus on how to screen or diagnose sarcopenia, leaving health care providers in the dark as to how to look for or diagnose this condition. A recent article proposes a screening and diagnostic protocol for sarcop ..read more