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

Prefer to listen? Check out my podcast here!   In follow up to my blog post a few days ago, the DiRECT trial 5 year results have now been published, and the global diabetes and obesity communities are in heated debate about its implications. The DiRECT study was a 2 year randomized controlled trial, assessing the efficacy of an intensive lifestyle program to induce remission of type 2 diabetes. The 5 year obeservational extension results were published in The Lancet Diabetes & Endocrinology. (coincidentally, within hours of my blog post about whether diabetes remission with lifestyle ..read more

Prefer to listen? Check out my podcast recording of this post here: As blogged previously, rare post marketing case reports of suicidality have emerged amongst people taking GLP1 receptor agonists for diabetes or obesity, prompting a review of this class of medications by regulators around the world.  A recent real world study evaluated electronic health records of people with overweight or obesity, drawn from a large American database, who were prescribed semaglutide (a GLP1 receptor agonist called Ozempic for type 2 diabetes and Wegovy for weight management), looking at new and recurr ..read more

Prefer to listen? Check out my audio recording of this post here: As we get older, our immune systems become weaker , making us more susceptible to getting more severe illness when we catch a virus. What are the risks associated with the RSV virus, and should you be vaccinated? RSV is a very common, highly contagious virus. Symptoms of RSV are similar to other respiratory viruses, including stuffy nose, sore throat, headache, fever, muscle pain, coughing, shortness of breath, productive cough, and/or wheezing. While most respiratory tract viruses like RSV and the flu are mild, they can lead t ..read more

    NEW ON DRSUE.CA!  Prefer to listen? Check out my audio recording of this post here:    As blogged previously, we should not gauge weight management success solely on weight nor body mass index (BMI), and the goal should not be a ‘normal weight’.    The primary target of weight management should be on improving health and quality of life.   With new and emerging evidence for the benefits of weight management medication far beyond simply weight loss, should we reframe and fine tune our targets further?   As extensively reviewed in our 2022 Canadia ..read more

NEW ON DRSUE.CA!  Prefer to listen? Check out my audio recording of this post here: It’s finally here! Approved in November 2022, tirzepatide (trade name Mounjaro) is now available at pharmacies in Canada.  We have been waiting a year due to the global shortage, in the context of unprecendented demand.   As blogged previously, tirzepatide is a GIP/GLP1 receptor agonist that is approved as a treatment of type 2 diabetes.  It is very effective for improvement in glucose control, and also very powerful to help people with type 2 diabetes and obesity lose weight.  &n ..read more

Type 1 diabetes is an autoimmune condition where the pancreas stops producing insulin. In early type 1 diabetes, there is often a ‘honeymoon phase’, where the pancreas is temporarily able to continue producing some amount of insulin.  Many approaches have been investigated to see if the honeymoon phase can be prolonged, such that the person with new type 1 diabetes may be able to use less or no insulin for a period of time before the pancreas stops producing insulin completely.   In a recent Correspondence paper in the New England Journal of Medicine, authors report their experience ..read more