GoggleDocs retweeted
CGM may have an important role in type 2 diabetes even for people who are not using insulin.
@NEJM
In this 26-week primary care RCT of 283 adults:
📉 HbA1c: 7.2% with CGM vs 8.0% with routine care
⏱️ Time in range: +21 percentage points
✅ No severe hypoglycaemia reported
lucose responses in real time may help connect food, activity and treatment with glucose levels.
Need robust data on cost-effectiveness and in which patient population with T2 diabetes
@AskDrShashank
@NEJM
In this 26-week primary care RCT of 283 adults:
📉 HbA1c: 7.2% with CGM vs 8.0% with routine care
⏱️ Time in range: +21 percentage points
✅ No severe hypoglycaemia reported
lucose responses in real time may help connect food, activity and treatment with glucose levels.
Need robust data on cost-effectiveness and in which patient population with T2 diabetes
@AskDrShashank
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GoggleDocs retweeted
@GoggleDocs @drkevinfernando @drpatrickholmes @scelee1 @DSNforumUK @HannahBeba @CristobMorales @NICEComms expects benefit in a frail, vulnerable cohort…. Show me the evidence… potential for harm has not been mitigated and needs to be balanced/addressed…
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💉 Once-weekly basal insulin is here. MHRA has authorised Onswik (efsitora) for #T2D
🏛️NICE: an option, but use the least expensive suitable basal, NPH included. Likely role: people who need help to inject.
UK price confidential. Awaiting final TA + ICB pathways.
rt
🔗frontiersin.org/journals/endoc…
🏛️NICE: an option, but use the least expensive suitable basal, NPH included. Likely role: people who need help to inject.
UK price confidential. Awaiting final TA + ICB pathways.
rt
🔗frontiersin.org/journals/endoc…
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GoggleDocs retweeted
🧓 Can GLP-1 RAs help preserve function in people with diabetes?
In 73,592 propensity-matched pairs, GLP-1 RA initiation vs DPP-4 inhibitors was associated with:
📉 Less frailty progression
🚶 13% lower fall rate (IRR 0.87, 95% CI 0.84–0.91)
⚠️ Associations were weaker in .
Real-world evidence, not proof of causality.
#Diabetes #Frailty #GLP1RA #Geriatrics
dom-pubs.onlinelibrary.wiley.com/doi/abs/10.111…
@AskDrShashank
In 73,592 propensity-matched pairs, GLP-1 RA initiation vs DPP-4 inhibitors was associated with:
📉 Less frailty progression
🚶 13% lower fall rate (IRR 0.87, 95% CI 0.84–0.91)
⚠️ Associations were weaker in .
Real-world evidence, not proof of causality.
#Diabetes #Frailty #GLP1RA #Geriatrics
dom-pubs.onlinelibrary.wiley.com/doi/abs/10.111…
@AskDrShashank
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GoggleDocs retweeted
🩺 HbA1c vs fasting glucose: Which better predicts cardiometabolic multiple long term conditions (multimorbidity) in people without diabetes?
Our study led by @scelee1 & Setor
In 2,233 adults in England followed for 12–15 years, both markers were associated with future cardity—but HbA1c was the stronger predictor.
📈 Each 1% higher HbA1c: ~2× higher odds
🔬 HbA1c improved risk discrimination more than fasting glucose.
HbA1c help identify long-term cardiometabolic risk earlier?
#Diabetes #CardiometabolicHealth #Prevention #PublicHealth
sciencedirect.com/science/articl…
@AskDrShashank @LDC_tweets @uniofleicester
Our study led by @scelee1 & Setor
In 2,233 adults in England followed for 12–15 years, both markers were associated with future cardity—but HbA1c was the stronger predictor.
📈 Each 1% higher HbA1c: ~2× higher odds
🔬 HbA1c improved risk discrimination more than fasting glucose.
HbA1c help identify long-term cardiometabolic risk earlier?
#Diabetes #CardiometabolicHealth #Prevention #PublicHealth
sciencedirect.com/science/articl…
@AskDrShashank @LDC_tweets @uniofleicester
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GoggleDocs retweeted
GLP-1 are a life changing and possibly a humanity changing group of medications. The fact that insurance will not cover them should cause patients to be extremely angry.
Obesity is the mother of chronic disease.
Successful obesity treatment should not be discriminated against.
Obesity is the mother of chronic disease.
Successful obesity treatment should not be discriminated against.
It seems that GLP-1s reduce the whole-body risk of disease.
Across 5 RCTs, semaglutide lowered blood-based risk scores for diabetes, and in 4 of 5 for AFIB, heart failure and coronary disease.
Just fascinating!
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GoggleDocs retweeted
Colleagues, we need your help -
We're seeking nephrologists' perspectives on management of iron deficiency in CKD. The survey takes <5 minutes & will help shape the design of a new international randomised trial
rnsapmredcap.nslhd.health.nsw.gov.au/redcap/surveys…
Thanks for sharing with your networks
We're seeking nephrologists' perspectives on management of iron deficiency in CKD. The survey takes <5 minutes & will help shape the design of a new international randomised trial
rnsapmredcap.nslhd.health.nsw.gov.au/redcap/surveys…
Thanks for sharing with your networks
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GoggleDocs retweeted
Next-Generation Obesity and Diabetes Therapy
CagriSema — REIMAGINE 2
HbA1c reduction: 1.9%
Weight reduction: 14.6%
TIR increased from 52.3% to 88.0% at week 68
Retatrutide — TRIUMPH-2
Major weight reduction with accompanying improvement in glycaemic control.
Survodutide — ant weight loss and HbA1c reduction, -gastrointestinal adverse effects ( concerning point)
Amylin-Based Therapies
-An emerging major pathway for obesity treatment, -cagrilintide and eloralintide.
Oral Incretin Therapies
-oral semaglutide
-orforglipron.
Once-Weekly Basal Insulin
CagriSema — REIMAGINE 2
HbA1c reduction: 1.9%
Weight reduction: 14.6%
TIR increased from 52.3% to 88.0% at week 68
Retatrutide — TRIUMPH-2
Major weight reduction with accompanying improvement in glycaemic control.
Survodutide — ant weight loss and HbA1c reduction, -gastrointestinal adverse effects ( concerning point)
Amylin-Based Therapies
-An emerging major pathway for obesity treatment, -cagrilintide and eloralintide.
Oral Incretin Therapies
-oral semaglutide
-orforglipron.
Once-Weekly Basal Insulin
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🚨Retatrutide TRIUMPH-1 (NEJM)
80 wk weight: ⤵️25% on 12 mg vs -3.9% placebo.
⤵️28.3% headline = efficacy estimand.
👉9 vs 12 mg near identical; only 54% still on 12 mg at wk 80
⚠️⚡️Dysaesthesia, hypotension, MACE 9 v 1 (small n)
Treat to target, not max dose❓
🔗 nejm.org/doi/full/10.10…
80 wk weight: ⤵️25% on 12 mg vs -3.9% placebo.
⤵️28.3% headline = efficacy estimand.
👉9 vs 12 mg near identical; only 54% still on 12 mg at wk 80
⚠️⚡️Dysaesthesia, hypotension, MACE 9 v 1 (small n)
Treat to target, not max dose❓
🔗 nejm.org/doi/full/10.10…
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🚨#Tirzepatide and AF: signal or noise? 🫀
🆕 JAHA meta-analysis (10 RCTs, n=6,515): AF OR 2.20 (0.81–6.75), any arrhythmia OR 1.84 (1.04–3.90)
🔹Only 38 AF events, mostly from SUMMIT
🔸Semaglutide: 541 events, OR 0.83 (0.70–0.98)
👉Different class, different signal❓
ph
🔗academic.oup.com/eurjpc/advance…
🆕 JAHA meta-analysis (10 RCTs, n=6,515): AF OR 2.20 (0.81–6.75), any arrhythmia OR 1.84 (1.04–3.90)
🔹Only 38 AF events, mostly from SUMMIT
🔸Semaglutide: 541 events, OR 0.83 (0.70–0.98)
👉Different class, different signal❓
ph
🔗academic.oup.com/eurjpc/advance…
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GoggleDocs retweeted
Dear @Ofcom
Please can you clarify to the nation why this is allowed under your current broadcasting rules?
A sitting MP [sometimes] on a TV channel he part owns, delivering a party political broadcast on behalf of Reform UK?
Seriously ... WTF?
Please can you clarify to the nation why this is allowed under your current broadcasting rules?
A sitting MP [sometimes] on a TV channel he part owns, delivering a party political broadcast on behalf of Reform UK?
Seriously ... WTF?
Nigel Farage exposes how Labour and the Tories hand out government contracts to their donors.
Under Reform UK, contracts will benefit the taxpayer - not our donors.
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GoggleDocs retweeted
🆕NICE guidelines
Arguably the biggest shift in #type2diabetes care in over a decade.
Phenotype first. HbA1c second.
@drkevinfernando & I are running a free hour on what it actually changes in clinic.
Thu 10 Sept, 7-8pm BST
No industry funding
🔗tickettailor.com/events/orangej…
Arguably the biggest shift in #type2diabetes care in over a decade.
Phenotype first. HbA1c second.
@drkevinfernando & I are running a free hour on what it actually changes in clinic.
Thu 10 Sept, 7-8pm BST
No industry funding
🔗tickettailor.com/events/orangej…
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GoggleDocs retweeted
Excited to work with @ATTDconf
👉🏽Management of older adults, technology & diabetes👈🏽
❓How do we manage older adults with diabetes
❓How do we balance intervention with support and QOL
❓What is the role of technology & how can we simplify/facilitate
us02web.zoom.us/webinar/regist…
👉🏽Management of older adults, technology & diabetes👈🏽
❓How do we manage older adults with diabetes
❓How do we balance intervention with support and QOL
❓What is the role of technology & how can we simplify/facilitate
us02web.zoom.us/webinar/regist…
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GoggleDocs retweeted
“CKD is not really a disease… trials don’t necessarily translate to living longer”
Not really sure where to start here. But trials in the last 20 years in which CKD therapies extend survival:
#DAPACKD HR 0.69 (0.53-0.88)
#FIDELITY HR 0.89 (0.79-1.00)
#FLOW HR 0.80 (0.67-0.95)
Not really sure where to start here. But trials in the last 20 years in which CKD therapies extend survival:
#DAPACKD HR 0.69 (0.53-0.88)
#FIDELITY HR 0.89 (0.79-1.00)
#FLOW HR 0.80 (0.67-0.95)
@mvaduganathaning about HF. TOPCAT in my view was positive trial due to fishiness in certain regions. SPIRITHF is harder to reconcile since stopped early. CKD is not really a disease and the outcomes from the trials don't necessarily translate to living better or longer. if you care so much about evidence why not advocate for a head to head trial? why are makers of finenrone and the academics who promote it afraid of elevating the best evidence?
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#ESCcongress2025
💊 STAREE in NEJM: atorvastatin 40mg vs placebo, 9,971 adults aged 70+, 5.9 yrs
📉 Major CV events HR 0.70 ✅ NNT 37
⚖️ Disability-free survival HR 0.94 (0.84–1.05) ❌
📊 CV death HR 1.00
Fewer heart attacks. Not a longer or more independent life
💊 STAREE in NEJM: atorvastatin 40mg vs placebo, 9,971 adults aged 70+, 5.9 yrs
📉 Major CV events HR 0.70 ✅ NNT 37
⚖️ Disability-free survival HR 0.94 (0.84–1.05) ❌
📊 CV death HR 1.00
Fewer heart attacks. Not a longer or more independent life
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GoggleDocs retweeted
Interviewed by the @NakedScientists on diabetes related foot wounds @Franers13 @iwgdf @gooday_c thenakedscientists.com/podcasts/ask-n…
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💊 The 82-year-old on a statin since their 60s. No ASCVD, no symptoms, no evidence either way
SAGA/SITE finally randomised it 🔬
📊 3-yr mortality 7.9% continue vs 7.2% stop
✅ Non-inferior (−0.68%, CI −3.95 to 2.60)
❗ No QoL gain from stopping
Shared decision, not a rule
hF
SAGA/SITE finally randomised it 🔬
📊 3-yr mortality 7.9% continue vs 7.2% stop
✅ Non-inferior (−0.68%, CI −3.95 to 2.60)
❗ No QoL gain from stopping
Shared decision, not a rule
hF
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GoggleDocs retweeted
#Obesity care in the #NHS is an absolute and utter shambles
Why don’t we just be honest and say we can’t afford any of the drugs till they go generic?
Saves lot of people angst.
And less said the better about improving conditions to tackle core issues of obesity
Either we need to park it in the “impossible” box and focus on other areas.
Why don’t we just be honest and say we can’t afford any of the drugs till they go generic?
Saves lot of people angst.
And less said the better about improving conditions to tackle core issues of obesity
Either we need to park it in the “impossible” box and focus on other areas.
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