Discover and read the best of Twitter Threads about #diabetes

Most recents (24)

1/15
Time for another #thursdaythread 🧵

In collaboration with the brill @diabetes_chat

This week is all about #diabetes diagnosis.

A moment that I personally will remember forever.

#diabeteschat #gbdoc Image
2/15
Do you remember the date when you or your family member were diagnosed with #diabetes?

Or as I call it 'D-day'.
3/15
Mine was 4008 days ago on 12th February 2012 🗓️

My blood glucose level was 30.6mmol/L🩸

I had my glucose measured in accident and emergency🏥

But the events that led to that moment was not smooth.

Where were you or your family member diagnosed with #diabetes?
Read 15 tweets
Uncontrolled #epileptic fits stopped by #insulin

1. A man aged 75 had for five days experienced tonic-clonic #seizures involving the right side of the face and right upper and lower limbs at a frequency of 20-30 per day. He had mild weakness of right arm and leg.
#MedTwitter
2. Patient was admitted in ICU under Medicine Unit. MRI brain and lumbar puncture were normal. New onset diabetes was detected for which he was treated with subcutaenous insulin.
Fits persisted despite treatment with midazolam and phenytoin. He was referred for neurology opinion
3. Patient was conscious but appeared exhausted. Review of blood tests showed high glucose of 350 mg/dL and mildly low sodium levels.
The diagnosis was obvious by now.
Read 8 tweets
LIVE: Opening of 152nd WHO Executive Board meeting twitter.com/i/broadcasts/1…
"Three years ago today, I declared a public health emergency of international concern over the global spread of #COVID19 – the highest level of alarm under the International Health Regulations, and for the moment, the only level of alarm"-@DrTedros #EB152
@DrTedros "As you know, on Friday the Emergency Committee met to consider whether that remains the case. The committee has advised me that in its view, #COVID19 remains a global health emergency, and I agree"-@DrTedros #EB152 bit.ly/3JtgqhJ
Read 122 tweets
I usually tweet about #obesity but since I recently had a pt with type 2 #diabetes go from 100 units/d insulin to 0 with tirzepatide, this is a good time to review #insulin management when you start a GLP1 / GIP

#endocrine #endocrinology #research #clinicians
1/
SURPASS-5: tirzepatide + basal insulin vs. placebo

Method: If baseline A1c<8, ⬇️long acting insulin dose by 20% at start of study

Result: At end of study, insulin was ⬇️11% for 15-mg tirzepatide group vs. ⬆️75% for placebo

jamanetwork.com/journals/jama/…

2/ Image
SUSTAIN-5: semaglutide 1.0 + basal insulin vs. placebo

Method: If baseline A1c<8, ⬇️long acting insulin dose by 20% at start of study

Result: At end of study, insulin ⬇️15% for 1-mg semaglutide group vs. ⬇️4% for placebo

academic.oup.com/jcem/article/1…

3/ Image
Read 7 tweets
HbA1c screening in adults can significantly reduce the time to diabetes diagnosis

1. HbA1C (glycosylated hemoglobin) is a marker of average plasma glucose during the previous 8-12 weeks.
An HbA1c of 6.5% is recommended as the cut point for diagnosing #diabetes.
#MedTwitter
2. In a recent population-based study in UK, HbA1c screening in adults aged 40–70 years reduced the time to diabetes diagnosis by a median of 2.2 years compared with routine clinical care. link.springer.com/article/10.100…
3. Highlights of the study
Read 5 tweets
1/4 "In this cohort study, more #severe acute illness, a higher #Charlson #Comorbidity #Index score, and being #unvaccinated were associated with a higher risk of reporting #COVID19 symptoms lasting 28 days or more."

#Unvaccinated and #immune naive or #convalescent?
2/4 "Participants with #COVID19 were more likely to seek medical care for #diabetes, #pulmonary, #neurological, and #mental health–related #illness for at least 6 months after onset compared with their pre-#COVID #baseline health care use patterns."
3/4 "These findings may inform the risk-benefit ratio of COVID-19 #vaccination #policy."

#SARSCoV2 #CovidIsNotOver #PASC #LongCovid

All were not checked for viral reservoirs and/or persistence, not tested in upper and lower respiratory tract and in the gastrointestinal tract.
Read 4 tweets
Do you interpret/rely on HbA1c often? ⚖️

Sometimes it may not truly represent glucose control.

Here are a few alternative methods to assess long-term glycemic control #MedTwitter.

A thread🧵
1/
Serum Fructosamine 🪢

This circulating glycated protein provides a 7 to 21-day estimate of glucose levels.

317 μmol/L -> HbA1c 7%
375 μmol/L -> HbA1c 8%

Limited use in nephrotic syndrome, liver disease, PLE, and pregnancy.
2/
Glycated Albumin 🪢

Glycemic control in the previous 14 to 21 days.

➗Divide by 3 for an approximate HbA1c.

Limited use in nephrotic, thyroid, and liver disease.
Read 7 tweets
Here, both metabolically healthy and metabolically unhealthy obesity were associated with higher risk of cancer, although though the risk relationships were weaker in the latter case.
- The combination of obesity and metabolically unhealthy status conveyed the highest risk of any obesity-related cancer, compared to other combinations of BMI and metabolic health status.
- The increased risk was found for most obesity-related cancers, with the highest relative risks found for endometrial, liver, and renal cell cancer.
Read 6 tweets
This one delves further into the cardiometabolic impact of body fat distribution, finding associations between visceral, abdominal subcutaneous, and gluteofemoral adipose tissue volumes at scale and risk of type 2 diabetes, and coronary artery disease. Image
This is not the first study of this group in this subject. They have done some previous, related, and very interesting work on the matter:


- The intention was to quantify visceral, abdominal subcutaneous, and gluteofemoral adipose tissue volumes at scale using machine learning and data from the studies mentioned above, in order to determine associations with type 2 diabetes and coronary artery disease.
Read 11 tweets
La investigación del #cacao sugiere que el chocolate puede tener efectos beneficiosos para la salud: ácidos grasos insaturados que contribuyen a controlar el colesterol; fibra que regula el tránsito intestinal; minerales que contribuyen a regular la presión sanguínea... 1/10
...para la transmisión neuronal y la memoria, así como el crecimiento y mantenimiento del sistema óseo, los alcaloides que mejoran el estado de ánimo y favorecen el rendimiento físico, explica la investigadora María Ángeles Martín Arribas (@ICTAN), en el 'El chocolate'. 2/10
Y, sobre todo, polifenoles como los flavanoles, con efectos antioxidantes y antiinflamatorios, que reducen la hipertensión, pueden prevenir el desarrollo y la progresión de algunos procesos cancerígenos y que actúan como agentes antidiabéticos y antiobesidad. 3/10
Read 10 tweets
Here, total intakes of folate, vitamin B6, and vitamin B12 were inversely associated with the incidence of meatbolic syndrome and the majority of its individual components among adults in the US.
- Folate intake was inversely associated with all of the individual components of the metabolic syndrome.
- The inverse association between vitamin B6 and metabolic syndrome appeared to be mainly explained by its favorable outcomes on adiposity, hypertriglyceridemia, low HDL-C, and elevated blood pressure.
Read 6 tweets
Taking frequent walking breaks during prolonged sitting could help lower blood sugar and BP

1. Sedentary lifestyle with prolonged sitting hours (>8 hours daily) is common these days.
Frequent walking breaks (1 min or 5 min every 30-60 minutes) could help lower blood sugar and BP
2. When participants took a 5-minute light #walk after every half hour of sitting, the blood #glucose spike after eating was reduced by 58% compared with sitting all day (reduction one would see in a diabetic using insulin or #diabetes medications to control their blood sugar).
3. The largest reductions in systolic blood pressure were observed when the walking break was 1 minute every 60 minutes (-5.2 mm Hg).
Read 7 tweets
TURNING OUT THE LIGHTS ON INFLAMMATION NATION

Concerned about #inflammation?

Good. You should be. Chronic inflammation leads to heart disease, #diabetes, #cancer, immune system dysfunction, mental illness and fatness.

I hear from doctors and diet gurus all the time that...
good diets, exercise & stress reduction all lower inflammation. And they do.

But you know what I never hear from doctors, diet gurus & supplement sellers?

I never hear them tell me to avoid the #1 creator of chronic inflammation.

Circadian Rhythm Disruption.

In other words...
too much artificial light at night and not enough sunlight during the day. Bright nights and dark days.

Now that you know, let me ask you this....

Why do these doctors and diet gurus not tell you about chronic circadian rhythm disruption? Is it because they just want you to...
Read 5 tweets
1/n Neues Jahr, neue Vorsätze. Viele möchten -mal wieder- mehr Sport machen, zudem #Diät und #Abnehmen. Doch das erfordert Disziplin und ist mühsam. Wie wäre es stattdessen mit einer Spritze 1x/Woche? #ElonMusk macht es vor. Die Entwicklung ist bedenklich. Ein Thread 🧵👇🏻 Image
2/n Auf Twitter schreibt Elon, dass er Diät mache u. zudem „Wegovy“ benutzt - wie auch Kim Kardashian. #Wegovy (Wirkstoff „Semaglutid“) ist ein sog. GLP-1-Rezeptoragonist der 1x pro Woche subkutan injiziert wird u. eigentl. bei Typ 2 Diabetes mellitus eingesetzte wird. Image
3/n #Liraglutid ist ein weiterer Vertreter dieser Gruppe u. führt ebenso zur Gew.abnahme. Es ist neben D.m. II auch zugelassen für „Adipositas als Ergänzung zu kalorienreduz. Ernährung […] zur Gewichtsregulierung bei BMI =/> 30 bei mind. 1 […] Begleiterkr. [z.B.Bluthochdruck]“
Read 16 tweets
A very interesting thread on @Reddit with @Walgreens employees and others discussing the rules made by @LillyPad to only place through prescriptions with the diagnosis of #diabetes - #Mounjaro is NOT YET indicated by the @US_FDA for #obesity as a diagnosis
The stigma for #obesity is directed at those with the disease. Unfortunately our society perceives that obesity is a “second class” disease and should be treated as such. Here @Walgreens employees are admitting to discriminating against patients 1/
The patients have been prescribed #Mounjaro “off-label” for the treatment of #obesity (because this medication has been shown to result in the highest weight loss of any medication at 22% total body weight lost) 2/
Read 4 tweets
Are "diet" soft drinks healthy?

1. People are opting for diet soft drinks in place of regular soft drinks, assuming that they are free of sugar, contain zero calories and hence are healthier & safer. But research shows evidence to the contrary.
#MedTwitter #HealthyFood
2a. In two studies conducted in US & Europe, individuals who consumed diet soft drinks had higher prevalence of metabolic syndrome than non-consumers.
Diet soft drink intake positively correlated with waist circumference and fasting plasma glucose in both studies.
Read 14 tweets
1) Welcome to our #accredited #tweetorial on clinical trial results and emerging data for treatment of Diabetes and CKD #DM in #CKD. I am Brian Rifkin MD, @brian_rifkin, from the Hattiesburg Clinic. #Nephtwitter #Medtwitter #FOAMed
2) This #accredited #tweetorial series on #kidneydisease #CKD is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US- or UK-based HCPs. Accreditation statement & faculty disclosures at ckd-ce.com/disclosures/.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists. Prior programs in this series, still eligible for CE/#CME, can be accessed at ckd-ce.com. FOLLOW US to learn from expert faculty!
Read 41 tweets
El entrenamiento de fuerza de hace perder grasa.

Vamos con un hilo 👇🧵
A día de hoy, el #ejercicio sigue siendo menospreciado en su capacidad como agente terapéutico no solo en la prevención, sino también en el tratamiento de múltiples patologías típicas del siglo XXI, tanto metabólicas, como neurologicas, psiquiátricas, cancer, autoinmunes, etc.
Además, dentro del propio ejercicio, el entrenamiento de fuerza es aún más infravalorado si cabe, siendo incluso mal visto por parte de la población y a veces hasta desaconsejado por algunos profesionales sanitarios no actualizados.
Read 10 tweets
Abro 🧵para hacer un recuento de lo que el #Año2022 nos dejó:
1. La aprobación por la @US_FDA en Noviembre del Tzield (#Teplizumab), un anticuerpo monoclonal anti-CD3 que retrasa la aparición de la #diabetes tipo 1.
2. La publicación en @ScienceMagazine de la fase 1 del ensayo clínico con la #vacuna eOD-GT8-AS01B para prevenir el #VIH, que indujo la sintesis de #anticuerpos neutralizantes vs el virus, en el 97% de los que fueron vacunados.
3. El #Daxxify una nueva forma de toxina botulínica tipo A, cuyo efecto tiene una duración de hasta 6 meses. El efecto del #botox es de alrededor de 3 meses.
Read 27 tweets
1/🧵Diabetes is part of Long COVID & a diabetes drug reduces Long COVID⁉️

📌 Studies of MILLIONS show COVID ⬆️ risk of new onset Diabetes by…
📌60%!! 🤯
📌 #Diabetes 1 & 2 are solidly documented components of #LongCOVID

👇 I unpack data & what this means & why should you care?
2/ First, this is fascinating & scary. Check it…

✔️COVID is vascular disease
✔️Diabetes is a vascular disease
✔️COVID causes a chronic immune disorder
✔️Diabetes is a chronic immune disorder.
✔️A diabetes drug with immune mechanisms may help both in unrelated ways
3/ This meta-analysis of 9 studies of ~40m people found 50% increased risk of DM type 1 (insulin dependent) & 70% higher risk of DM type 2 across age groups & sex - plus way more risk than general upper respiratory infections.
 
bit.ly/3G0j4bC
Read 9 tweets
This one found chronic hyperglycemia to be associated with cognitive decline in people with type 2 diabetes.
- Insulin resistance markers were not associated with cognitive Z score changes.
- In contrast, higher time-weighted mean HbA1c level over a period of 10.6 years was associated with later cognitive decline.
Read 7 tweets
ذیابیطس میں پاؤں کے السر کو سمجھیے
ذیابیطس میں پاؤں کا السر کیا ہے؟اسکی کیا وجہ ہے؟
ذیابیطس آپ کے پیروں کو کیسے نقصان پہنچاتی ہے؟
وہ عوامل جو پاؤں کے السر ہونے کا خطرہ بڑھاتے ہیں؟
آپ اپنے پیروں کو صحت مند رکھنے کے لیے کیا کر سکتے ہیں جاننے کے لیے یہ تھریڈ مکمل پڑھیں۔
#TDCthread
ذیابیطس میں پاؤں کا السر کیا ہے؟
ذیابیطس میں پاؤں کا السر ایک کھلا زخم ہے جو عام طور پر ذیابیطس والے شخص کے پاؤں کے نیچے ہوتا ہے۔
زخم ایک معمولی چوٹ، جلنے یا شدید سردی کی وجہ سے شروع ہو سکتا ہے جس پر آپ کا دھیان نہ ہو۔
RT plz for awareness @draffanqaiser @javerias @falamb3
اس کے بعد زخم متاثر ہو سکتا ہے اور ذیابیطس کی عام پیچیدگیوں کی وجہ سے ٹھیک نہیں ہو سکتاہے
اعصابی نقصان اور خون کا خراب بہاؤ
ذیابیطس کے 34 فیصد مریضوں کو پاؤں کے السر ہوسکتے ہیں
RT plz for awareness, @NabiqasimPvtLtd @SaniaNishtar @Dr_YasminRashid @mrazaharoon @ShamaJunejo
Read 13 tweets
The less we eat, the longer we live

1. This seems to be true.
A recent extensive review of studies done in geographies with maximum 100+ aged people showed that most of them practiced some form of calories restriction (CR) right from childhood.
#fasting #Longevity #MedTwitter
2. Calorie restriction (CR) is defined as consuming fewer (10-30% lower) calories as compared to usual.
This can be achieved by either intermittent fasting, or time-restricted feeding or substantially reducing carbohydrate intake.
#nutrition #HealthyEating
3. In ageing, #Insulin increases and insulin sensitivity decreases, which increase the risk of #diabetes, #obesity and #cardiovascular diseases. CR reverses these- reduces insulin levels and increases insulin sensitivity. #Glucose levels also reduce with CR.
Read 10 tweets

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