#ClinicalPearl #MedTwitter

GLP-1 and GIP are both incretin hormones. Incretins are the X factor in the pathogenesis of type 2 diabetes and are a key component of the 'Ominous octet' - the 8 factors that cause type 2 diabetes. Contd..
But GLP-1 and GIP have subtle differences
GLP-1 inhibits insulin and also inhibits glucagon secretion
GIP on the other stimulates glucagon production in hypoglycemic situation and also stimulates insulin in hyperglycemic situation
DPP-IV inhibitors prevent the breakdown of both GLP-1 as well as GIP due to DPP-IV enzyme. Hence the half-life of these incretins is increased
In the situation of hypoglycemia, the increased half-life of GIP proves useful for glucagon secretion and hence preventing severe hypoglycemia
Hence DPP-IV inhibitors are not only useful in treatment of hyperglycemia (high sugars) but also prevent severe hypoglycemia (low sugars)
Understanding the actions of GIP is the next phase of understanding type 2 diabetes and developing therapeutics for the same.

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More from @omlakhani

6 Feb
Happy to share the publication of a very interesting case report, published in the 'Journal of Orthopedic case reports'. The first author is the renowned spine surgeon @modispine (Dr. Hitesh Modi)
The Patient has a spinal tumor which was thought to be the cause of the Quadriparesis.
However, it turns out the patient has hypokalemic period paralysis secondary to Primary aldosteronism
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15 Oct 20
Happy to share the new 'Libre' is officially launched in India. Got my demo from the Abbott representative today.

@IndiaESI #EndoTwitter

(A thread...)
Of course, I had been using the Libre for more than a year now, but here are some of my thoughts on the new launch from Abbott
Pro 1 :

The device comes with a built-in Glucometer and Ketone meter. The strips from Abbott's FreeStyle Optium glucometer can be used for the purpose
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@shuomi3 is a very smart guy.I love his YouTube videos on note making, especially the one on Zettelkasten method for research. I have made a modified easy to understand modification of the same for doctors and medical researchers, read on...
The first step make small notes while reading a review article or a research paper in your own words. @shuomi3 calls this "Literature notes"
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27 Sep 20
Starting my "Dopamine Detox" today.

Taking it slow, step by step because I have failed several times before.

Removed all the unncessary apps like Facebook, Twitter, all the financial trackers etc from my phone. They can now be accessed only via my tablet.
Irony that I am writing this on Twitter. Still couldn't offload WhatsApp from my mobile phone, but will try it in the next phase. Wish me luck.
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26 Sep 20
This is an amazing story. My father would be interested to know this
My father is a working professor of medicine. Been in academics all his life. Back in the day, he was very interested in neurology and took up DM Neurology in Mumbai
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I am sure you have heard of the term "Getting into the zone" or being in the "Flow state"
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Everybody gets into the "Flow state" with some work or hobby
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