So many cool interventional bariatric procedures that can cause weight loss with many of them also showing metabolic effects like decrease in A1c and changes in hormones (ie ghrelin). #obesity#AACE2021#Endotwitter
Wow this is a thing...bariatric arterial embolization which trans-arterially embolizes the gastric fundus through the left gastric artery (LGA) and/or gastroepiploic artery (GEA) --- leading to lower ghrelin levels #obesity#AACE2021#Endotwitter
Duodenal mucosal resurfacing promising for diabetes and improving insulin resistance but not as good for weight loss (just over 2kg weight loss) #AACE2021#obesity#Endotwitter
Gastric vest with very promising results that may be close to what you would see with surgery. Clip would mimic a sleeve but it can be removed. AspireAssist is like a peg tube used to remove food already eaten...with effective weight loss #AACE2021#obesity#Endotwitter
Intragastric balloons although effective for weight loss over time can cause a lot of symptoms and discomfort in that first 1-2 weeks after placement. Early removal rate 3-19% #obesity#AACE2021#Endotwitter
Jejunal bypass liner -- food on inside and pancreatic secretions on outside of liner leading to less absorption = weight loss and DM control --- down side is possible AE of hepatic abscess, GI hemorrhage and perforation #AACE2021#Endotwitter#obesity
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Let's hear The Evidence For and Against Combination #Thyroid Hormone therapy by Dr. Bianco #AACE2022#Endotwitter. This conversation is controversial here are some of the main slides
Patient's on Lt4 reporting a lot of residual symptoms in energy, cognition
Normal physiology the majority of thyroid hormone production is T4 (16:1 T4:T3) and gets converted peripherally to T3 (5mcg made in thyroid, 25mcg made peripherally)
Now to talk about Phosphatonins and #phosphorus metabolism/bone disease by Dr. Kumar moderated by @sfeirjad...I'm ready to learn since admittedly I know little of this #AACE2022#Endotwitter#bone
Why bother about phosphorus? Well it plays many roles in cellular signaling and maintenance of membrane structure of #bone. Low concentrations associated with rhabdo, decreased cardiac function and bone dysfunction (#osteomalacia, #rickets). low and high phos causes bone disease
High Phos Concentrations are Associated with CV Disease and Excess Mortality in CRF and decreasing levels reduces CV mortality
Look how far we have come in #diabetes technology and there is still a lot more to go #AACE2022. #CGM technology has been a game changer and the accuracy continues to improve with each generation
So what's new in the pipeline for #diabetes technology? Let me tell you starting with #dexcom G7. It will be smaller with a better MARD, better warm up and ALL-IN-ONE applicator and transmitter! Just pending FDA review #AACE2022#endotwitter#medtwitter
#NAFLD has effects on other conditions including DM, CVD, CKD etc due to increased hyperinsulinemia, insulin resistance, proinflammatory factors etc
How do we screen for #NAFLD and find the ones with fibrosis? A lot will be missed if just checking transaminases. FIB-4 and NFS is a better screening tool