Thread by @cardiomet_CE

Time for a shit in gear as the @GoggleDocs continue their £takeover of the @cardiomet_CE account.

From treatments that are still in the development stage now back to basics.

In this mini-thread today we are going to cover a couple of sessions from #EASD2021 that caught our 👁️

First up led by Prof. Roy Taylor of @UniofNewcastle in collaboration with the @UniofOxford Diabetes Trial Unit.

You may remember Prof. Taylor from the seminal DiRECT Study 👉directclinicaltrial.org.uk

Today I will be going through some of the preliminary data from the ReTune Study

📍Twin Cycle Hypothesis (R. Tayor 2008) of #type2diabetes
📍Once an individual' subcutaneous fat reserves are full
▶️ Fat is stored in the liver
▶️ Liver derived VLDL in turn, among other things, ⤴️ pancreatic fat
▶️⤴️pancreatic fat leads onto ⤵️ insulin secretion to food

What is the ReTUNE Study?

📍Similar to DiRECT except in non-obese (BMI<27) people with #type2diabetes
📍DM duration < 7 years
📍Similar intervention as DiRECT (i.e. at least 2 weeks of 800 Kcal/day meal replacement)
📍funded by @DUK_research 🙏

👉dtu.ox.ac.uk/OurTrials/ReTu…

⚠️ Preliminary results only
📍 Full results due 2022
📍Intervention led to:
⤵️ liver fat
⤵️ pancreatic fat content
⤵️ wt.loss of 10-15kg assoc with similar levels of remission seen in DiRECT

👏👏👏

What does this mean?

📍 Wt. ⤵️ of 10-15kg early in #type2diabetes REGARDLESS of BMI can lead to remission‼️

📍 Extends the hope of remission to people with lower BMI

📍Challenges our traditional view of #obesity

📍 Time to define #obesity on complications rather than BMI⁉️

Let's move from remission of #type2diabetes to management through food.

Tiny RCT from @Nestle (n=26)
👇
clinicaltrials.gov/ct2/show/NCT04…

📍 single centre, crossover design

📍 In people with #type2diabetes

📍120mls whey protein microgels shot 😋 15 min before a meal

📍Results

⤵️ Post-prandial glucose by 22% (2h), 18% (3h)

⤵️ GLP-1 by 66%

⤵️ Insulin first phase by 61%

⚠️larger/longer studies planned
😒 not vegan friendly

Keep checking back to the @cardiomet_CE account as we have only just scratched the surface of the #EASD2021

Later today we will be asking the Qusetion "what next after metformin?" in the drug management of #type2diabetes reflections from Grade to TriMaster.

Hope everyone is enjoying the @GoggleDocs takeover of our feed. While we "rest" tied up in the @cardiomet_CE basement and others provide superb tweetorials on our behalf, let us remind you that . . .

This program is intended for healthcare professionals and is supported by educational grants from AstraZeneca, Bayer, Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company, Chiesi, and NovoNordisk. And that you can see archived programs at cardiometabolic-ce.com