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 Image
📍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 Image
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

👏👏👏 ImageImageImageImage
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

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More from @cardiomet_CE

7 Oct
Welcome to our final Goggledocs tweetorial from this #EASD2021 takeover!
Over the last few days we have discussed all things cardio-reno-metabolic including SGLT2s, GLP1s, dual agonists, triple agonists….but not mentioned much about type 1 diabetes…
So today we are going to end on a cardiometabolic focused look at Type 1 Diabetes with data from #EASD2021 interwoven in... stay tuned!
One of the key sessions and guidance from @EASDnews #EASD2021 was the formalized joint ADA-EASD consesnsus report for management of type 1 diabetes… care.diabetesjournals.org/content/early/…
Read 28 tweets
6 Oct
The @GoggleDocs takeover of @cardiomet_CE continues!

We are 4 UK 🇬🇧 based doctors working across primary & secondary healthcare

Our interests are "what's new, and meaningful, in cardiorenal metabolic medicine"

Check out our YouTube channel youtube.com/c/GoggleDocs Image
Yesterday we had key messages from ReTune & diabetes remission & TriMASTER exploring “what next after metformin?”

Today @GoggleDocs will take you through some SGLT2 inhibitor highlights from #EASD2021 - the gift that keeps on giving!
Let’s start with some history!

SGLT2 inhibitors were originally developed from natural compounds found in what?
Read 29 tweets
6 Oct
Yes it's the @GoggleDocs as we continue our #takeover of the @cardiomet_CE account.

Reporting some of the things that interested us in the recent #EASD2021

Please check out our previous mini-tweetorials.

@EASDnews @EASDelearning @ADA_DiabetesPro
Thus far we have covered...

▶️ Latest data on tirzepatide (GIP/GLP-1 dual agonist)✅
▶️ "Triple G" - a new GIP/GLP-1/Glucagon agonist✅
▶️ Remission in non-obese #type2diabetes

Next up is "what's next after metformin?" - what the GRADE & TriMaster Studies add Image
Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)

📍Presented an update at the #EASD2021 , although little changed from the #ADA2021 presentation.

Please check out one of our own @GoggleDocs posts at the time

Read 13 tweets
4 Oct
It's Monday and time for us @GoggleDocs to #takeover the @cardiomet_CE account for the next few days.

It's time to revisit the recent #EASD2021 conference.

Highlights in what's new in
#T1D
#type2diabetes
#NAFLD
#CKD
#HeartFailure
Just to remind you guys

The @GoggleDocs are a bunch of 🇬🇧 docs/🤓 who are fascinated about the cardio-metabolic conditions we are increasingly managing.

Please check out our @YouTube channel
youtube.com/channel/UC8Tzu…
This accredited educational program is intended for healthcare providers only, and is supported by grants from AstraZeneca, Bayer, Chiesi, and NovoNordisk. Follow this thread for a link to credit. CE/#CME credit for #physicians, #nurses, #pharmacists in US, Canada, GB, EU.
Read 22 tweets
10 Sep
STEP this way for the last of our tweetorials covering #ESCCongress @escardio Looking at a trial of intensive blood pressure control in older adults with hypertension
First...step aside to a different STEP trial – Semaglutide in Obesity – our last tweetorial on this was very popular – have a look!
Now step forward to this tweetorial on BP lowering…
Read 38 tweets
9 Sep
Welcome to the final set of tweetorials from @GoggleDocs A look at some of the interesting trials on hypertension from #ESCCongress
First up we're giving you some SSaSS!
No, not that, we are talking about salt and salt substitution!
Read 32 tweets

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