Lissa Bauer Profile picture
May 12 10 tweets 7 min read
Dr. Tuttle discussing diabetic CKD and benefits of relatively new med Finerenone #AACE2022
#diabetes is responsible for half of #CKD. CKD worsens CVD risk. 90% die from other cause before reaching ESRD #AACE2022 #endotwitter
#ckd -- screen, treat and refer. #kdigo to help us know when to do it #diabetes #AACE2022
Mineralocorticoid receptors increase inflammation and fibrosis --- blocking them decreases this (ie. Finerenone)
Finerenone clinical trials with positive results. Fidelio with #CVD outcome of 13% reduction, 23% reduction in kidney disease reduction #AACE2022
Finerenone dosing depending on eGFR, monitor potassium
#KDIGO updating this year for #CKD- should be published in the next few months. "harmonized" recommendations with ADA and AACE. SGLT2i and ARB/ACEi first line therapy. MRA and/or GLP1-RA for next line targeted therapy #aace2022
We aren't checking enough for albuminuria -- only 30-40% best picture -- 10% screening is the avg. We are also not treating them enough!
SGLT2i can decrease potassium so using with MRA can improve outcomes and decrease unwanted side effects

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More from @lissabauer

May 13
Excited to hear this talk about Time-Restricted Diets by Dr. Grajower moderated by @theweightmd I'll try to share what I learned #AACE2022 #endotwitter Image
What are time restricted diets? We are using intermittent fasting incorrectly -- most are actually doing time restricted eating Image
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Read 5 tweets
May 13
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 Image
Patient's on Lt4 reporting a lot of residual symptoms in energy, cognition ImageImage
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) Image
Read 9 tweets
May 13
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 Image
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 ImageImage
High Phos Concentrations are Associated with CV Disease and Excess Mortality in CRF and decreasing levels reduces CV mortality ImageImage
Read 12 tweets
May 13
Starting day 2 #AACE2022 with @ArchanaSadhu talking to us about #diabetes technologies in 2022 #endotwitter Image
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 ImageImage
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 Image
Read 11 tweets
May 12
The third lecture of the series of NAFLD by Dr. Cusi - Fatty liver guru -- presenting on Current and future treatments ImageImage
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Pioglitazone decreases visceral fat (liver fat, CV fat, muscle fat) but increases SQ fat. Effective at decreasing NASH and fibrosis ImageImageImage
Read 8 tweets
May 12
Diagnostic tools for diagnosis of #NAFLD and complications by Dr. Lomonaco #AACE2022 #endotwitter ImageImage
#NAFLD has effects on other conditions including DM, CVD, CKD etc due to increased hyperinsulinemia, insulin resistance, proinflammatory factors etc ImageImage
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 ImageImage
Read 8 tweets

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