EPCA winner|QiC award DIADEM| @BrJCardiol|Diabetes Consultant-frailty, ageing, dementia, oral health, sustainability, cardiovascular| @GoggleDocs|tweets my own
A pleasure to be appointed as an Honorary Senior Lecturer @BangorUni - hoping to build on this and continue to contribute on educating future generations! @kamleshkhunti
💉 Once-weekly basal insulin is here. MHRA has authorised Onswik (efsitora) for #T2D
🏛️NICE: an option, but use the least expensive suitable basal, NPH included. Likely role: people who need help to inject.
UK price confidential. Awaiting final TA + ICB pathways.
🔗gov.uk/government/news/mhra-…
🔗frontiersin.org/journals/end…
🧓 Can GLP-1 RAs help preserve function in people with diabetes?
In 73,592 propensity-matched pairs, GLP-1 RA initiation vs DPP-4 inhibitors was associated with:
📉 Less frailty progression
🚶 13% lower fall rate (IRR 0.87, 95% CI 0.84–0.91)
⚠️ Associations were weaker in severe baseline frailty.
Real-world evidence, not proof of causality.
#Diabetes#Frailty#GLP1RA#Geriatricsdom-pubs.onlinelibrary.wiley…@AskDrShashank
GLP-1/GIP RAs vs finerenone in T2D + CKD: What does real-world evidence show?
In 4,554 propensity-matched patients, GLP-1/GIP RAs were associated with a 29% lower relative hazard of kidney disease progression vs finerenone over 2.5 years (HR 0.71, 95% CI 0.55–0.91).
🔎 However, no clear difference in absolute risk or chronic eGFR slope emerged.
#Nephrology#Diabetes#CKD#GLP1RA@AskDrShashankdom-pubs.onlinelibrary.wiley…
GLP vs finerenone
🚨Retatrutide TRIUMPH-1 (NEJM)
80 wk weight: ⤵️25% on 12 mg vs -3.9% placebo.
⤵️28.3% headline = efficacy estimand.
👉9 vs 12 mg near identical; only 54% still on 12 mg at wk 80
⚠️⚡️Dysaesthesia, hypotension, MACE 9 v 1 (small n)
Treat to target, not max dose❓
🔗 nejm.org/doi/full/10.1056/NE…
In the phase 3 TRIUMPH-1 trial involving patients with obesity, retatrutide, a triple hormone receptor agonist, resulted in substantial weight reduction and a decrease in knee osteoarthritis pain and obstructive sleep apnea events. Full trial results: nej.md/4ycgSHz
ALT A graph from an Original Article published in the New England Journal of Medicine article titled "Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity." The graph shows effect of retatrutide on body weight. The trial name, TRIUMPH-1, is in parentheses after the title. The NEJM identity sits at the bottom.
If you are at @EASDnews and fancy coming to a “different” way of doing a session?
Come along
Sharing a stage with those with lived experience - what’s the point otherwise anyway
#T1Diabetes and #T2Diabetes
And some provocative discussions on whether everyone should have a CGM in tight health budgets
Whether hypos are really THAT big an issue
Whether AI is just about tech-bros jumping onto a fad in diabetes care
And whether pineapple belongs on a pizza.
And oh it’s not a typical stage either
Come along for some fun- if you can.
#EASD2026#Milan
Great to share the stage with colleagues and friends @EASDnews#EASD2026
Discussing bringing data to the masses:
👉🏽how we shape conversations
👉🏽build interest
👉🏽maintain integrity
👉🏽 enjoy ourselves 🥳
Thank you @novonordisk for the opportunity and the interest!
🚨#Tirzepatide and AF: signal or noise? 🫀
🆕 JAHA meta-analysis (10 RCTs, n=6,515): AF OR 2.20 (0.81–6.75), any arrhythmia OR 1.84 (1.04–3.90)
🔹Only 38 AF events, mostly from SUMMIT
🔸Semaglutide: 541 events, OR 0.83 (0.70–0.98)
👉Different class, different signal❓
🔗ahajournals.org/doi/10.1161/…
🔗academic.oup.com/eurjpc/adva…
❗️Interesting to see the confluence of specialty areas❗️
Thank you @PCDSUK for the invite to talk! A forward thinking meeting!
(Loving the purple theme 😁)
Fascinating to hear dermatology interest & create plans going forwards -another specialty to bring to the metabolic mix!
🆕NICE guidelines
Arguably the biggest shift in #type2diabetes care in over a decade.
Phenotype first. HbA1c second.
@drkevinfernando & I are running a free hour on what it actually changes in clinic.
Thu 10 Sept, 7-8pm BST
No industry funding
🔗tickettailor.com/events/oran…
ALT Clinical presentation, pathophysiology, biochemistry and treatment approach in men with organic and functional hypogonadism are summarised. fT=free testosterone. SHBG=sex hormone-binding globulin. TT=total testosterone. –=no effect. Figure created with Biorender.com.
Excited to work with @ATTDconf
👉🏽Management of older adults, technology & diabetes👈🏽
❓How do we manage older adults with diabetes
❓How do we balance intervention with support and QOL
❓What is the role of technology & how can we simplify/facilitate
us02web.zoom.us/webinar/regi…
Waist circumference–based measures outperformed body mass index as classifiers of diabetes status among 598,883 adults with BMI < 30 kg/m2 living in 82 low- and middle-income countries.
Read here ➡️ doi.org/10.2337/dc26-0106@AmDiabetesAssn@ADA_DiabetesPro@ADA_Pubs
ALT The image is an infographic about assessing waist circumference, relative fat mass index, and BMI as classifiers of diabetes status in 82 low- and middle-income countries (LMICs). It includes charts comparing these measures for classifying diabetes in adults with BMI less than 30 kg/m² across LMICs. The left section details the objective and methods, while the right section presents results with graphs showing performance differences by BMI, listing "Female" and "Male" on separate graphs.
ALT Bone marrow adipose tissue content and composition changes following bariatric surgery are specific to diabetes, sex, menopausal status, procedure, and bone site. BMD=bone mineral density. BTM=bone turnover marker. GIP=glucose-dependent insulinotropic polypeptide. GLP-1=glucagon-like peptide-1. PTH=Parathyroid hormone. PYY=peptide YY.
💊 The 82-year-old on a statin since their 60s. No ASCVD, no symptoms, no evidence either way
SAGA/SITE finally randomised it 🔬
📊 3-yr mortality 7.9% continue vs 7.2% stop
✅ Non-inferior (−0.68%, CI −3.95 to 2.60)
❗ No QoL gain from stopping
Shared decision, not a rule
🔗thelancet.com/journals/lanhl…
Excited to highlight this unique conference! Please join us!
⭐️The 7th Annual IGDS Workshop brings together experts & leaders in the world of diabetes, technology & weight management for older adults⭐️
November 11th-13th 2026 Boston, Mass, USA
geriatricdiabetes.org/