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GoggleDocs @goggledocs.bsky.social · May 10

📢 TyG-BMI: a new vital sign in #MASLD?

🔹 NHANES study: TyG-BMI ⤴️ = ⤴️ all-cause ☠️ & 💔☠️

🔸 U-shaped risk curve—both high & low TyG-BMI = ⤴️ risk

🔹 HbA1c mediated most of the effect

👉 For MASLD, insulin resistance isn’t just present—it’s predictive❗️

🔗 ggdocs.co/9cu63n

@pharmrj.pharmsky.app

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Kevin Fernando @drkevinfernando.bsky.social · May 1

🚦Updated @medscape.com Primary Care #Hack

🔥Interpreting iron studies in primary care🔥

🎯 What are iron studies?
🎯 Top tips & pitfalls to avoid
🎯 Managing ⬆️ ferritin
🎯 Iron deficiency: once daily dosing help absorption

PDF download link in comments 👇🏾

@goggledocs.bsky.social @pharmrj.pharmsky.app

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Kevin Fernando @drkevinfernando.bsky.social · May 2

🚦Latest @medscape.com Primary Care #hack is live!

🔥Paired #hacks covering the diagnosis & management of #HFrEF & #HFpEF in primary care

PDF download link in comments 👇🏾

@pharmrj.pharmsky.app @goggledocs.bsky.social @hpillminster.pharmsky.app

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GoggleDocs @goggledocs.bsky.social · May 2

📢 Can LFTs track liver fat loss after weight loss in #T2D❓

🔹 DiRECT sub-study: 74% achieved MASLD remission with ~12kg wt loss

🔸 ⤵️ ALT & GGT= predictors of liver fat ⤵️ (ALT >40 = PPV 100%)

🔹 ALT change most closely linked to liver fat ⤵️

👉LFTs = simple tool to track remission

🔗 ggdocs.co/9g8ffo

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GoggleDocs @goggledocs.bsky.social · Apr 30

Who’s getting #GLP1 for #obesity 🇺🇸❓

🔹 <3% of 39M eligible pts got Sema/tirz

🔸 ⚫️⚪️ ⚠️ Px lower in ♂️, ⚫️/Asian/Hispanic pts, high SVI & rural area

🔹 Uptake ⤴️ overall, but disparities persist

🔸 Reflects system-level barriers

👉 #ObesityCare evolving—equity must catch up❗️

🔗 ggdocs.co/ao046p

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Kevin Fernando @drkevinfernando.bsky.social · Apr 29

🔥Our #CVRMUK paper is now published!

💡"Advancing Cardiovascular, Kidney, and Metabolic Medicine: A Narrative Review of Insights and Innovations for the Future"

🎯This review advocates for an integrated #CKM framework

Open access link in comments 👇🏾

@goggledocs.bsky.social @pharmrj.pharmsky.app

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GoggleDocs @goggledocs.bsky.social · Apr 15

📢 Danuglipron dropped—can orforglipron still be the “oral GLP-1 that delivers”?

🔹 Pfizer halts danuglipron after liver signal

🔸 Orforglipron P2=HbA1c ⤵️2.1%, Wt ⤵️14.7%, no liver signal

🔹 P3 2025—will it safely deliver?

👉 Small molecule GLP-1: blockbuster or cautionary tale?

🔗 ggdocs.co/5qu8y3

ggdocs.co

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Kevin Fernando @drkevinfernando.bsky.social · Mar 27

Hot on heels of CVRMUK congress, @EimearDarcy
& I present our updated @medscape.com
Primary Care #Hack

🔥#T2D #CVRM checklist🔥

💡A holistic, person-centred approach to supporting our patients living with #T2D

PDF download in comments below👇🏾

@goggledocs.bsky.social @pharmrj.pharmsky.app

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Kevin Fernando @drkevinfernando.bsky.social · Mar 24

🎯 CVRMUK London conference tomorrow!

I'm covering

💡A history lesson: the evolution of cardio-renal disease
💡The intersection of sleep & #CVRM
💡EASL-EASD-EASO #MASLD guidance

🔥 Our Autumn CVRMUK conference is on 26/11/25

Register 👇🏾

@goggledocs.bsky.social @pharmrj.pharmsky.app

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Prof Derek Connolly @profderekconnolly.bsky.social · Mar 22

🌍 Our real-world paper shows GLP1s are associated with lower risk of MACE & less costs than DPP4s or insulin in T2DM at higher CV risk 💔

link.springer.com/article/10.1...

@pccs.bsky.social @goggledocs.bsky.social @sabouretcardio.bsky.social @astonuniversity.bsky.social @swbhnhs.bsky.social

Real-World Comparisons Between Glucagon-Like Peptide-1 Receptor Agonists and Other Glucose-Lowering Agents in Type 2 Diabetes: Retrospective Analyses of Cardiovascular and Economic Outcomes in England...

Introduction Clinical trials have demonstrated that glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce the risk of major adverse cardiovascular events (MACE) in adults with type 2 diabetes (T...

link.springer.com

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GoggleDocs @goggledocs.bsky.social · Mar 22

📢 #GLP1 ⤵️ kidney decline, CV events & mortality in CKD❗️

🔹 Meta-analysis of 18K pts w/ eGFR <60:
⤵️ eGFR decline ≥50% (OR 0.72)
⤵️ 💔 (OR 0.86)
⤵️ ☠️ (OR 0.77)

🔸 ⤵️⤵️ with human GLP-1 backbone

🥇Evidence across CKD stages—not just macroalbuminuria

👉 GLP-1 now a key 🎯 in CKD + #T2D

🔗 ggdocs.co/tnqomz

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GoggleDocs @goggledocs.bsky.social · Mar 21

Oral semaglutide cost-effective vs. liraglutide—even at 50% ⤵️ price

🔹 🇬🇧 modelled data: ⤴️ QALYs (+0.18) & ⤵️ comp.

🔸 💊 = ⤵️ Rx burden vs. daily 💉

🔹 Results robust across sensitivity analyses

⚠️ funded by NovoNordisk

👉 Challenges low-cost liraglutide, supports 🎯 oral GLP-1 use

🔗 ggdocs.co/9h0bz1

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Kevin Fernando @drkevinfernando.bsky.social · Mar 17

🎯Updated @medscape.com Primary Care #Hack

🔥 #DOAC dosing for stroke prevention in #NVAF & kidney impairment🔥

🚨 #DOACs are not "fire & forget" drugs
💡 Do not use #eGFR; #CrCl should be used for drug dosing

PDF download link in comments below 👇🏾

@goggledocs.bsky.social @pharmrj.pharmsky.app

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GoggleDocs @goggledocs.bsky.social · Mar 16

📢 ACR in Obesity (Ob): Are we under Dx albuminuria?

🔹 Ob ⤴️ creatinine excretion = ACR underestimates albuminuria

🔸 Delay Rx in #CKD & #T2D—esp. RASi, SGLT2i, nsMRA

🔹 Bias = in ♂ & ⤴️ muscle

🔸 Review calls➡️♀️♂️ cutoffs or estimated AER (eAER)

🕓 to rethink ACR thresholds in Ob❓

🔗 ggdocs.co/l1htvt

Redirecting

ggdocs.co

GoggleDocs @goggledocs.bsky.social · Mar 14

Albuminuria: The CKM biomarker we’re overlooking❗️

🥇 risk biomarker

🔹 Even UACR <3.4 mg/mmol = ⤴️ #CVD, #CKD & ☠️ risk

🔸 Signals early endothelial dysfunc. in HTN, #T2D, #HF & #MASLD

🔹 Yet 💧screening rates low

🔸 Newer Rx (SGLT2i, #GLP1 , nsMRA) = 🎯

⌛detect, disclose & treat❗️

🔗 ggdocs.co/hot30b

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GoggleDocs @goggledocs.bsky.social · Mar 12

GLP-1 & blood cancer risk: Encouraging signal in cohort study

🔹 #T2D patients on GLP-1 ⤵️ risk vs. insulin for hematological cancers (HR 0.46)

🔸 ⤵️ risk of MDS, MPN, leukaemia, lymphoma & myeloma

🔹 No benefit vs. met

🔸 ⚠️ RWD = unresolved bias

👉 Supports 🎯 trials ⤵️cancer

🔗 ggdocs.co/3yosuj

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Kevin Fernando @drkevinfernando.bsky.social · Mar 10

💡 My latest Medical Mentor podcast is live!

🔥Interpretation & management of hypocalcaemia for PC 🔥

On Spotify, Apple Podcasts & Medscape website (link👇🏾)

+see my @medscape.com PC #Hack on hypercalcaemia and hypocalcaemia in PC (link👇🏾)

@goggledocs.bsky.social @pharmrj.pharmsky.app

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Dr Hema Chaplin @hemachaplin.bsky.social · Mar 7

📢 Are you a #UK #HealthcareProfessional managing patients with #KidneyDisease, #HighBloodPressure, #Diabetes or #Lupus?

👩‍⚕️ We want to hear what information/education you deliver about #kidneys, & anything that helped or hindered you.

🔗 app.onlinesurveys.jisc.ac.uk/s/salford/ph...

🙌 Thank you!

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GoggleDocs @goggledocs.bsky.social · Mar 5

#Finerenone: CV & renal protection across all #T2D therapies❗️

🔹 Pooled analysis: 15,365 pts w/ T2D + CKD or CV

🔸 Consistent benefit on 💔☠️, 🏥💔& kidney outcomes

🔹 ⤴️K+ ⤵️ with SGLT2i use

🔸 Benefit independent of SGLT2i/GLP-1 use

👉 Supports finerenone as a 🎯 in high-risk #T2D❗️

🔗 ggdocs.co/tx2a5r

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GoggleDocs @goggledocs.bsky.social · Feb 28

📢 #T1D Closed-Loop: MiniMed™ 780G in Real-World France

🔹 TIR ⤴️ 11.8% (2.8h/day) at 6m, HbA1c ⤵️ 0.52%

🔸 Hypoglycemia risk ⤵️, zero severe hypos @ 12m

🔹 Diabetes distress ⤵️ & QoL ⤴️ in adults & teens

🔸 Fear of hypos ⤵️ in adults & children

👉 HCL the new standard in #DiabetesCare❗️

🔗 ggdocs.co/pwpsiu

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GoggleDocs @goggledocs.bsky.social · Feb 27

📢 Mediterranean Diet: A Recipe for Cancer Prevention?
🇬🇧1 in 10 cancers - Obesity related (ORC)

🔹 n450,111, 15y follow-up in EPIC study

🔸 6% ⤵️ risk ORC withMedDiet adherence (HR 0.94)

🔹 Colorectal, liver, kidney cancer ⤵️

🔸 Not weight—no mediation via BMI/waist-to-hip ratio

🔗 ggdocs.co/7larkw

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GoggleDocs @goggledocs.bsky.social · Feb 27

MASLD: ‘Elephant in the Room’ of #CKM

🔹 🌍 crisis: 1/3 adults affected, 65% in #T2D

🔸 Liver fibrosis=predictor of ☠️ & #CVD, #CKD,&HCC

🔹 No approved Rx – 🎯 lifestyle, ⤵️weight & multi-specialty care

🔸 Future hope: GLP-1s, PPAR, THR-β agonists

👉 Access the full paper via link

🔗 ggdocs.co/dz0kai

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GoggleDocs @goggledocs.bsky.social · Feb 26

📢 #GLP1 & Safety: 82 Deaths Reported 🇬🇧

🔹 60 deaths linked to #T2D use, 22 to weight loss

🔸 Mounjaro (18), Ozempic/Wegovy (29), Victoza/Saxenda (35)

⚠️Reports ≠ causation, but raises need for better patient education

👉MHRA warns against unregulated online sales & fake pens

🔗 ggdocs.co/oapff4

GLP-1 agonists: 82 deaths linked to adverse reactions, UK data show

Data submitted to the UK drugs regulator show a total of 82 deaths related to glucagon-like peptide-1 receptor agonists, the class of drugs used for weight loss and type 2 diabetes. Data from the yel...

ggdocs.co

GoggleDocs @goggledocs.bsky.social · Feb 26

"Computer says yes" to help pick the best glucose-lowering drug #T2D

🔹 Machine-learning predicts optimal therapy (GLP1, SGLT2i, SU, DPP4i, or TZD)

🔸 Model-concordant Rx = 5.3 mmol/mol ⤵️ HbA1c at 12m

🔹 Better long-term outcomes: 38% ⤵️ glycaemic failure, 29% ⤵️ renal risk, 15% ⤵️ 💔
🔗 ggdocs.co/9p2tgf

A five-drug class model using routinely available clinical features to optimise prescribing in type 2 diabetes: a prediction model development and validation study

We have developed a five-drug class model that uses routine clinical data to identify optimal glucose-lowering therapies for people with type 2 diabetes. Individuals on model-predicted optimal therapy...

ggdocs.co

GoggleDocs @goggledocs.bsky.social · Feb 24

📢 Beyond GLP-1: The next wave ...

🔹 GIP/GLP-1 dual agonists (e.g., #Tirzepatide) ⤴️ wt loss vs. GLP-1

🔸 3x agonists (GIP/GLP-1/Glucagon) aim for >25% wt loss

🔹 Emerging 💉💊: Amylin + GLP-1 combos, FGF21 analogs, oral non-peptides

👉 Will the next-gen 💉 ⤴️ wt loss beyond 30%❓

🔗 ggdocs.co/hefyaj

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