🔹 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
🔹 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
🔥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
🔥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
🔥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
🔥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
🔹 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
🔹 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
🔹 <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
🔹 <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
💡"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
💡"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
🔹 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
🔹 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
& 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
& 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
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
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
link.springer.com/article/10.1...
@pccs.bsky.social @goggledocs.bsky.social @sabouretcardio.bsky.social @astonuniversity.bsky.social @swbhnhs.bsky.social
link.springer.com/article/10.1...
@pccs.bsky.social @goggledocs.bsky.social @sabouretcardio.bsky.social @astonuniversity.bsky.social @swbhnhs.bsky.social
🔹 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
🔹 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
🔹 🇬🇧 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
🔹 🇬🇧 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
🔥 #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
🔥 #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
🔹 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
🔹 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
🥇 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
🔹 #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
🔹 #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
🔥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
🔥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
👩⚕️ 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!
👩⚕️ 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!
🔹 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
🔹 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
🔹 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
🔹 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
🇬🇧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
🇬🇧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
🔹 🌍 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
🔹 🌍 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
🔹 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
🔹 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
🔹 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
🔹 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
🔹 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
🔹 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