Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 20180125045128
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
Adjunct Associate Professor Chong Wei Sheng, Head of the Psoriasis Unit at the National Skin Centre, Singapore, speaks to Roshini Claire Anthony on the vital role played by primary care physicians (GPs) in tackling psoriasis.
Pearl Toh spoke with Dr Teh Ming Ming, senior consultant at the Department of Endocrinology, Singapore General Hospital (SGH), on the major challenges of diagnosing and managing diabetes in primary care, in conjunction with the World Diabetes Day on 14 November. Awareness of the symptoms of diabetes is important, and patients should be empowered to manage their conditions.
Roshini Claire Anthony speaks to Dr Adoree Lim, a consultant at the Department of Endocrinology, Singapore General Hospital, on how GPs can help tackle hyper- and hypothyroidism in the primary care setting.
With the rise in life expectancy and the nation’s fixation with all things sweet, it is no wonder type 2 diabetes is now one of the country’s biggest health worries. The National Health and Morbidity Survey (NHMS) 2015 places the prevalence of type 2 diabetes at 17.5%. With such a high burden of disease, patient care and education can take its toll on the healthcare system. It falls upon the shoulders of healthcare personnel to ensure complications are minimized and targets are met. Here, the role diabetes educators play in the care of people with diabetes can help stem the tide of type 2 diabetes and its impending outcome on the healthcare system.
A 55-year-old man presented with almost one year history of heat intolerance, mild palpitation and significant weight loss. Free T3 and T4 were elevated with normal TSH. Patient had suboptimal response to carbimazole therapy.
Spinal fractures are often the result of underlying osteoporosis. Radha Chitale spoke with Dr. Hee Hwan Tak, medical director and senior consultant at the Pinnacle Spine & Scoliosis Centre at Mount Elizabeth Medical Centre, about managing osteoporotic spinal fractures in primary care.
This case scenario was presented at a grand round in the Department of Medicine, The University of Hong Kong. Unlike traditional grand rounds that directly or indirectly deal with clinical challenges posed by patients, this one was equally about doctors and how they care for their charges. All doctors who tend patients dread being implicated on the receiving end of medico-legal proceedings. This topic is therefore intimately linked to the professionalism of doctors, their standing in the community, and the ethical aspects of how they interact with patients and relatives.
During the recent Malaysian Endocrine and Metabolic Society’s 7th Annual Congress, two teams of endocrinologists gave their take on the motion of ‘A1c target of 7% as expounded by the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) is more pragmatic than the target of 6.5% recommended by the Malaysian CPG for T2DM, AACE and IDF.’
Women with pre-eclampsia or gestational hypertension during their first pregnancy had an increased risk of developing chronic hypertension, type 2 diabetes (T2D), and hypercholesterolaemia than those who were normotensive during pregnancy, according to a study. The risk persisted for several decades later, signalling these hypertensive disorders of pregnancy (HDP) as red flags for cardiovascular (CV) health for life.
Patients with type 2 diabetes (T2D) treated with sulphonylureas as second-line drugs are at an increased risk of myocardial infarction (MI), all-cause mortality and severe hypoglycaemia compared with those who remained on metformin monotherapy, a recent study has found.
There appears to be a nonlinear relationship between total oestradiol and free oestradiol and all-cause mortality among older men, according to data from the Three-City cohort study. Specifically, the association is stronger for cardiovascular disease mortality and nonexistent for cancer mortality.