Umaira Aziz

A nice reminder of when to consider T1D diagnosis #ATTD2026

❗️Knowledge (of glycaemia) is power❗️ FREEDOM2 trial presented by @WilmotEmma #ATTD2026 @ATTDconf 🔹CGM in those with T2DM on basal Insulin 🔸⬇️Hba1c at 4 and 8 months 🔹Improved sensor metrics/glycaemic profiles 🔸No increased hypoglycaemia 🚫 🔹No change Total Daily Insulin dosing 🔹Interesting patient reported outcomes and dietary/exercise data @AmarPut @drpatrickholmes @kamleshkhunti @TBattelino

Exercise: The Most Underused Blood Pressure Drug As a neurologist, I often tell patients this: If exercise were a pill, it would be one of the most widely prescribed drugs in the world. Because the effect of exercise on blood pressure is real, measurable, and surprisingly large. Let us look at what the evidence shows. ▶️How much can exercise lower BP? Different forms of exercise lower blood pressure to different degrees. 1. Aerobic exercise (brisk walking, jogging, cycling, swimming) • Average reduction: 5–8 mmHg systolic • Works in both hypertensive and normotensive individuals • 30–45 minutes, most days of the week Even a 5 mmHg drop reduces stroke risk by about 14%. 2. Resistance training (weight training, resistance bands) • Reduction: 4–6 mmHg systolic • Also improves insulin sensitivity and metabolic health Best when done 2–3 times per week along with aerobic exercise. 3. Isometric exercise (wall sits, handgrip exercises) Surprisingly powerful. • Reduction: 8–12 mmHg systolic in some studies • One of the largest BP reductions seen with exercise Example: handgrip exercise for 2 minutes × 4 sets, several days per week. 4. Yoga / slow breathing / pranayama • Reduction: 3–5 mmHg on average • Helpful particularly in stress-related hypertension Works best as an adjunct, not a replacement. ✅When is exercise alone enough? Exercise alone may control BP in: • High-normal BP (130–139 / 85–89) • Stage 1 hypertension without other risk factors • Younger individuals with sedentary lifestyle In these cases, 3–6 months of lifestyle therapy may normalize BP without drugs. ▶️When exercise must be combined with medicines? Lifestyle alone is usually not enough when: • BP ≥160/100 mmHg • Diabetes, kidney disease, or prior stroke • Multiple cardiovascular risk factors • Long-standing hypertension Here, exercise becomes a powerful add-on therapy, often allowing lower drug doses. ✅A useful perspective Typical BP reduction with: • One antihypertensive drug: ~10 mmHg systolic • Regular exercise: ~5–8 mmHg So exercise is roughly half a BP pill, but with dozens of additional health benefits. ✅Bottom line The most effective “exercise prescription” for BP: • 150 minutes/week aerobic exercise • 2–3 sessions/week resistance training • Add isometric exercises or yoga Dr Sudhir Kumar @hyderabaddoctor

Nice article in The Print discussing emerging evidence that GLP-1 drugs used for diabetes and obesity may also help reduce addiction to alcohol and smoking by influencing the brain’s reward pathways. Thank you Sneha Richhariya for quoting me in this. theprint.in/health/how-glp… @ThePrintIndia @RichhariyaSneha

In adults with type 1 diabetes and chronic kidney disease with albuminuria, the decrease in the urinary albumin-to-creatinine ratio was significantly greater with finerenone than with placebo. Full phase 3 FINE-ONE trial results: nejm.org/doi/full/10.10… Editorial: Finerenone for Diabetic Kidney Disease in Type 1 Diabetes — A Fine Answer? nejm.org/doi/full/10.10…

🎙️ How are #diabetes guidelines created & how do they influence #care? Hear from EASD Committee for Clinical Affairs (CCA) Chair @RichardIGHolt , @momofmax & @atsapas on new #guidelines, #Type1Diabetes updates & why #patient voices matter. 🎧 Listen now: easd.org/media-centre/p…

Read more about the growing evidence suggesting that GLP-1 drugs may help reduce alcohol consumption and other addictive behaviours. @ThePrintIndia

"Just stop taking it and keep the weight off." That's not how chronic disease works. I just published the most comprehensive breakdown of what actually happens — hormonally, metabolically, neurologically — when you stop GLP-1 therapy. 48 studies. 9,000+ patients. 3 meta-analyses. Here's what the data show: → 60% of lost weight returns within 1 year → Regain starts within weeks — not months → Your hormones fight you for YEARS after weight loss → But the regain curve decelerates. ~25% of the benefit may persist. → And reduced-dose maintenance strategies are showing real promise. This isn't a willpower problem. It's a biology problem. And the science is not ambiguous. Full article: substance-over-noise.beehiiv.com/p/why-weight-r… ↪️ michaelalbertmd.com #SubstanceOverNoise #GLP1 #ObesityMedicine

BELIEVE phase 2 trial with #bimagrumab, an antibody that blocks activin type II receptors to reduce fat mass, prevent #sarcopenia and promote skeletal muscle growth, plus semaglutide 2.4 mg produced 22% weight loss at 48–72 weeks, with ~93% of loss from fat mass and preserved/increased lean mass. nature.com/articles/s4159…

New study finds a sweet spot of 7 hours 18 minutes of sleep a night for lowest insulin resistance risk. Too little or too much sleep raises risk, and big weekend “catch-up” sleep may actually worsen glucose metabolism if you already get enough during the week. everydayhealth.com/sleep/amount-o…

Useful 👇👇👍👍 Joint TOS/OMA/OAC Expert Guidance Statement on the Pharmacological Management of United States Adults With Overweight or Obesity Using the GRADE Approach - Alexander - Obesity - Wiley Online Library onlinelibrary.wiley.com/doi/10.1002/ob…

Obesity isn’t just a metabolic risk. It’s an infection risk. Evidence suggests ~1 in 10 infection-related deaths worldwide may be attributable to obesity. Obesity increases hospitalisations and mortality across many pathogens and populations. #Obesity #InfectionRisk #PublicHealth sciencedirect.com/science/articl… @TheLancet

“A total of 242 pts were randomized…” I’m not sure I can think of a more effectively marketed medicine than finerenone: NEJM publishes a tiny trial w a surrogate marker The sky is blue and every F trial is positive. (Except they never use generic MRA as a comparator)

The “Fantastic Four” in renal protection for diabetics are revolutionizing care! iSGLT2, GLP-1 agonists, finerenone, and RAS inhibitors (IEC/ARA2) are game changers, drastically slowing kidney function decline. 🌟 Watch my video in to learn how these treatments are transforming lives! #RenalHealth #DiabetesCare #MedicalInnovation @DrMarthaGulati @hvanspall @mvaduganathan @AndrewJSauer @safchat @Hragy @biljana_parapid @Abdul_alkindy @almucastro01 youtu.be/cuQfWKyR6E8

🧪 SGLT2 vs Insulin: What Happens to Beta Cells? In a cross-over study (n=17), empagliflozin was compared with NPH insulin at similar glycaemic control. 📉 Despite equal glucose levels: • 🔬 Beta cell glucose sensitivity ↑ • 💪 Insulin sensitivity ↑ • 💉 Insulin levels were lower vs insulin therapy 🧠 Suggests SGLT2 inhibitors may enhance β-cell function beyond glucose lowering #T2D #SGLT2 #Empagliflozin #BetaCells #MetabolicScience link.springer.com/article/10.100…

Improving medication adherence in type 2 diabetes: strategies for better clinical and economic outcomes Our paper led by Patrick Highton link.springer.com/article/10.100… @DiabetologiaJnl

FDA approval announced today for @AllurionTech’s swallowable, excretable intragastric balloon…the innovative “Smart Capsule” expanding less-invasive options in obesity care. stocks.apple.com/AHmtR34hNTwu8U… @ASMBS @IFSO_NAC

🚨 BREAKING: FDA APPROVES NEW OBESITY DEVICE TECHNOLOGY - - - @alluriontech (NYSE: ALUR) announces FDA PMA approval for the Allurion Gastric Balloon System, featuring the Allurion Smart Capsule. 🔹 Swallowed in a ~15-minute office visit 🔹 No surgery, endoscopy, or anesthesia 🔹 Single administration → ~4 months of therapy 🔹 Naturally passes from the body 🔹 Indicated for adults with BMI 30–40 With approval from the U.S. Food and Drug Administration, Allurion can now reach ~80 million Americans within the indicated BMI range. Real-world and clinical data outside the U.S.: 📉 ~14% total body weight loss (single cycle) 📉 >20% with repeat cycles 📉 >20% when combined with low-dose GLP-1 therapy + virtual care A new non-pharmacologic, procedure-based option enters the U.S. obesity treatment landscape. 🔗businesswire.com/news/home/2026…

Relevant paper for those currently fasting 🌙🕌 SGLT2 inhibitors during Ramadan? Meta-analysis (12 studies, n=3,625)- mainly observational studies ✔️ Lower risk of symptomatic hypoglycaemia (RR 0.53) ✔️ ↓ BP modestly ⚠️ Higher risk of postural dizziness (RR 6.39) & hypotension (RR 4.43) 📊 HbA1c, weight, renal function ≈ similar SGLT2i may be safe during fasting-but caution is warranted. Larger RCTs needed. pmc.ncbi.nlm.nih.gov/articles/PMC12…

A PRIMARY ALDOSTERONISM PODCAST Appreciate the Curbsiders team for letting me join their amazing platform to share the message: “essential hypertension is primarily aldosteronism”. Including some helpful resources in the thread below youtube.com/watch?v=mqpltX…