Hannah Beba

Our West Yorkshire Guideline for CKD approved today at APC. This guidance should help us screen, refer & optimise care for people living with CKD. Thank you to all the brilliant minds who contributed and to Andrew Frankel and the imperial team for the inspiration

Conferencing @HannahBeba 💗 @DiabetesUK

Yesterday’s away day was a great opportunity for the PCDO Society team to step back, reflect, and focus on what’s ahead. We had productive discussions shaping our strategy and mapping out a 3-year plan to strengthen our impact and support our community. Excited about what’s to come and the direction we’re heading in - watch this space. 🚀 #Strategy #Planning #Teamwork #PCDOSociety

Firstly, commend @NICEComms on -finally- catching up with evidence in the #T2Diabetes space Secondly- it brings us to some realities and how it indicates the mess the #NHS is in. 1. SGLT2i is more available because it's now gone generic- not due to the science. It's also why GLP-1 is unlikely to go up much-in spite of guidance. 2. 'Savings routed back into #Diabetes care' is a pipe dream- without any levers. It could be used - for other interventions -but likely will be used to fill deficit gaps 3. Implementation - who tracks this- and tackles variation? One awaits this space developing with interest @kamleshkhunti @mmamas1973 @DrSelvarajah A view from the @bmj_latest bmj.com/content/392/bm…

Retatrutide TRIUMPH-4: 29% weight loss at 12mg. Impressive. ⚠️But here’s what needs discussing: 20.9% experienced dysesthesia (abnormal skin sensations) at that dose vs 0.7% placebo. Before everyone panics: - Generally mild - Rarely led to discontinuation - Overall dropout rates similar across all arms This is novel for incretins. GLP-1s and dual agonists don’t typically cause sensory symptoms—they stick to GI effects. Triple agonism (GLP-1/GIP/glucagon) may affect neural pathways differently. What we don’t know: - Mechanism (why would metabolic receptors affect skin sensation?) - Long-term persistence - Whether slower titration helps The risk-benefit still looks favourable. Most people tolerated it and stayed on treatment. But 1 in 5 experiencing unexplained neurological symptoms at therapeutic doses deserves transparency, not dismissal. For context: This efficacy (29% weight loss) exceeds anything currently available. That’s practice-changing if the safety profile holds. 🎯Bottom line: Unprecedented efficacy with a manageable but unexplained sensory side effect. We need larger, longer trials to understand this fully.

@parthaskar @DSNforumUK @WilmotEmma @Tims_Pants @drpratikc @youngdiabendo @DigiBeteUK @PNewlandJones @AbbieSBrooks @Rezaidi Sounds ideal

How would it be if there was an educational day for clinicians.. But ALL the faculty and teachers were those with #T1Diabetes? Will there be interest to attend? To learn about tips from those who live with #T1D Let me know…! #gbdoc

The introduction of me as a speaker @pcdosociety 🤣 Controversial opinion or quip? Me? Never! Happy to regale with stories of (nearly) a decade in @NHSEngland It's been a most wonderful ride indeed And thank you for the invite 🥰 @kamleshkhunti

@AmarPut @EASDnews @GoggleDocs @kamleshkhunti @WilmotEmma @drpratikc @AskDrShashank @banshisaboo @dramitaol @DSNforumUK @drkevinfernando @docwas @Mortdecai Looking forward to it buddy ! See you soon

En route to Vienna for #EASD2025 looking forward to catching up with friends and colleagues… and anyone else and sharing data! @EASDnews @GoggleDocs @kamleshkhunti

@parthaskar @shaungreen969 @drpatrickholmes @GoggleDocs @DSNforumUK @TIME_research @ShivaniM_KC @AmarPut @padsbigsis @hilarynathan01 @KarenFAddington Over a decade ! I think just like we are held to account to do PPIE for research ( rightly so) we should also expect implementation to be considered.

@shaungreen969 @HannahBeba @drpatrickholmes @GoggleDocs @DSNforumUK @TIME_research @ShivaniM_KC @AmarPut @padsbigsis @hilarynathan01 @KarenFAddington and it’s been around for how long?

A reflection: If the world of #Diabetes put a fraction of the energy they put into research and publication of papers - into implementation of the science? The world would have been a far more unequal place. The #NHS is the same. As are conferences. Excitement about the latest science -without having delivered the last one equitably. Implementation is always “others business” Till we all appreciate the relevance of “science into lives”? We only build CVs - not change lives at scale.

Now…a few things about this new development in #T2D via @NICEComms Firstly? Good update in keeping with the science available Now the main points: 1. No way @NHSEngland can implement this AND #Obesity together with finances as they are. 2. One hope is the patent going (see legal case vs Astra Zeneca) and thus generic use of SGLT2i 3. Asking people to raise with GP or diabetes team is not appropriate. They can’t do anything till approved by local system - where point 1 will be important. I can’t stress this enough to comms teams of ALL national organisations There needs to be far more honesty about what the NHS can deliver. And setting of expectations @kamleshkhunti @GoggleDocs @DiabetesUK @VictoriaTzB

@SEACityLight We’ve just been restored thank you !

@HannahBeba There are multiple outages right now - does the map have an estimated time of restoration for your outage?

Fuse blew. Power for the remaining 655 should be back on approx. 9:30pm. RT @SEACityLight: Crews are responding to an outage in Lake Forest Part affecting ~3,200 customers. Cause is under investigation. When we know more, we will provide an estimated time of restoration.

@ShivaniM_KC @AliaGilani @SouthAsianHF Feel like the diabetes avengers are assembling 💕 #legendscollide

Congratulations to my very talented friend and colleague @AliaGilani 🥳🥳🎈🎈 @SouthAsianHF are in safe hands with their new Trustee So happy for you, Alia!

❤️ My latest @Medscape @GinP_Medscape Primary Care #Hack has been a longstanding passion project! 🔥Prescribing Pearls for Primary Care🔥 🎯Tips on using mirtazapine, rosuvastatin, low-dose doxycycline, once-weekly rosuvastatin among others! PDF link in comments below👇🏾

Quality in Care (QiC) Diabetes 2025 Awards entry deadline is Friday 11 July 2025 - three weeks today. Enter now: qicdiabetes.awardsplatform.com View the full list of categories here: qualityincare.org/diabetes/categ… #qicdiabetes @sanofi #diabetes

⚠️In #T2D STATIN DELAY = CV RISK 💔 In 7,239 adults w/ diabetes (JAHA 2025): 🕒 1 in 5 delayed statins after initial offer 📈 LDL-C 126 vs 99 mg/dL (while off statin) 💔 CV event rate 10y: 8.5% (delay) vs 6.4% 💥 HR 1.49 for MI/stroke 🧪 LDL exposure mediated risk (HR 1.62) 🗣️ Not just inertia. Nonacceptance matters. 🔗 ahajournals.org/doi/10.1161/JA…

🚦Updated @GinP_Medscape Primary Care #Hack 🔥Paired #Hacks covering identification and interventions for #CKD in primary care🔥 Includes diagnosis, classification, coding, #RAASi, #SGLT2i, #finerenone, #semaglutide, #hyperkalaemia & referral! PDF download link in comments 👇🏾

@GoggleDocs @drkevinfernando @DamianFog @drjamesburton @SantosGallegoMD @NephJC @rfradaeli @brendonneuen @mvaduganathan @ShelleyZieroth Interesting about impact on EPO and therefore renal anaemia. I wasn’t aware of this. Certainly would like to know about cost efficacy of this as a strategy vs. recomb epo . Another selling point for using these medications !

🧠 SGLT2 inhibitors in kidney disease: mechanism meets medicine Kasralainy Nephrology Group review 100+ studies across 8 renal domains 📄 📍 Beyond glycaemia: ↓ Glomerular pressure (tubuloglomerular feedback) ↓ Sodium reabsorption (NHE3 inhibition) ↑ Autophagy, ↓ ROS & hypoxia ↑ EPO, ↓ hepcidin → ↑ erythropoiesis Possible immunomodulation 🩺 Applications: ✅ CKD (±diabetes, ±albuminuria) ✅ Renal anaemia ✅ AKI (esp. post-MI, PCI) ⚠️ Dialysis: off-label but emerging 🚫 PKD: avoid outside trials 🔍 Table 3 = practical prescribing guide 📄 doi.org/10.1186/s13098…