Dr.Suresh Shinde

Consulting Physician, Pune.

[Dr.Suresh Shinde @acmepune]

@LillyObesityInt My proposed new index combines both BMI and waist circumference to give a unified risk assessment tool. Assess here: https://t.co/MUREPoezGH

[Dr.Suresh Shinde @acmepune]

@dramitaol @ADA_DiabetesPro @IntDiabetesFed @EASDnews Heartiest congratulations, sir ! 🌹

[Dr.Suresh Shinde @acmepune]

@swatigar 🙏💐RIP

[Dr.Suresh Shinde @acmepune]

@JoySanyal74 @mmamas1973 @Hragy @DrRajeshG1 @nadig_cardio @DrDeepakKrishn1 A silly question'Is she hypothyroid ?'

[Dr.Suresh Shinde @acmepune]

@DrEenfeldt Both dietary nutrients, fats and carbohydrates increase insulin via GIP & GLP-1 respectively. Both lead to lipogenesis. However, fats lead to Good obesity (MHO) and carbohydrates to Bad obesity (MUHO) respectively.

[Dr.Suresh Shinde @acmepune]

@DrEenfeldt The dietary fat forms chylomicrons with ApoB 48 as the guide to storage to subcutaneous area. Endogenously generated fat has ApoB100 which directs it to visceral area. You may quote evidence to the contrary please.

[Dr.Suresh Shinde @acmepune]

*The good, the bad and the ugly fat*:
Excess fat intake can only be stored as subcutaneous fat (good fat) with adiponectin as the storage size indicator. Excess carbs over and above that can be stored as glycogen, is converted to triglycerides and exported as VLDL to periphery. This is visceral (bad fat). Leptin is the storage size indicator. Both exogenous and endogenous fats are stored separately. Further, each gram of visceral fat generated dissolves equivalent quantity of subcutaneous fat, which gets deposited in to the organs as ectopic fat (ugly fat) which increases insulin resistance and causes T2D.

[Dr.Suresh Shinde @acmepune]

@ifixhearts A quote worth quoting, "A surgeon should not sale the operation, the patient should buy it!"

[Dr.Suresh Shinde @acmepune]

@Unnikri cognitive-behavioral therapy can be used as a tool by an individual to modify his diet/exercise/sleep and thus correct his dysmetabolism!

[Dr.Suresh Shinde @acmepune]

@realDaveFeldman Hi. want to know as to why LMHR are lean?

[Dr.Suresh Shinde @acmepune]

@StayingStrong57 Hi, I am a physician from India. I read your query on one of the youtube video on LMHR. I can discuss this with you if you so desire. Dr Suresh Shinde, MD. 919822021003.

[Dr.Suresh Shinde @acmepune]

@baxirahul Very interesting report. This indicates very high De-novo lipogenesis. Must control his diabetes, decrease carbs and fructose corn syrup from beverages, add exercise routine. i'm sure this will restore normalcy.

[Dr.Suresh Shinde @acmepune]

@SBakerMD @MarkSmellyBell Worth listening: Benefits of keto diet

[Poonam Joshi @PoonamJoshi_]

Four members of the richest family of Britain, Prakash Hinduja, his wife Kamal Hinduja, their son Ajay Hinduja and his wife Namrata Hinduja have all been sentenced to jail by a Swiss court for exploiting Indian migrant servants whom they made to work for upto 18 hours a day for less than Rs 700 (£7) per day.
The hourly rate in Switzerland is 32chf which is Rs 2800 (£28).

They paid them in Indian rupees rather than the local currency. Confiscated their passports and didn't allow them to go out. They spent more money in looking after their dogs than paying a decent salary to their servants.

Prakash Hinduja and his wife are in their mid to late 70's. This age is for retiring and moving towards spirituality and not going to jail on serious charges like human trafficking. They have both received 4.5 yrs jail term while the son Ajay and his wife Namrata have got 4 yrs each.

This is how the justice system works in developed country, even though the family did an out of court settlement with the servants in the civil court, criminal charges were still brought against them and they were tried in the court and punished. It doesn't matter how rich or influential one is, law is equal for all.

They probably spent a lot of wealth fighting this case that took away a lot more than money from them. All they needed to do was to treat and pay those working for them, cooking for them and looking after their children, right. Karma always catches up.
#Hindujas #PrakashHinduja #KamalHinduja #AjayHinduja #NamrataHinduja #Humantrafficking #Swisslaw

[Dr.Suresh Shinde @acmepune]

@PanktiMehta24 @nihardesai7 @NicoGagelmann @debaditya_roy @BrownJHM @chandrachud_n @BhattArshad Is there a big bulla on left upper zone in addition to rt pl thickening?

[Dr.Suresh Shinde @acmepune]

@PeterItebimien @NicoGagelmann Trichinella spiralis. Ate Polar bear flesh?

[Dr.Suresh Shinde @acmepune]

1. Duration of T2D not known.
2. @BMI 23 and with basal insulin, DPP4i & metformin, her endogenous insulin was very low then. With such scenario, her chances of reversing are very low as the visceral fat content, which is the mainstay of reversal, is unlikely to be significant.
3. However, having lost weight from BMI 23 to 17.5 and attaining HbA1c of 5.6 %, she no longer needs to take any anti diabetes medication now.
4. Thinking of her symptoms, she needs to STOP VLCD asap and try to put on some weight by way of high protein, moderate fat and low carb diet, maintaining her present physical activities.
5. I would monitor, if logistics permit, her fasting and stimulated insulin, weight and A1c. Would advise OAD if these parameters worsen.
PS: In early years of VLCDs, fatalities were reported. So, we must know how much to stretch the string before it breaks. Good luck!

[Dr.Suresh Shinde @acmepune]

@Janetbirdope @RheumNow DiGeorge syndrome (also known as 22q11.2 deletion syndrome), which can present with both 4th toe hypoplasia and hypoparathyroidism Disorders including the heart, immune system, and parathyroid glands.

[Dr.Suresh Shinde @acmepune]

@BrownJHM I would test for retrovirus infection