Bikram Sidhu

endocrinology, diabetes, med ed, social equity and whatever else catches my fancy today- tweets occasionally reflect views of my employer

[Stephen L. Archer @DrStephenArcher]

Ontario to reserve medical school spots for students from the province? With only 11 of 3,732 seats in ON schools occupied by international students why do this? Want more doctors? INVEST! Train more doctors & add residency spots⁩ ⁦@QueensuDOM⁩ https://t.co/PyRgmgX3nu

[Emma Dennison @DennisonEmma_]

Did you know: faith-based hospitals are publicly funded, but religiously-oriented, upholding discriminatory policies that restrict access to surgical contraception and gender-affirming surgeries. Check out our petition to end this in Kingston, ON: https://t.co/EWOXFtWh9W

[Bikram Sidhu @bsidhu28]

@Ricky_Turgeon @DrToddLee @BlairMacPharmD @medmyths Oh I am! But I dont think the trial will be long enough or high risk enough. I just think HF is a very low risk, CKD is a very low risk, even CAD is a very low risk in "new dx type 2 dm".

But retinopathy. Just need 1% a1c difference for the curves to separate.

[Bikram Sidhu @bsidhu28]

@Ricky_Turgeon @DrToddLee @BlairMacPharmD @medmyths If its treat to target to avoid that, you get messy results with disproportionate glp1ra use for example.

There is at least one trial (SMARTEST) looking at this question, but it is too short I think to show any meaningful difference.

I like the Diabetes Canada approach.

[Bikram Sidhu @bsidhu28]

@Ricky_Turgeon @DrToddLee @BlairMacPharmD @medmyths Metformin wins.

In the primary prevention population, sglt2i will have only small absolute macrovascular benefit (if it can even be shown).

The microvasc - glycemic link is strong and easier to show. And metformin is stronger than sglt2i at glucose lowering.

[Julie A. Lovshin @JulieALovshin]

Yet another big announcement from Novo Nordisk this week...the first once weekly insulin, Awiqli- insulin icodec, now approved in Canada !👏👏👏👏👏👏👏👏👏👏👏👏🥇

[Naheed Nenshi @nenshi]

Hi, I’m Naheed Nenshi. I’m running to be the leader of Alberta’s NDP and the next premier of this province.

I can’t do this without your support. Visit https://t.co/OqpFCojIcF to buy a membership and sign up as a supporter.

We can do this. Together. For Alberta. For all of us.

[Ashley Winter MD || Urologist @AshleyGWinter]

Just reminding everyone on international women's day that when started within 10 years of menopause, hormone therapy with estrogen can reduce all cause mortality by up to 30%.

Let's start talking about the risks of NOT offering hormones.

[Bikram Sidhu @bsidhu28]

@venuskev @DrToddLee @FralickMike @husam247 @fs36r @ashley_raud @Ray_Prach @brittdrog @GalenWright @JenniferTsang12 @JonZipursky @jamesrassos @dunbar37 Thats another peeve of mine!

Probably half the euDKA I have seen havent been on SGLT2i at all, and half the SGLT2i DKA havent been euglycemic.

I am going to stamp out this euDKA = SGLT2i DKA one med student at a time.

[Bikram Sidhu @bsidhu28]

@venuskev @DrToddLee @FralickMike @husam247 @fs36r @ashley_raud @Ray_Prach @brittdrog @GalenWright @JenniferTsang12 @JonZipursky @jamesrassos @dunbar37 I dont test just because of SGLT2i DKA - but I do often find later that many are insulin deficient +/- sensitive.

[Bikram Sidhu @bsidhu28]

@DrToddLee @FralickMike @husam247 @fs36r @ashley_raud @Ray_Prach @brittdrog @GalenWright @JenniferTsang12 @JonZipursky @venuskev @jamesrassos @dunbar37 This was my exact hypothesis whenIm I first discussed with Mike- I would estimate at least half sglt2i dka I have seen have later been found to be type 1.

[Bikram Sidhu @bsidhu28]

@venuskev @husam247 @DrToddLee @FralickMike @fs36r @ashley_raud @Ray_Prach @brittdrog @GalenWright @JenniferTsang12 @JonZipursky @jamesrassos @dunbar37 Interesting that both patients are on prednisone with only a cursory mention. Its couterregulatory, and with the sglt2i you avoid the glucose dependent insulin stimulus to suppress ketogenesis.

[Bikram Sidhu @bsidhu28]

@IAmCaseStephens Only one: The Old Man and the Sea.

Twice. And I knew the whole book the second time.

[Bikram Sidhu @bsidhu28]

@DocMCohen @ShopprsDrugMart The cherry is when the patient leaves your clinic after a 30 minute comprehensive chronic care visit, fills their prescription, and you receive the medscheck fax the next day....essentially reminding you what you prescribed?

[Bikram Sidhu @bsidhu28]

We are taking one more step to an "in network" / "out of network" type of healthcare system with this Manulife/Loblaws business.

Every step closer to American healthcare is a step in the wrong direction.

[Bikram Sidhu @bsidhu28]

@DrJacobsRad @Royal_College @fordnation Is it though?

In a world in which a computer can make better and faster medical expert decisions than I can, maybe we need to prioritize being a good person.

Not to mention that medical expert expertise is easy (and easy to teach) Being good & just is hard (and hard to teach).

[Bikram Sidhu @bsidhu28]

@supermarioelia I counted my faxes today. Average 8 per day for the past 3 weeks. Half had suggestions (prepopulated). Only one had a contextualized suggestion:

"Liraglutide and dulaglutide temporarily covered by NIHB"

Which is huge news for anyone who works in high first nations' populations.

[Bikram Sidhu @bsidhu28]

@GavinPrestonMD $11.30 CAD (8.20 USD) in Ontario.

[Daniel J Drucker @DanielJDrucker]

Another huge win for GLP-1, semaglutide and PPL with #T2D at risk of developing #kidney disease. FLOW stopped early for efficacy @novonordisk https://t.co/yiXZbCnrUC

[Bikram Sidhu @bsidhu28]

I am not convinced virtual walk in clinics are improving anything at all.

"Please see for DM2. I checked the A1c. It is 10%. I have done nothing except write this referral to someone with a 2 year waitlist and refill metformin."