Akhil Sureshbabu

🥼🩺 IM Resident / MBBS (AIIMS Bhubaneswar)

[Akhil Sureshbabu @drakhilsb]

Honoured & privileged to receive the gold medal from the first citizen of India, the epitome of women empowerment & inspiration to many, Honourable President of India, Smt. Droupadi Murmu ji at the 5th Convocation of AIIMS Bhubaneswar 😇

[President of India @rashtrapatibhvn]

President Droupadi Murmu graced the fifth convocation ceremony of AIIMS, Bhubaneswar. The President said that AIIMS, established in various parts of the country, are providing healthcare through the latest medical science and experienced doctors. People are getting quality medical facilities at a low cost in these institutes. She expressed confidence that the success of AIIMS institutions will help establish India as a leading healthcare destination globally.

[Akhil Sureshbabu @drakhilsb]

@docakx Leriche’s syndrome

[Akhil Sureshbabu @drakhilsb]

@nervemed CKD

[Akhil Sureshbabu @drakhilsb]

@TrackYourHeart Woltman sign-hypothyroidism

[Akhil Sureshbabu @drakhilsb]

@TrackYourHeart Bilateral mvp

[Akhil Sureshbabu @drakhilsb]

@IhabFathiSulima Looks like neurofibromatosis

[Akhil Sureshbabu @drakhilsb]

@docakx Leptospirosis

[Akhil Sureshbabu @drakhilsb]

@docakx @NEJM DES

[Akhil Sureshbabu @drakhilsb]

@docakx Chagas disease

[Akhil Sureshbabu @drakhilsb]

@docakx Gottron’s papules

[Akhil Sureshbabu @drakhilsb]

@docakx @Medtwitteer Felty syndrome

[CME INDIA @CMEINDIA1]

CME INDIA NEWS

FDA Approves the World’s First Once-Weekly Basal Insulin for Type 2 Diabetes

In a landmark development for diabetes care, Novo Nordisk has announced that the US FDA has approved Awiqli® (insulin icodec-abae) — the first and only once-weekly basal insulin for adults with type 2 diabetes.

This approval marks a major shift in insulin therapy, potentially reducing the burden of 7 basal insulin injections per week to just 1.

🔬 Why This Matters

For many patients, insulin initiation and adherence are often delayed because of the psychological and practical burden of daily injections. A once-weekly basal insulin could improve acceptance, persistence, convenience, and treatment satisfaction in appropriately selected adults with T2DM.

📌 What is Awiqli®?

Awiqli® is insulin icodec, an ultra-long-acting basal insulin designed for once-weekly administration, to be given on the same day each week using the FlexTouch® device.

It is approved as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes.

📊 Evidence Behind the Approval

The FDA approval is based on the ONWARDS phase 3a programme, which included approximately 2,680 adults with uncontrolled type 2 diabetes across four randomised, active-controlled, treat-to-target trials.

Across these studies:

Once-weekly insulin icodec achieved HbA1c reduction

It was compared against daily basal insulin regimens

It demonstrated a safety profile broadly consistent with the basal insulin class

Patients in these trials received Awiqli® along with:

mealtime insulin, or

oral antidiabetic agents, and/or

GLP-1 receptor agonists

🩺 Potential Clinical Impact

This may be particularly relevant for:

Patients reluctant to start insulin

Those with poor adherence to daily basal insulin

Individuals needing a simpler injection schedule

Busy patients who struggle with treatment fatigue

⚠️ Important Clinical Caution

While once-weekly insulin is exciting, it is not automatically for everyone.

Clinicians will need to be careful about:

Dose titration

Missed doses

Hypoglycaemia risk

Patient education

Transition from daily to weekly insulin protocols

In real-world practice, the key question will not just be “Can it reduce injections?” but “Can it improve outcomes without increasing complexity or risk?”

🇺🇸 Launch Timeline

Novo Nordisk has stated that Awiqli® is expected to launch in the US in the second half of 2026.

It is already approved in the US, EU, and 13 additional countries, with market-specific indications.

💬 CME INDIA TAKE-HOME

This is not just another insulin approval — it may represent a new era in basal insulin therapy.

If cost, accessibility, titration simplicity, and safety hold up in the real world, once-weekly basal insulin could become one of the most practice-changing advances in diabetes care in years.

CME INDIA

“From 7 injections to 1: Basal insulin enters the once-weekly era.”

“Insulin therapy just got simpler.”

“Awiqli® may redefine how we start basal insulin in T2DM.”

“Once-weekly basal insulin: convenience meets clinical innovation.”
https://t.co/WvwCKwFf0V

[Dr Kamlesh Darji @DrKamleshDarji1]

Residency tip:

The Notes You Write Today Are Legal Documents

That scribbled, half-legible entry you rushed through at the end of a 36-hour shift? It just became a court document. Everything you wrote - and everything you didn't - is now the official version of what happened that night. No one will ask how tired you were! They'll ask why it wasn't documented. Write the reasoning, write the conversation, write that you checked. Because when things go wrong, and sometimes they really do, your notes are the only thing standing between you and "there's no record of that, my loooord"

[Akhil Sureshbabu @drakhilsb]

What an absolute honor to listen to the legend of clinical medicine, Dr Archith Boloor sir in person!
#fiestamedica2026 #gmckottayam

[Akhil Sureshbabu @drakhilsb]

@DrAkhilX Osborn wave-hypothermia

[Dr. AK 🇮🇳 @docakx]

Blood flowing through the vessels in the conjunctive layer of the eye.

The eye's fundus and conjunctiva provide the only non-invasive site for direct observation of microcirculation in humans.

[Akhil Sureshbabu @drakhilsb]

Comments on this ecg?

[Akhil Sureshbabu @drakhilsb]

@DrAkhilX Bedaquiline

[Akhil Sureshbabu @drakhilsb]

@DrAkhilX Werner syndrome

[Dr Aditya Gudheniya @Gastronaut___]

The Baveno VII “Rule-of-Five” for chronic liver disease:

• It is a simple, non-invasive system using liver stiffness (LS) cutoffs that rise in steps of ~5 kPa (10 → 15 → 20 → 25 kPa) plus platelet count to classify patients into: no cACLD ( Compensated Advanced CLD) → probable cACLD → definite cACLD → probable CSPH → definite CSPH.

• As LS and thrombocytopenia worsen, the likelihood of clinically significant portal hypertension (CSPH) rises sharply.

But new data show something crucial: not all CSPH is the same.
• Traditionally, LS ≥25 kPa = CSPH.
• This new large cohort study reveals that patients with LS 50–75 kPa behave very differently :- they have nearly double the risk of death and decompensation compared with LS 25–50 kPa.
• This ultra-high-risk group is now termed “critical CSPH.”

Risk doesn’t jump randomly but it rises stepwise across Rule-of-Five tiers:
• Each upward category shows a clean, linear increase in mortality, decompensation, and variceal bleeding.
• It works across liver diseases, including MASLD and obesity, where LS has long been questioned.

And importantly:
• HCC risk increases across early categories but plateaus once LS passes ~25–50 kPa.
• This suggests Rule-of-Five is less useful for HCC risk stratification than for portal hypertension outcomes.

[Akhil Sureshbabu @drakhilsb]

‘Miracle drug’? Time to think again…
Excellent commentary by @fperrywilson

[F. Perry Wilson, MD MSCE @fperrywilson]

I’ve called GLP-1 agents like Ozempic and Mounjaro "miracle drugs." But a new study forces me to re-evaluate that moniker.

The miracle has a problem: It ends when the prescription runs out.

Let's look at the data on the "Rebound Effect." 🧵