Scott Isaacs @scottisaacsmd Twitter profile

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Scott Isaacs

@scottisaacsmd

1 year

Physical activity is 1.5 times more effective at improving symptoms of depression, anxiety and distress compared to antidepressants.

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Scott Isaacs

@scottisaacsmd

1 year

Physical inactivity is now recognized as the 4th leading cause of death and is a contributor to 40 chronic diseases.

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Scott Isaacs

@scottisaacsmd

1 year

More people lose weight when they exercise in the evening.

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Scott Isaacs

@scottisaacsmd

1 year

Intermittent fasting is superior to caloric restriction for weight and visceral fat loss. #IntermittentFasting #VisceralFat #MetabolicSyndrome @ObesitySociety

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Scott Isaacs

@scottisaacsmd

4 months

Obesity is a disease.

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Scott Isaacs

@scottisaacsmd

1 year

#Tirzepatide the golden child. Meme credit: Alex Bonnecaze

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Scott Isaacs

@scottisaacsmd

5 months

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Scott Isaacs

@scottisaacsmd

1 year

Changes that occur from down-regulation of GLUT4 in adipocytes in obesity and insulin resistance.

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Scott Isaacs

@scottisaacsmd

1 year

Excellent review of the cardiovascular effects of exercise and the mechanisms involved.

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Scott Isaacs

@scottisaacsmd

1 year

Exercise is superior to caloric restriction for visceral fat.

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Scott Isaacs

@scottisaacsmd

8 months

The clinically most relevant mechanisms of action of GLP-1, glucagon, and GIP.

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Scott Isaacs

@scottisaacsmd

1 year

Suboptimal sleep causes obesity and metabolic dysfunction.

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Scott Isaacs

@scottisaacsmd

1 year

GLP-1 receptor agonists may help Alzheimer’s disease & Parkinson’s disease by reducing neuroinflammation through restoration of insulin signaling pathways, inducing neuroprotective effects.

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Scott Isaacs

@scottisaacsmd

3 months

GLP-1 as the backbone of future obesity pharmacotherapy.

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Scott Isaacs

@scottisaacsmd

6 months

All patients with type 2 diabetes should be screened for NAFLD/MASLD.

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Scott Isaacs

@scottisaacsmd

7 months

Tirzepatide reduces both systolic and diastolic blood pressure, reduces total and LDL cholesterol levels, reduces triglycerides, and increases HDL cholesterol levels.

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Scott Isaacs

@scottisaacsmd

8 months

GLP-1 medications are not associated with an increased risk of thyroid cancer.

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Scott Isaacs

@scottisaacsmd

1 year

Regular exercise (e.g.,150 min/wk of walking) is 3.5 times more likely to achieve clinically meaningful liver fat reduction independent of weight loss. Exercise is not just for weight loss. #NAFLD

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Scott Isaacs

@scottisaacsmd

11 months

New #NAFLD Nomenclature! Fatty Liver = Steatotic Liver Disease #SLD NAFLD = #MASLD NASH = #MASH MASLD who drink ETOH = #MetALD Alcohol related liver disease = #ALD SLD with known cause (drug, Hep C, Wilson, other genetic etc.) = specific etiology SLD SLD without known metabolic

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Scott Isaacs

@scottisaacsmd

10 months

Exceedingly high HDL-C levels (>80 mg/dL in men and >100 mg/dL in women) increase the risk for cardiovascular events.

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Scott Isaacs

@scottisaacsmd

7 months

All patients with type 2 diabetes should be screened for NAFLD/MASLD.

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Scott Isaacs

@scottisaacsmd

8 months

Importance of 24-hour physical behaviors for type 2 diabetes.

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Scott Isaacs

@scottisaacsmd

1 year

Anti-inflammatory and anti-diabetic effects of palmitic acid.

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Scott Isaacs

@scottisaacsmd

7 months

Cardiorenal mechanisms of action of GLP-1 RAs and SGLT2i.

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Scott Isaacs

@scottisaacsmd

5 months

Exercise even without weight loss improves multiple serum biomarkers of liver fibroinflammation in NAFLD/MASLD.

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Scott Isaacs

@scottisaacsmd

11 months

There are significant reductions in HbA1c, BMI, and abdominal fat with intermittent fasting. #intermittentfasting

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Scott Isaacs

@scottisaacsmd

3 months

Insulin resistance is implicated in both the pathogenesis of #MASLD and its progression from steatosis to steatohepatitis, cirrhosis, and even hepatocellular carcinoma. @ADA_Pubs @AmDiabetesAssn

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Scott Isaacs

@scottisaacsmd

2 years

Thyroid hormones regulate liver enzymes. When the liver is fatty, thyroid hormones don’t work right. #HepaticHypothyroidism

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Scott Isaacs

@scottisaacsmd

1 year

GLP-1 RAs reduce hepatic inflammation, steatosis, and fibrosis primarily through weight loss, as hepatocytes, Kupffer cells, and stellate cells do not express the canonical GLP-1R. #NAFLD @DanielJDrucker

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Scott Isaacs

@scottisaacsmd

1 year

Exercise snacks (isolated ≤1-min bouts of vigorous exercise performed periodically throughout the day) alleviate the need for planning and allocating leisure time for structured exercise.

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Scott Isaacs

@scottisaacsmd

4 months

Endocrinology for the hepatologist.

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Scott Isaacs

@scottisaacsmd

1 year

The ability of #tirzepatide and #semaglutide to melt weight away by tweaking biology gives credence to the idea that obesity is a disease. #weightloss

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Scott Isaacs

@scottisaacsmd

1 year

The fatal triple association between obesity, type 2 #diabetes , CVD, and #NAFLD

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Scott Isaacs

@scottisaacsmd

1 year

Metabolically healthy obesity is a misleading term because it is associated with many chronic diseases and will eventually progress to metabolically unhealthy obesity.

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Scott Isaacs

@scottisaacsmd

5 months

Sleep deprivation causes insulin resistance.

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Scott Isaacs

@scottisaacsmd

1 year

Sleep deprivation causes metabolic dysfunction.

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Scott Isaacs

@scottisaacsmd

3 months

Pharmacological approaches to #MASLD and #MASH . @AmDiabetesAssn #semaglutide #tirzepatide #pioglitazone #SGLT2 #resmetirom

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Scott Isaacs

@scottisaacsmd

6 months

Obesity is a disorder of energy metabolism, in which there is low usable energy in the setting of elevated total energy. This leads to metabolic effects independent of excess energy while the excess energy drives weight gain.

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Scott Isaacs

@scottisaacsmd

9 months

Fast weight loss is better than slow weight loss. This study reaffirms that initial weight loss predicts long term success.

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Scott Isaacs

@scottisaacsmd

1 year

New CVD Risk Calculator: SCORE2-Diabetes was validated to predict 10-year risk of CVD in patients with type 2 #diabetes .

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Scott Isaacs

@scottisaacsmd

1 year

Semaglutide 1.0 mg weekly is superior to liraglutide 3.0 mg daily for post-bariatric surgery weight loss.

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Scott Isaacs

@scottisaacsmd

9 days

The FLOW trial: #semaglutide significantly reduces the risk of serious kidney outcomes, major cardiovascular events and death among people who have type 2 diabetes and chronic kidney disease. #CKD @NEJM

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Scott Isaacs

@scottisaacsmd

4 months

I am proud to have coauthored this article on Endocrinology for the Hepatologist with my daughter Arabella Isaacs.

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Scott Isaacs

@scottisaacsmd

1 year

This table of weight loss medications from @TheAACE 2023 Type 2 Diabetes Management Algorithm summarizes therapies currently approved by the FDA, efficacy, dosing, delivery, potential side effects and contraindications. #weightloss #obesity

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Scott Isaacs

@scottisaacsmd

7 months

When treating millions of people with GLP-1 medications like #semaglutide and #tirzepatide even relatively rare side effects will occur in a large number of people.

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Scott Isaacs

@scottisaacsmd

1 year

Progression of metabolic abnormalities in obesity and #NAFLD .

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Scott Isaacs

@scottisaacsmd

1 year

Sleep deprivation causes insulin resistance, metabolic dysfunction and decreases fat oxidation.

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Scott Isaacs

@scottisaacsmd

1 year

Regular breakfast consumption and minimizing post-dinner snacking is critical for sustained weight loss.

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Scott Isaacs

@scottisaacsmd

1 year

Alternate day fasting showed the highest effectiveness for weight loss in a meta-analysis comparing the effectiveness of alternate day fasting, the 5:2 diet, and time-restricted eating for weight loss. #IntermittentFasting #weightlossjourney

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Scott Isaacs

@scottisaacsmd

1 year

This is everything you need to know about how to manage dyslipidemia in diabetes.

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Scott Isaacs

@scottisaacsmd

2 years

Impaired thyroid hormone conversion and increased rT3/T3 ratio in #NAFLD #NASH comes from a predominance of deiodinase-3 over deiodinase-1 in an injured liver. #livertwitter #HepaticHypothyroidism

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Scott Isaacs

@scottisaacsmd

8 months

Anti-obesity medication is important in managing obesity and type 2 diabetes, both before & after bariatric surgery.

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Scott Isaacs

@scottisaacsmd

2 months

A summary of guidance for lipid management for primary and secondary prevention of cardiovascular disease from the NHS.

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Scott Isaacs

@scottisaacsmd

4 months

Calcium supplementation is associated with an increased risk of CVD events and all-cause mortality in people with diabetes, but not in those without diabetes.

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Scott Isaacs

@scottisaacsmd

1 year

Patients with type 1 diabetes and obesity can benefit from type 2 diabetes medications SGLT2i and GLP1-RA to improve body weight and glucose levels.

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Scott Isaacs

@scottisaacsmd

8 months

Most patients will benefit from having a primary weight-centric approach to diabetes treatment.

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Scott Isaacs

@scottisaacsmd

1 year

14% of patients with type 2 #diabetes have advanced liver fibrosis and 6% have cirrhosis. #NAFLD

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Scott Isaacs

@scottisaacsmd

10 months

GLP-1 medications (especially dulaglutide and semaglutide) are associated with reduced rates of nonfatal stroke and ischemic cerebrovascular events.

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Scott Isaacs

@scottisaacsmd

1 year

Approaches for weight maintenance via energy expenditure & lean mass preservation. Targets include sympathetic nervous system, transient receptor potential channel activation, over browning of white adipose tissue & increased nonshivering thermogenesis.

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Scott Isaacs

@scottisaacsmd

5 months

Number 1 Top Cardiometabolic Story of 2023: Phase 2 trial with #retatrutide , a GIP-GLP-1-GCG receptor triple agonist, resulted in a mean weight reduction of 24.2% after 48 weeks.

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Scott Isaacs

@scottisaacsmd

27 days

Cardiovascular disease is the leading cause of mortality in #MASLD and type 2 diabetes.

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Scott Isaacs

@scottisaacsmd

1 year

Proposed NAFLD/MAFLD subtypes: 1⃣ Obesity subtype 2⃣ Metabolic unhealthy subtype 3⃣ Diabetes subtype 4⃣ Metabolic unhealthy non-diabetes subtype 5⃣ Obesity and diabetes subtype 6⃣ Metabolic unhealthy non-obesity subtype 7⃣ Mixed subtype

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Scott Isaacs

@scottisaacsmd

1 year

Metabolically unhealthy people with a normal BMI and at least 1 component of the metabolic syndrome have 3 times higher risk of type 2 diabetes.

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Scott Isaacs

@scottisaacsmd

1 year

Ultra-processed foods play a role in weight gain, the development of the metabolic syndrome and other chronic inflammatory diseases. #Endotwitter #Medtwitter

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Scott Isaacs

@scottisaacsmd

1 year

Circadian disruptors (such as shift work, chronotype, sleep timing, sleep regularity, and meal timing) are detrimental to cardiometabolic health.

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Scott Isaacs

@scottisaacsmd

5 months

Number 10 Top Cardiometabolic Story of 2023: Oral #orforglipron , a nonpeptide GLP-1 receptor agonist, was associated with -9.4% to -14.7% weight loss. Adverse events reported with orforglipron were similar to those with injectable GLP-1 receptor agonists.

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Scott Isaacs

@scottisaacsmd

1 year

Intermittent fasting works for poorly controlled insulin-treated type 2 #diabetes by reducing total daily insulin dose and body weight. #IntermittentFasting #VisceralFat #MetabolicSyndrome @ADA_DiabetesPro

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Scott Isaacs

@scottisaacsmd

1 year

Long afternoon naps are associated with obesity and metabolic syndrome. #siesta

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Scott Isaacs

@scottisaacsmd

8 months

Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).

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Scott Isaacs

@scottisaacsmd

5 months

The STRONG-D trial found that strength training was superior to aerobic training for improving glycemic control and increasing lean mass in people with type 2 diabetes.

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Scott Isaacs

@scottisaacsmd

3 months

Tirzepatide and GLP-1 RA have demonstrated superiority in inducing weight loss and the ability to target multiple metabolic parameters (glycemic profile, lipid parameters, and blood pressure).

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Scott Isaacs

@scottisaacsmd

1 year

This is the first time #NAFLD has been included in the @TheAACE Diabetes Management Algorithm since it was first published in 2009. I’m proud of AACE for recognizing that NAFLD is the hepatic complication of type 2 #diabetes .

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Scott Isaacs

@scottisaacsmd

11 days

The SELECT trial on semaglutide for weight loss in obesity without diabetes! Weight loss was sustained over 4 years, semaglutide led to weight loss of -10.2%, reduced waist circumference by -7.7 cm, and improved waist-to-height ratio by -6.9%. #obesity #weightloss #semaglutide

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Scott Isaacs

@scottisaacsmd

1 year

Alternate day fasting combined with aerobic exercise can decrease hepatic steatosis, body weight, fat mass, waist circumference, and ALT levels and increase insulin sensitivity. #NAFLD #LiverTwitter

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Scott Isaacs

@scottisaacsmd

10 months

This is an excellent article about the past, present, and future of the new wave of anti-obesity medications.

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Scott Isaacs

@scottisaacsmd

5 months

Dapagliflozin significantly decreases liver fat content and pancreatic fat content in patients with type 2 diabetes and NAFLD/MASLD.

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Scott Isaacs

@scottisaacsmd

1 year

Sarcopenic obesity is associated with an increased risk of chronic kidney disease.

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Scott Isaacs

@scottisaacsmd

1 year

Sleep deprivation causes weight gain by lowering #leptin and raising #ghrelin levels.

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Scott Isaacs

@scottisaacsmd

2 years

Thyroid hormones regulate liver enzymes via thyroid hormone receptors. When the liver is steatotic, hepatic thyroid hormone receptors don’t respond effectively. This results in an intrahepatic hormonal milieu where the liver is essentially hypothyroid. #livertwitter #endotwitter

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Scott Isaacs

@scottisaacsmd

10 months

Weight loss was the same with artificially sweetened beverages vs. water in this 12-week study.

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Scott Isaacs

@scottisaacsmd

11 months

The presence of #NAFLD in non-overweight individuals doubles the risk for diabetes and has a more significant impact than being overweight itself.

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Scott Isaacs

@scottisaacsmd

1 year

Exercise has minimal effect on weight loss, but is critically important for metabolic health and physical functioning. @HeartinDiabetes

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Scott Isaacs

@scottisaacsmd

11 months

Sarcopenic obesity is associated with myosteatosis, which is representative of poor muscle quality.

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Scott Isaacs

@scottisaacsmd

1 month

Metformin does not have any significant impact on reducing the incidence of malignant neoplasms in individuals with prediabetes, diabetes, or obesity.

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Scott Isaacs

@scottisaacsmd

2 years

Thanks @TheEndoSociety for my notepad and including the liver as an endocrine organ. #ENDO2022 #LiverTwitter #NASH #NAFLD #swag

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Scott Isaacs

@scottisaacsmd

7 months

Understanding the mechanism of action of lipid-lowering medications is the key to approaching the patient with suboptimal statin response.

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Scott Isaacs

@scottisaacsmd

9 months

SGLT2i reduce MACE without reduction of MI or stroke, probably implicating nonatherosclerotic mechanisms of benefits possibly related to prevention of heart failure-related events, sudden cardiac death and arrhythmias.

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Scott Isaacs

@scottisaacsmd

3 months

The “weekend warrior” pattern of physical activity (concentrated physical activity in 1 or 2 days per week) is equally effective as regular physical activity in reducing abdominal and general adiposity.

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Scott Isaacs

@scottisaacsmd

2 months

Testosterone replacement can improve insulin resistance and metabolic syndrome.

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Scott Isaacs

@scottisaacsmd

8 months

This review nicely captures our current understanding and use of incretin signaling as a major therapy in patients with obesity and steatotic liver disease.

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Scott Isaacs

@scottisaacsmd

4 months

Cardiovascular and mortality outcomes with GLP-1 receptor agonists vs other glucose-lowering drugs in individuals with #MASLD and type 2 #diabetes .

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Scott Isaacs

@scottisaacsmd

2 months

Exercise combined with GLP-1 medications improves weight loss maintenance and body composition.

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Scott Isaacs

@scottisaacsmd

4 months

This systematic review and meta-analysis found that 36 minutes of brisk walking each day, is the optimal physical activity dose to optimize A1c control.

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Scott Isaacs

@scottisaacsmd

1 year

A high calorie diet causes hepatic de novo lipogenesis and inflammation amplified by a lipodystrophy-like phenotype with increased visceral adipose tissue, free fatty acids, ceramides and #hepatokines . #NAFLD

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Scott Isaacs

@scottisaacsmd

8 months

Our paper on the identification of high-risk patients with NAFLD/MASLD in endocrinology clinics. Free download via this author link.

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Scott Isaacs

@scottisaacsmd

17 days

A dual-mode drug combining a GLP-1 RA with an NMDA receptor inhibitor shows promise in rewiring brain circuits for appetite and reward. It leads to significant and sustained weight loss in rodents, activates reward-regulating areas of the brain, and modulates synaptic plasticity.

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Scott Isaacs

@scottisaacsmd

1 year

Sleep deprivation results in lower levels of satiety hormone #leptin and higher levels of hunger-promoting #ghrelin .

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Scott Isaacs

@scottisaacsmd

11 months

Nice review on incretin hormones (GLP-1 & GIP) and type 2 #diabetes . In type 2 diabetes, the #incretin effect (greater insulin secretory response after oral glucose) is markedly reduced or absent.