Dr.Syed Sibtain ul Hassan

10/10/2025

ایک ہی خاندان کے تین افراد نے صرف تین مہینوں میں اپنی شوگر کو نارمل حدود میں لایا۔
ڈاکٹر سید سبطین الحسن کی رہنمائی میں باقاعدہ دوا، متوازن غذا، اور طرزِ زندگی میں تبدیلی کے ذریعے —
یہ ثابت کیا کہ ڈائیبیٹیز ریورس ممکن ہے، اگر علم اور تسلسل کے ساتھ عمل کیا جائے۔ 💪

📍 Omar Hospital & Ehsan Mumtaz Hospital, Johar Town, Lahore

08/10/2025

“Behind every blood sugar test is a story of patience, worry, and courage.
Let’s talk about diabetes distress — and heal the mind as we treat the body.”

29/09/2025

28/09/2025

ہمارے محترم مریض جنہیں تھلیسیمیا بھی ہے، انہوں نے ہمت نہیں ہاری۔
مسلسل محنت، بہترین ڈائٹ، اور ادویات کی پابندی کے ساتھ ایک سال کے اندر اپنی شوگر کو ریورس کر دکھایا۔

📊 آج ان کا HbA1c بالکل نارمل ہے!

یہ اس بات کا ثبوت ہے کہ اگر انسان حوصلہ کرے، علم کے مطابق عمل کرے اور اپنی صحت کو ترجیح دے تو ناممکن کچھ بھی نہیں۔

💪 یہ مریض ہر اس شخص کے لیے مثال ہیں جو سوچتا ہے کہ شوگر کنٹرول یا ریورس کرنا مشکل ہے

27/09/2025

ہمارے محترم مریض جناب M. Azhar نے اپنی محنت، مستقل مزاجی اور صحت مند طرزِ زندگی کے ذریعے HbA1c کو 8.4% سے کم کر کے 5.9% تک لانے میں شاندار کامیابی حاصل کی ✅۔

یہ اس بات کا ثبوت ہے کہ اگر مریض اور ڈاکٹر مل کر ایک ٹیم کی طرح کام کریں تو ذیابیطس پر قابو پایا جا سکتا ہے۔

📌 صحت مند خوراک
📌 باقاعدہ ورزش
📌 دوا کا صحیح استعمال
📌 اور ڈاکٹر کی ہدایات پر عمل

یہ سب شوگر کنٹرول کا راز ہیں۔

ہم سب کے لیے یہ حوصلہ افزا پیغام ہے کہ ذیابیطس کو شکست دینا ممکن ہے! 💪

25/09/2025

🔴 GLP-1 RAs and Anesthesia:
2025 Consensus Update:
Patients on GLP-1 receptor agonists (e.g., semaglutide, tirzepatide, dulaglutide) can continue their medications before anesthesia if asymptomatic, with extended fasting to reduce aspiration risk.

🟠 Guideline Evolution
▪️ GLP-1 RAs delay gastric emptying, raising concern for aspiration during anesthesia
▪️ 2023 ASA guidance recommended holding GLP-1s for one half-life
▪️ 2024 update allowed continued use in low-risk patients, but advised a 24-hour liquid diet for higher-risk groups
▪️ Experts criticized lack of evidence supporting stratification by dose or phase

🟡 New 2025 Multidisciplinary Consensus
▪️ Led by the Society for Perioperative Assessment and Quality Improvement
▪️ Endorsed by AACE
▪️ Based on 112-study review and expert Delphi process
▪️ Recommends continuing GLP-1 RAs with extended fasting, not discontinuation

🟢 Fasting Guidelines for Asymptomatic Patients
▪️ Stop solid food ≥24 hours before anesthesia
▪️ Allow low-glucose clear liquids until 4 hours pre-op
▪️ Avoid high-glucose clear liquids (≥10%) for 8 hours pre-op
▪️ Acceptable: water, black coffee, broth, sugar-free electrolyte drinks
▪️ Avoid: juice, soda, sweetened beverages, anything with cream or milk

🔵 When to Delay Surgery
▪️ Significant nausea, vomiting, or poor oral intake
▪️ Active GI symptoms or suspected gastric stasis
▪️ Refer to prescribing physician for symptom and medication management

🟣 Restarting After Surgery
▪️ Resume GLP-1 RAs when normal diet is tolerated
▪️ Avoid restarting if NPO or symptomatic
▪️ Titrate slowly if therapy was interrupted

🔴 Why Continuation Is Preferred
▪️ Stopping GLP-1s can worsen glycemic control in T2D
▪️ Discontinuation may lead to nausea or weight regain
▪️ Re-titration is burdensome and affects adherence
▪️ Delayed gastric emptying may persist even after drug is held

🟠 Clinical Takeaway
▪️ Don’t stop GLP-1 RAs routinely—extend fasting instead
▪️ Screen for symptoms and assess risk
▪️ Collaborate across specialties for perioperative care
▪️ Consider gastric ultrasound in uncertain cases.

23/09/2025

21/09/2025

20/09/2025

18/09/2025

Introduction
🟢 A real-world study in Denmark examined semaglutide (Wegovy) use for weight loss among adults without diabetes
🟢 Clinical trials show high adherence, but in daily practice many patients stop early
🟢 Key reasons include cost, side effects, and unmet expectations
🟢 The study highlights particular challenges for younger adults and lower-income groups

🟡 Main Findings
🟡 Study population: 77,310 adults without diabetes who started semaglutide between Dec 2022–Oct 2023
🟡 Median age: 50 years; 71% were women; population mostly Caucasian
🟡 Within 1 year, 52% of patients discontinued treatment
🟡 Dropout rates: 18% at 3 months, 31% at 6 months, 42% at 9 months

🟠 Age and Discontinuation
🟠 Younger adults (18–30 years) were nearly 50% more likely to stop than those aged 45–60 years (RR 1.48; CI 1.45–1.51)
🟠 Younger people have higher obesity burden but less disposable income to cover drug costs
🟠 This pattern raises concerns that treatment may worsen social inequalities

🔴 Socioeconomic Disparities
🔴 Living in low-income areas raised discontinuation risk by 14% (RR 1.14; CI 1.10–1.17)
🔴 Lower-education and lower-income groups have nearly double the obesity prevalence but are less likely to continue treatment
🔴 Prescription rates show only 1.3% of the lowest income quartile received semaglutide compared with 3.6% of the highest quartile

🔵 Comorbidities and Prior Medications
🔵 Prior gastrointestinal medication use raised discontinuation risk by 9% (RR 1.09; CI 1.08–1.11)
🔵 Prior psychiatric medication use raised risk by 12% (RR 1.12; CI 1.10–1.14)
🔵 Some patients initiated psychiatric medications after starting semaglutide, suggesting possible psychiatric side effects
🔵 Cardiovascular disease or other chronic conditions raised discontinuation risk by ~10% (RR 1.11 and 1.09)
🔵 Men were more likely than women to discontinue (RR 1.12; CI 1.11–1.14)

🟣 Reasons for Stopping & Broader Implications
🟣 Financial burden significant: ~€2000/year for lowest dose (2025)
🟣 Side effects common: gastrointestinal (nausea, vomiting) and psychiatric (mood changes)
🟣 Some patients satisfied with modest weight loss and did not pursue long-term therapy
🟣 Many underestimate the risk of regaining weight after discontinuation
🟣 Real-world discontinuation is much higher than in trials, where adherence exceeded 80% with free treatment and close monitoring
🟣 Findings underscore the need for better patient communication on realistic goals, side effect management, and the importance of sustained therapy.

18/09/2025

🙂