News in brief: Urgent call for obesity strategy release; Diabetes drug slows Alzheimer’s impairment; 10 Choosing Wisely tips for COVID-19

Wednesday, 25 Aug 2021

Call for obesity strategy’s urgent release

The RACP is calling for the Preventive National Obesity Strategy’s urgent release for review and action.

Originally announced in 2018 and developed based on 2019/2020 consultations, the “much delayed strategy is at risk of becoming obsolete and ineffective if not acted on in a timely manner”, the RACP wrote on their website.

It’s hoped the strategy — which isn’t expected to reach health ministers until 2022 — will include guidance on preventing obesity, improving diets, and environmental and social health determinants.

“These repeated delays are concerning given the combined disease burden of poor diet and unhealthy weight in Australia is now greater than tobacco smoking,” the RACP wrote in a letter to Minister for Health and Aged Care, Greg Hunt.

Obesity is a key risk factor for COVID-19 complications, impacts physical and mental health and wellbeing and puts significant costs on children, families, governments, private health insurers, employers and society, they noted.

“The direct costs of obesity to Australia in 2011–2012 were determined to be $3.8 billion, while indirect costs were calculated to be $4.8 billion,” they wrote.

The college is requesting the primary and secondary prevention part of the strategy be released now and the treatment and management section be released at a later stage, following further consultations.

Diabetes drug slows Alzheimer’s disease-related cognitive impairment

Dipeptidyl peptidase-4 inhibitor (DPP-4i) use could help slow Alzheimer’s disease-related cognitive impairment (ACDI) in diabetes patients, a new study has shown.

The review of 282 ADCI patients with positive amyloid PET images revealed diabetic patients on DPP-4i treatment had lower global amyloid burden than patients who weren’t on DPP-4is (β: 0.075, SE: 0.024, P = 0.002) and non-diabetic patients (β: 0.054, SE: 0.021, P = 0.010).

They also had lower regional amyloid burden in temporo-parietal areas and slower decreases in longitudinal Mini-Mental State Examination (β = 0.772, SE = 0.272, p = 0.005) score and memory recall sub-score (β = 0.291, SE = 0.116, p = 0.012) than non-DPP4i users and non-diabetics.

“These findings suggest that DPP-4i use is associated with low amyloid burden and favourable long-term cognitive outcome in diabetic patients with ADCI,” the authors wrote in Neurology.

Top 10 Choosing Wisely tips for COVID-19

An international taskforce on Choosing Wisely for COVID-19 has released its top ten recommendation for the general public and for physicians.

The 18-member taskforce from India, Canada, the US and UK, encompassed the disciplines of public health, primary care, infectious diseases, respiratory medicine, critical care and more.

The five recommendations for the general public reinforce prevention messages, when to get tested and when to seek medical help.

The five recommendations for physicians focus on the management of COVID-19. They are:

  • Do not use prescribe unproven or ineffective therapies for COVID-19
  • Do not use drugs like remdesivir and tocilizumab except in specific circumstance where they may be of use
  • Do use steroids prudently only in patients with hypoxia, and monitor blood sugar levels to keep them in normal range
  • Do not routinely perform investigations that do not guide treatment, such as CT scans and inflammatory markers
  • Do not ignore the management of critical non-COVID-19 disease during the pandemic.

Read more in Nature Medicine

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