We update our protocols against published evidence rather than conference enthusiasm. A few of the areas we are watching closely, and what would have to be true for us to change practice.
Continuous glucose monitoring in non-diabetics
Useful for behaviour change and for spotting post-prandial excursions that fasting glucose misses. What we want to see: outcome data linking variability reduction in healthy adults to hard endpoints.
Lipoprotein(a)
Largely genetically determined, strongly associated with cardiovascular risk, and until recently untreatable. Trials of targeted therapies are reading out over the next few years; we measure it now so that patients know their number when treatment arrives.
Senolytics
Compelling animal data, thin human data. We will offer a protocol when there is a randomised trial with a clinical endpoint, not before.
GLP-1 receptor agonists
Genuinely effective for metabolic disease and weight, with an important caveat we act on: lean mass loss. Anyone on them in our care is on a resistance training and protein protocol, with body composition tracked.