Maybe it’s not diabetes

There’s been some concern — a surprising number of Covid-19 patients seemed to be getting diabetes when they leave the hospital. Good news for them (out of a Massachusetts General Hospital study): They aren’t getting full-blown diabetes, but more likely “a transitory form of the blood sugar disorder.”

Their hypothesis: Covid stress causes insulin resistance, and once out of hospital the stress goes down and insulin back to normal.

“[I]insulin deficiency, if it occurs at all, is generally not permanent. These patients may only need insulin or other medications for a short time, and it’s therefore critical that physicians closely follow them to see if and when their conditions improve.”

Another factor: Some people have their blood sugar tested for the first time after Covid hospitalization, leading to a diagnosis of diabetes or pre-diabetes. That skews the stats even after their blood sugar stabilizes.

Opioid settlement update

The latest news in the never-ending opioid lawsuits has a settlement finally settled between a steaming pile of states (46 of them, including Georgia), cities, tribes, towns, and whatnot and the three major drug distributors (plus Johnson & Johnson).

The deal:

The three distributors will contribute up to $19.5 billion over the next 18 years to communities affected by the opioid epidemic. […] J&J will also kick in $5 billion to settle claims against it.

And that’s that. Until it isn’t.

Marijuana for glaucoma — “no” becomes “maybe”

Eye docs are coming around to the idea of marijuana treating glaucoma.

While eye societies — the American Glaucoma Society, American Academy of Ophthalmology, and even Canadian Ophthalmological Society — officially give the thumbs-down for using cannabis to treat glaucoma (even where it’s legal), patients are a lot less conservative.

With access to marijuana on the rise, those patients see the potential, and that means ophthalmologists are forced to have their interest piqued. So, while right now only 27% think marijuana has a role in treating glaucoma, more than three-quarter “expressed interest in receiving additional education on the topic.”

Pregnancy weakens anti-seizure meds

Got pregnant patients taking anti-seizure meds? Keep an eye out. It seems that pregnancy can significantly lower their concentrations.

The neurologists who studied this “suggest the need for higher doses of several antiseizure medications during pregnancy and support therapeutic drug monitoring beginning early in pregnancy.”

(Which drugs? Lacosamide, lamotrigine, levetiracetam, oxcarbazepine, and zonisamide.)

Basic science: finding a diabetes trigger

The pancreas secretes insulin (obviously), but it also secretes human islet amyloid polypeptide (hIAPP) — that also helps to regulate blood glucose levels. Sometimes, though, hIAPP can ‘malfunction,’ — it turns in to amyloid fibrils. Those can clump up and keep the pancreas from secreting insulin, which can lead to type 2 diabetes.

So … stop that hIAPP malfunction, maybe stop the diabetes? The first step is to figure out how a happy little molecule turns bad. Was it television? Video games? The wrong crowd?

Probably the latter. In a pretty big step toward understanding diabetes, British researchers discovered two molecule modulators that control whether the hIAPP clumps or not. If they can control those modulators, they might control the onset of diabetes.

Today’s potential Covid-19 treatment is …

Melatonin. Why not? It’s an antioxidant and an anti-inflammatory, and (as an international group of researchers, including a German dermatologist, point out) it…

… has pan-antiviral effects and it diminishes the severity of viral infections and reduces the death of animals infected with numerous different viruses.

There’s some evidence that Covid patients treated with it did better, so maybe it’s time for clinical trials, they argue. (If not trials, just post a lot on social media.)

All reasonable treatment options should equally be considered, not only those that have the backing of the most influential medical/pharmaceutical personnel.

The Long Read: Immunity edition

A body’s immune system isn’t simple, but in broad strokes it’s about the picket line of antibodies (from B cells), the army of killer T cells, and the ongoing intelligence of memory B and memory T cells.

For the details, two immunologists explain: “How long does protective immunity against COVID-19 last after infection or vaccination?”

Something to consider this weekend

Found among my medical science news reading: “Democrats and Republicans see each other as ‘more stupid than evil,’ according to new psychology research.”

(As one Reddit commenter put it, “That’s promising. I also think I’m stupid, so we have common ground right out of the gate.”)