Men, women, and diabetes

Could diabetes originate differently in men and women? As usual, we wouldn’t ask if the answer wasn’t at least “Maybe.”

The exact mechanism of diabetes development isn’t known, although there’s a connection to abdominal fat. Fact is, men and women store that differently (men around the organs, women under the skin). With that in mind, Canadian researchers reviewed the studies and concluded that…

[T]here were overall differences observed in the immune cell, hormone, and cell signalling level in men and women that seem to support different origins in diabetes between the sexes.

Or as they titled their paper, “Sex differences in regional adipose tissue depots pose different threats for the development of Type 2 diabetes in males and females.”

Check those new PBM contracts

NCPA is advising pharmacies to check their upcoming Medicare Part D plan year PBM contracts carefully. Not only may some PBMs be offering reduced reimbursement (potentially below cost), but …

… some contracts are opt-out contracts that require a pharmacy to proactively send a specific form of notice to a PBM, sometimes within a short period of time, declining participation in the network if the pharmacy determines that the terms offered are not satisfactory.

Snails vs pain

Those shifty Danes think they’ve found a painkiller in the venom* of sea snails.

Surprisingly, it wouldn’t be the first painkillers to come from sea snails — one from Conus magus already exists, but it’s expensive and needs to be injected via a spinal implant. The new one, though, comes from a different species: Conus rolani. (Chosen because it was the only species they could get enough samples of.)

Resembling a somatostatin, the substance they’ve isolated “can block out pain in mice for an even longer time than morphine.” More importantly, it uses an entirely different mechanism.

“We have discovered a so-called toxin that blocks out pain in a completely different way than well-known drugs like morphine, and hopefully this will enable us to avoid some of the most damaging effects of morphine on humans.”

Plenty more work to be done, but it’s clear we’re finding more and more pathways to block our pain.

* The article calls it “poison,” but it’s actually venom.

Cold comfort coming?

Moderna is working on a bunch of mRNA vaccines including, the company said, “a vaccine against all four of the endemic human coronaviruses.” It doesn’t mean Covid — it’s talking about the common cold.

The vaccine candidate, dubbed mRNA-1287, wouldn’t stop all colds (because there are a lot of ‘cold’ viruses), but it could cut down on a bunch — 10% to 30% of upper respiratory infections every year, according to Moderna.

Dig deeper: Is this feasible? Or even worth it? Endpoints News contemplates those questions.

The latest Covid-19 prevention

Broccoli and Brussels sprouts. Microbiologists at Johns Hopkins found that sulforaphane from cruciferous plants (which is already known to be pretty darned good for you) also seems to inhibit the replication of SARS-CoV-2 and other coronaviruses.

Even cells with low exposure to sulforaphane saw the replication of SARS-CoV-2 get cut in half — and that included the delta and omicron variants. Even cooler, “lower doses of both sulforaphane and remdesivir, when combined, are more effective against the viruses than either applied alone.”

But don’t get too crazy, they say: “While the results are promising, the researchers caution the public against rushing to buy sulforaphane supplements.”

Immunity stays

With Covid vaccines or exposure, the focus has been on antibodies. How are they? How many are they? Are they comfortable? Did they have enough to eat? ARE THEY WANING???

Antibodies get a lot of press because they’re easy to count. But there’s plenty more to the immune system, as you know, and now a new Australian study found that — whether primed via vaccine or exposure — T cells are ready to respond, even after a (relatively) long time.

“Even though some parts of the immune response wane, we can now see that T cells recognising the virus are quite stable over time. After more than a year, they were still roughly 10-fold higher than someone who had never been exposed to the spike protein through infection or vaccination.”

While they may not prevent you from getting Covid, they’ll certainly be ready to drive the invaders out once they cross the border.

Captain Obvious clips coupons

“US Drug Prices Distorted to Favor Pharmacy Benefit Managers”

The entire drug distribution system is based on fake prices. List prices are artificial […] So is average wholesale price. The AWP for 20 mg of omeprazole magnesium (Prilosec) in 2021 ranged from $0.30 per unit to nearly $9.

Play it again, Joe

Three studies (to be presented at the American College of Cardiology’s annual meeting) found the same result we’ve heard repeatedly: Drinking two to three cups of coffee a day is good for your heart — and helps you live longer.

In general, having two to three cups of coffee a day was associated with the greatest benefit, translating to a 10%-15% lower risk of developing coronary heart disease, heart failure, a heart rhythm problem, or dying for any reason. The risk of stroke or heart-related death was lowest among people who drank one cup of coffee a day.

Fun facts:

• “Two to three cups” translates to about one or two typical American mugs.
• Instant or the real stuff — it doesn’t matter (other than, you know, the shame of drinking instant coffee).
• Decaf provided almost all the same benefits, except against arrhythmia and heart failure. “[T]he findings suggest caffeinated coffee is preferable across the board, and there are no cardiovascular benefits to choosing decaf over caffeinated coffees.”
• Coffee is safe even for people with heart disease.

Non-pharma, but amazing

(And a little happy, a little sad.)

A fully paralyzed 36-year-old man with ALS was able to communicate using only his brain. With the help of physicians and engineers, he was able to learn to use neurofeedback to control a tone — first using it to indicate “Yes” or “No,” then later to make individual letters.

His first requests: “Goulash soup and sweet pea soup,” “I would like to listen to the album by Tool loud,” and “I love my cool son.”

The Long Read: Do No Harm edition

What’s a physician’s responsibility — or any healthcare provider’s — when it comes to vaccine-hesitant patients? It’s patient autonomy vs. the danger to society.

Physicians respect the patient’s right to refuse treatment for their own illness, but may find it difficult to respect the patient’s right to refuse treatment for a contagious disease that can affect everyone else.