Metformin vs long Covid

For people who’ve been vaccinated, taking Paxlovid doesn’t do much to prevent long Covid. (It’s also expensive for a lot of people, so for mild cases it’s probably not worth it.)

What might be worth considering to prevent long Covid is metformin. It’s cheap, safe, and — per several studies — effective at reducing the risk of long Covid significantly.

One study found that….

If metformin was started within the first three days of illness and continued for 14 days, [the] study showed a 41% reduction in the incidence of long Covid, with an absolute decrease of 4·1%, compared with placebo.

Others found that metformin reduced patients’ viral load as well. “At a minimum,” wrote the author of the Forbes piece, an infectious-disease specialist, “I believe all adults with acute Covid-19 should be offered metformin.”

A stem-cell cure for diabetes?

Chinese scientists say they’ve effectively cured type-1 diabetes by creating pluripotent stem cells, turning them into pancreatic islet cells, and transplanting them into a patient’s pancreas.

After the transplant of CiPSC-islets, she [a diabetic patient] regained the capability to autonomously regulate her blood sugar. Seventy-five days after the transplant, she became insulin independent and has remained insulin injection-free for over a year. All her diabetes-related indicators have reached the levels of a healthy person, confirming the clinical cure of this type 1 diabetes patient.

Transplanting islet cells has been known to be a treatment for diabetes, but it’s tough to find donors. The big breakthrough here was turning plain ol’ somatic cells into stem cells — the lead author won China’s Future Science Prize for the process — then making those into islet cells for transplant.

Short Takes: Medicare prescription coverage

Premiums are going down: According to CMS, the average premium for a standalone Part D plan will drop by about 4% in 2025 (from $41.63 to $40), while Medicare Advantage prescription coverage will drop about 7% (from $18.23 to $17). That’s thanks to competition and “regulatory reforms and key provisions from the Inflation Reduction Act.”

But patients don’t compare: Despite the average Medicare recipient having 43 Medicare Advantage plans and 21 standalone Part D drug plans to choose from (in 2024), “nearly 7 in 10 (69%) Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area.” (And 43% didn’t even review their plans for changes in premiums or out-of-pocket costs.)

Baby steps

Private insurance companies are slowly but surely beginning to cover prescriptions written by pharmacists, as more states allow the practice.

Health insurers see an opportunity to make sure their patients get needed prescriptions quicker in an effort to improve health outcomes. Thus, insurers are paying pharmacists as they have physicians in states where laws allow for such expanding prescribing.

ICYMI: Fluoride questions

A federal judge wants the EPA to reduce the risk of fluoride in drinking water … although he didn’t say how. The ruling comes after a report found that consuming high levels might stunt intellectual development.

Keep in mind that the questionable fluoride levels are twice what’s allowed in drinking water, so it’s unclear what exactly the EPA is supposed to do. Reevaluate? (US drinking water has about half the fluoride that the WHO recommends to prevent tooth decay.)

The judge seemed cool with fluoridation in general — “a practice that has been hailed as one of the greatest public health achievements of the last century” — but he wanted to be sure there was enough of a safety margin between what’s allowed in water and what might cause developmental issues.

Half baked

Dermatologists: “Targeted, careful use of UV radiation can treat some skin conditions.”

TikTok: “So sunburning your face can remove acne!”

Dermatologists: “No, that’s not what we—”

TikTok: “Aieee! The sun — it burns!”

Oncologists: “You wanna schedule your appointment now?”

Weird science

Hearing an unexpected sound triggers a dopamine release (found Yale researchers), and that can lead to poor decision making.

The Elis tested this hypothesis in the most boring way possible^*: First, they played the test subjects a sequence of tones. Then they changed one of those tones and asked the subjects to make a decision that could reward them more if they took more risk.

“We found that surprising sensory events, these unexpected sequences of tones, increased people’s risk-taking,” said the lead researcher.

“Think about say an urban environment where there are so many sounds that are mostly irrelevant to our daily decisions. Maybe those sounds are affecting decisions even when we don’t notice.”

^* We would have used an air horn.