Type 2 diabetes drug associated with 35% lower risk of dementia, study finds
theguardian.com
theguardian.com
- SGLT-2 inhibitors: canagliflozin, dapagliflozin, sotagliflozin, bexagliflozin
- DPP-4 inhibitors: sitagliptin, saxagliptin, linagliptin
Other beneficial drugs beyond/with/for diabetes and/or weight:
- Metformin
- AGIs: acarbose
- GLP-1 agonists: tirzepatide, semaglutide, liraglutide
- DACRAs: cagrilintide
Maybe in the future it will be possible to manage a person's glucose and related hormone levels in roughly a continuous keto or borderline low blood sugar state using the equivalent of an "insulin pump" and a real-time blood glucose monitor control system such that it doesn't promote low-blood sugar neurological symptoms.
I could imagine that being responsive, and toggleable.
AAPS (unlike the Tandem T , which I’m less familiar with) uses a more sophisticated algorithm to calculate the required insulin, considering several factors:
- Blood sugar levels received via XDrip from the Libre 2 sensor.
- A profile that includes:
- - The basal rate per hour for each time slot
- - The insulin-to-carb ratio
- - The target blood sugar range
- Automatically calculated insulin sensitivity.
- Insulin on board (remaining active insulin), calculated using a curve to estimate how much insulin is still active after injection.
- Carbs on board, with AAPS tracking active carbs over time.
The lack of carbs is perhaps the worst for me. Even if I track then on the Dexcom app, it doesn't use them. The automatic boluses are often wrong. When I had it anywhere near my real ratio, it would 'predict' I was going over 160 and automatically dose me. So, say I was at 85, and had 15 grams of potato chips. My glucose would rise quickly and as it went over 125, 140, the system would predict it was going up past 160 - or who knows, since it doesn't know how many carbs I ate. So then it would dose me with say, 1.1 units, which was enough to take my glucose -back to 85-. That sent me in loops a couple of times... 85, eat, up to 145, automatic bolus, back to 85, eat, up to 145 - very annoying when it happened at night. I had to set my carb ratio so high that the automatic boluses are now insignificant amounts like .16 units. It also doesn't notify you on your phone about automatic boluses, which has caused me major problems when I'd also manually correct. The automatic basal reduction (Basal IQ) is useful though.
Anyhow, I'd love to try AAPS but I don't have an Android phone. I also used to follow someone on Twitter who was developing his own software that he said removed the need to pre-bolus at all. Not sure about the details though.
With AAPS - it is usually able to deal with my blood sugars at night automatically.
During holidays ( 0 stress day), AAPS can almost completely determine boluses just based on my profile and carb intake. ( i.e. I don't force a bolus ) However, during normal workdays, I usually need to bolus right before carb intake. AAPS also allows you specify bolus a percentage and then let it figure out the rest automatically.
There is an AAPS-like app for iOS but I am not sure how good it is. See https://loopkit.github.io/loopdocs/#what-is-the-loop-app
That said- it is an adaptive mechanism that is rapidly reversible, and totally different from type II diabetic insulin resistance.
To be clear, most brain and heart cells do not require glucose to function. Although, a small subset do.
For your interpretation to be accurate, you’d need to also show that the other popular medicine doesn’t work for diabetes type 2 treatment.
FWIW, the last line of the article is a dismissal from a UK doctor saying that this would make the diabetes drug better than any existing Alzheimer treatments, and suggesting that there’s a confounding variable in the study instead.
But I don't know though
This is not true. It's possible that there are multiple effects of type 2 diabetes, with multiple drugs that treat the main factor (sugar levels), but with a subset of the drugs affecting other factors (hormones, cellular activities, something else) that influence dementia.
That is, the medication doesn't improve anything per se. The problem is obesity and diabetes. The medication does not perform better than these not being present at all.
The presume diabetes - sans T1 - is a norm is false if not dangerous. In other words, "Sure just throw more meds at it" is not a narrative anyone should be comfortable with.
What you describe is not smarter way. It's jumping to conclusions.
In other words, how effective is this "cure" vs no diabetes at all? *That* is the question.
An animal who has a normal weight for one of its species at some time of year is not obese.
Also, the life expectancy of humans is >10x a bear.
Why are people bending over backwards to normalize diabetes and obesity?
The weeds in a garden need to be pulled or they will take the garden. Problems need to be recognized and then fixed, anything else is delusion.
Bears are an example that shows very clearly it's normal for animals in nature to become very much "not lean" to survive, and the drive to put on fat stores is probably much broader in nature than animals that hibernate to survive winter.
What's unique about humans is that we've engineered our environment to the point that most of us no longer suffer long stretches of being unfed or underfed to strip the excess fat stores off of us.
Some people are clearly better than others at fighting the behavior evolution has programmed into them. It's not good for them today, but at the same time that drive for survival is what kept their ancestors alive.
My suggestion is to look at old black/white tribal photos of natives. They do not fullfill your beauty standards, but they lived normal sustenance lifes. And yes, the woman and men have bellies. Not huge ones, but noticeable ones. Same thing in the animal kingdom. The dominant monkey in a harem, besides the normal hormonal dominance meat-mountain bloat, usually has a belly. Our beauty standard is met by animals in distress, being pushed into marginal territories. Healthy is, somewhere in the middle, not on either side of the isles of madness.
Of course, everyone instinctively knows this even if they want to use mental gymnastics to explain why it is OK. Alcoholics, drug addicts, etc are defensive too and have many excuses at the ready for why their behavior is acceptable.
In the end, however, reality will hit hard and five dollar words aren’t going to save the obese and those with unhealthy lifestyles from sickness and early death.
Most primates including us humans are tropical and subtropical creatures, which didn't face classical winters until relatively recently. The Neanderthals did, for a considerable amount of time, and their physiology might have been different, but the Neanderthals were also developed enough to protect themselves using clothing and shelters, and possibly store food, so physiological adjustments might not have been necessary.
Modern humans are basically Africans adapted to ~ Kenyan climate, though. (Yeah I know about the Neanderthal and Denisovan admixture.)
I never understood why these references are being made regarding health.
Bears aren’t healthy. Bears don’t live long. Ancient people weren’t healthy, their diets weren’t healthy and they had lots of untreated issues as well.
I supose quite a few bears live quite long lives -- for being bears.
> Ancient people weren’t healthy, their diets weren’t healthy and they had lots of untreated issues as well.
As far as I've gathered from (pop-sci summaries of fairly recent-ish) research, people in prehistoric and pre-agricultural hunter-gatherer societies were on average at least as healty as -- and often healthier than -- people in later agricultural societies, from the Bronze and Iron Ages through antiquity, the Middle Ages and Renaissance, up until at least the early Modern Age and quite possibly through to our days of (relative, unequally-distributed) affluence and its concomitant recent global obesity.
For some reason GLP-1 drugs are not that popular in Korea (and still not prescribed just for the weight loss), so that may explain why these researchers haven't done that.
My own PoV is that a lot of it comes down to the massive increase in heavily refined foods and seed oils in the past century and a half. You have a lot of carbs and a really different mix of fatty and amino acids. So higher blood glucose, more of the time combined with a very different mix of fatty and even amino acids in the diet. Likely exacerbated by half a century of low-fat, low cholesterol diets perpetuated largely in busted myth. Combine this with hyper-palatability and it's just hard to get away from.
Heart disease, alzheimer's, dementia, diabetes, obesity... All of it comes down to food and exercise. With a bit more exposure from RFKjr, it's ironic that Time magazine is now doubling down for the conglomerates, can't find the cover photo for this, but the recent article on why ultra-processed foods aren't that bad is astounding.