Eva D B Fain, BSN MPH RN CDE, CHES

#SATIETY in his book, @davidludwigmd discusses a topic I carefully researched. insulin responses to food/glycemic index. I went VERY deep. @MichaelMindrum I found variation. many over respond by making more insulin. survival mechanism?

Therefore, D2O can be used to reliably assess human hepatic DNL in repeated measures designs with at least 3 weeks between measures Crossovers are powerful designs to efficiently detect small differences in hepatic DNL Thanks @TheBHF for funding doi.org/10.1152/ajpend…

AI copy slop is taking over all of social media Content creators think it makes them look clever & witty, but it's so fucking obvious Best study is the one from MIT showing AI rots your brain

@simonmaechling bingo

Some people refuse vaccines because they think they’re being tracked. Then pull a iPhone out of their pocket… …and use it to broadcast that belief to the world.

@slotkinjr @matthewherper @eringriffith @nytimes 1/ Well done! However there is a small flaw in your through explanation! THERE IS NOTHING STOPPING COMPOUNDERS FROM MAKING ORAL TERZAPETIDE. That the beauty of the law. As long as the label claim matches the content, there is jack FDA can do about it. The lawsuit will be tossed

I really did not want to be writing this morning. But this issue is too important. It’s been said that the last thing the weather person should do before going on the air is look out the window. The _day before_ @eringriffith profiled Medvi in @nytimes as the AI company of the future, the FDA approved Lilly’s new oral medication: orforglipron. *Not tirzepatide.* In fact, it’s not even a peptide. It’s the first non-peptide, small-molecule oral GLP-1 receptor agonist. Lilly owns tirzepatide. They invented it. If you could put tirzepatide in a pill, Lilly would do it. They would desperately want to. Instead, they spent millions and nearly eight years licensing a completely different kind of molecule, because oral tirzepatide is a biological impossibility. Tirzepatide is a 39-amino-acid, 4,813-dalton peptide. Your gut does not distinguish it from a piece of chicken. SNAC, the absorption enhancer that barely gets oral semaglutide to 1% bioavailability, is compound-specific. It failed with liraglutide, another GLP-1 peptide, and has no demonstrated mechanism for tirzepatide. There is no published human study of oral tirzepatide. There is no plausible mechanism. Medvi sells it starting at $279 a month. A RICO class action against its supply chain partners has already called the product modern-day snake oil. Lilly’s own strategy is the best witness. We can hear the lawyers now: “So doctor, what was your assumption on why Lilly was not pursuing oral tirzepatide despite that in not doing so they would instead pursue an entire entirely different type of molecule and possibly create market confusion with their new entrant?” The Times profile actually described an accountability architecture whose impact in part is that no single entity owns the patient and process. Medvi handles marketing. CareValidate provides the clinical workflow. OpenLoop provides prescribers and pharmacy fulfillment. The marketing layer can say the doctors make the decisions. The doctor platform can say the brand controls the messaging. The prescribers say the pharmacy fills what’s ordered. Everyone can point at everyone else. That structure explains a lot of the financials. Medvi reported a 16.2% net margin. Hims, with 2,442 employees selling the same drug categories, reported 5.5%. The 10.7-point spread represents in part everything Medvi may not pay for: extensive clinical oversight, advanced adverse event monitoring, satisfactory regulatory compliance, sound quality systems. The Times says they verified Medvi’s revenue. They did not seem to verify or note many other aspects. Six weeks before the profile ran, the FDA had issued Warning Letter #721455 for misbranding compounded GLP-1s. OpenLoop had disclosed a data breach: a threat actor claimed access to 1.6 million patient records, and multiple class actions were filed. The company’s ad network included fabricated physician personas, “Professor Albust Dongledore,” “Dr. Tuckr Carlzyn MD,” running over 5,000 Meta ads alongside a website disclaimer that these individuals “may be actors or AI portraying doctors.” The Times told the story of a man who used AI to build a billion-dollar company alone. The article was really a transcript of a Silicon Valley fever dream. A byproduct of regulatory lag and consumer desperation A billion dollars in pharmaceutical transactions running through an organization with no one seeming to care if a product can survive contact with the human stomach better than a chicken nugget.

essentially it appears to be spyware. I stopped being real on X as it felt like GROK was spyware.... maybe I need to take up whiskey drinking again?

@metapredict @nick_krontiris in the past, athletes on insulin pumps would need to shut off infusions of insulin or risk getting super low. why? I will look this preprint over very thoroughly; especially the references. very difficult to prove/disprove since its happening at cell level.

@nick_krontiris Interesting! It's funny though that people think just stimulating glucose uptake is a therapeutic strategy. It's not, it's a temp effect - only so much ⬆️ in glycogen possible. There's a reason why there's feedback mediated ⏬ G uptake Turn over is key; or excretion via kidney

🧐

@nick_krontiris prior research claims the inside metabolism of the cell is over taxed & must have more energy so glucose channels open up & allow glucose to diffuse inside. do you need any of this research? I may be able to find it in my "cloud"

Whoever wrote the part about glucose getting into muscle needs to do QUITE A BIT MORE RESEARCH. hello folks! NEWSFLASH! Glucose will cross into muscle WITHOUT INSULIN! 🤪🤪🤪🤪🤪🤪 🦫🦫🦫🦫🦫👩🏽‍💻👩🏽‍💻👩🏽‍💻👩🏽‍💻👩🏽‍💻

Just eating earlier (aligned with your circadian rhythm) in the day also improves: 1) Weight loss 2) Cholesterol 3) Glucose 4) Insulin resistance

The desire for sweet tastes is part of our NORMAL hedonic drives. Did the food industry stay up at night plotting? NO. However sugar & salt was used to prevent bacteria growth. Now? @davidludwigmd book is correct: we can adjust to less sweetness

#JNutr study finds "#beans improve #satiety to an extent that is not significantly different from beef in older adults, supporting the role of beans as a nutrient-dense source of #protein and dietary #fiber as part of a satisfying meal for older adults." ow.ly/C9CF50VQ3he

#lipids #human_lipids

Associations in humans suggest that Hyperglucagonemia in the face of higher hepatic lipid content in early #T2D is not due to differences in insulin sensitivity or glucagonotropic metabolites but could suggest hepatic glucagon resistance diabetesjournals.org/care/article/d…

@elonmusk @X who will own the stunning visuals? @nikitabier ? I may outlive my savings. Not willing to offer gi

Interesting

Years ago, @gerdosi introduced this concept online= lactate instead of ketones.. thank you @doctorinigo for doing a write up.

After 30 years studying lactate, I have learned this: Lactate is not just a metabolite. It is a major regulator in the human body body. It can support metabolic health or contribute to disease. Same molecule. Different context. Lactate has been the most misunderstood molecule in biology. If you want to learn more about lactate and its multiple roles, link to my Substack article here 👇 @inigosanmillan/note/p-192080657?r=2nunp3&utm_medium=ios&utm_source=notes-share-action" target="_blank" rel="nofollow noopener">substack.com/@inigosanmilla…