Normalizing blood sugar can halve heart attack risk
New study shows: Prediabetes remission protects the heart and saves lives
For the first time, an international analysis has shown that when people with prediabetes bring their blood glucose back into the normal range through lifestyle changes, their risk of heart attack, heart failure, and premature death is cut in half. These findings could revolutionize prevention and establish a new, measurable target for clinical guidelines. Among others, researchers from University Hospital Tübingen, Helmholtz Munich, and the German Center for Diabetes Research (DZD) took part in the study.
Millions of people in Germany live with elevated blood glucose levels without knowing it. They are considered to have “prediabetes” – an early stage that until now has lacked clearly defined treatment targets. People with prediabetes are usually advised to lose weight, be more physically active, and eat a healthier diet. These lifestyle changes make sense, as they improve fitness, well-being, and several risk factors. However, one crucial question has remained unanswered: Do they also protect the heart in the long term? So far, no lifestyle program for people with prediabetes has been able to clearly demonstrate a sustained reduction in heart attacks, heart failure, or cardiovascular deaths over decades.
Is that proven? It might do less so than atorvastatin but is there evidence that it pitavastatin does not inhibit HSDH and does not lower UDCA and GLP-1 levels?
What difference does it make? The point is that unlike other statins whether lipophilic like atorvastatin or hydrophilic like rosuvastatin, pitavastatin in head to head RCTs comparing these statins does not raise FBG, A1c, affect insulin sensitivity, affect liver fat or raise the risk of new onset T2DM. There are also studies against placebo showing the exact same thing. If you want, I can round up some citations, though I believe I already posted such studies before in some threads.
If there is no impact on these measures and the whole point of adding UDCA for statin users is to avoid those very effects, then there is no reason to add UDCA if you don’t take a statin at all or take pitavastatin. If nonetheless you insist on the need, then you need to show outcomes that justify it, the way it’s shown for other statins. That needs showing.
Here’s one against a placebo:
Effects of Pitavastatin on Insulin Sensitivity and Liver Fat: A Randomized Clinical Trial
Yes, pitavastatin is neutral with respect to insulin sensitivity, but could it still cause gut dysbiosis? Although I agree that most likely it doesn’t act on the Clostridium-UDCA-GLP1 axis mentioned in the paper as this axis seems to be the cause of statin-induced glucose intolerance.
Well, I posted before studies showing pitavastatin preventing LPS movement out of the gut and into the brain, and pita increasing the integrity of the BBB. As to gut dysbiosis I can’t find anything specific to pitavastatin, but in general the findings for statins are mixed:
Cholesterol Gallstones and Long-Term Use of Statins: Is Gut Microbiota Dysbiosis Bridging over Uncertainties?
Effect of pitavastatin on glucose, HbA1c and incident diabetes: A meta-analysis of randomized controlled clinical trials in individuals without diabetes
Third-generation PCSK9 inhibitor approved for high cholesterol
The FDA approved lerodalcibep (Lerochol) injections for the treatment of elevated LDL cholesterol in adults, maker LIB Therapeutics announced.
A third-generation PCSK9 inhibitor, lerodalcibep is indicated as an adjunct to diet and exercise to reduce LDL cholesterol in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia.
Lerodalcibep is a recombinant fusion protein that offers more convenient dosing than the current PCSK9 inhibitors. As such, the drug marks a new pharmacological option that may help more individuals reach their guideline-recommended cholesterol targets. …
Unlike monoclonal antibodies, lerodalcibep is a smaller molecule that binds to PCSK9. Its high solubility allows for a much lower injection volume, and it has a plasma half-life of 12 to 15 days. …
This might have been covered before (and I missed it) but what’s the benefit of using Repatha (or any of the PCSK9) compared to other cholesterol lowering meds, i.e. statins, ezetimibe etc…?
@Kelman
I believe repatha is often more powerful than statins, but I’m sure the experts will chime in.
I’m on it because I don’t feel well on statins. I am also taking BA and EZ
Most people would use the others and only go to pcsk9 if they don’t tolerate them or if they don’t bring their numbers down low enough. If it were cheaper, then perhaps there would be advantages to make it first line, but I’m not sure?
I do know statins have demonstrated they can stabilize plaques. I don’t know that repatha has shown this.
Forgive me if this was covered further up top, but is your insurance covering the repatha? I’d like to get my hands on an economical pcsk9 inhibitor… Is there a cheap solution overseas yet? Maybe there are independent longevity doctors in the US who can now prescribe this loosely?
Fortunately, I can pop high dose statins like pez, have never noticed any side effect at all from simvastatin 40 (high dose)/ezetimibe10/bempedoic 180… Would love to add pcsk9 to this tho and shoot for as low as possible ldl
I can’t speak to your particular doc, but I’ve never had a doctor deny me anything I’ve asked for (I have good docs, I’m very assertive, and don’t ask for anything that is not appropriate for me, so my experience could of course be different)
My insurance sorta kinda covers it, but I have an 8k deductible, so I’m paying mostly out of pocket, unfortunately.
I do get a coupon from them, so for a few months per year I only pay aprox $15.
I’d see if you are eligible for the coupon and consider what some others have done… just use it on occasion to make it last?
Or perhaps your insurance is better, so it’s worth looking into .
