geoffrey modest medical blogs

  A recent article explored the relationship between difficult-to-control diabetes and endogenous hypercortisolism, finding improved glycemic control with the use of mifepristone   in the CATALYST study (see   dm hypercortisolism mifepristone rx DiabCare2025  in dropbox, or   https://doi.org/10.2337/dc25-1055 ), in the CATALYST study Details : -- 136 individuals who had type II diabetes (T2D) and hemoglobin A1c between 7.5% and 11.5% on multiple medications were then randomized in this prospective, multicenter, double-blind study of  the glucocorticoid receptor antagonist mifepristone (300 to 900 mg daily) vs placebo for 24 weeks, stratified by the presence or absence of an adrenal imaging abnormality     -- specifically, patients had to be on least three glucose lowering medications, or taking insulin and any other glucose lowering medication(s), or taking at least two glucose lowering medications and having at least one microvascular or mac...

  A recent study found that women with high levels of plasma phosphorylated tau217 (p-tau217) had a higher risk of subsequently developing mild cognitive impairment (MCI) or dementia (see   dementia tau217 inc risk women JAMA2026  in dropbox, or doi:10.1001/jamanetworkopen.2026.1295) Details -- 2766 women were recruited from 39 US clinical sites between 1996 and 1999 into the Women’s Health Initiative Memory Study (WHIMS), a study of community-dwelling cognitively unimpaired women who were post-menopausal, aged 65-79yo, then randomized to either oral conjugated equine estrogens 0.625mg/d alone (with addition of medroxyprogesterone acetate 2.5mg/d if they had intact uterus) vs placebo -- baseline plasma p-tau217 was measured in 2024 -- mean age 69.9, White 74%/Black 18%/Asian 5%/7% Latina -- hormone therapy treatment group:     -- estrogen alone, the placebo group: 569 women (21%)     -- estrogen alone, the intervention group: 570 women (...