geoffrey modest medical blogs

    In patients with difficult-to-control type II diabetes, an impressive study found that about one quarter of them have hypercortisolism, and mifepristone improves their hyperglycemia (see dm hypercortisolism DiabCar2025  in dropbox or https://doi.org/10.2337/dc24-2841 ). thanks to Dr Elvira Isganaitis for bringing this to my attention.   Details : -- the CATALYST study enrolled 1063 participants with type II diabetes and a hemoglobin A1c ranging from 7.5%-11.5% and who were on two or more glucose lowering medications with or without micro/macro vascular complications or taking multiple blood pressure lowering medications -- these patients were screened with a 1 mg dexamethasone suppression test (DST)     -- common causes of false positives in DST evaluations were excluded, including taking oral contraceptives, excessive alcohol consumption, severe untreated sleep apnea, severe psych/medical/surgical illness, night shift work or hemodia...

  As many areas in the United States are making mifepristone illegal, and the US Supreme Court will be weighing in on the potential of a federal ban soon, it is noteworthy that several studies have found that single agent misoprostol is quite effective, similar to its standard combination with mifepristone. A recent study documented the safety and effectiveness of self-managed abortion in the US using misoprostol alone through an online telemedicine service (see  abortion misoprostol single agent telemed PerspecSexReproducHealth2023  in dropbox, or    doi.org/10.1363/psrh.12219 ) .   Thanks to Paul Susman for sending me a great article on this:  https://societyfp.org/wp-content/uploads/2023/02/SFP_ScienceSays_misoprostol.pdf   Details :  -- 1016 women received prescriptions for misoprostol from Aid Access in the month of June 2020      -- Aid Access is a non-profit based in Vienna, Austria, but is the only telemedicine organiza...