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Posted by randycupertino 19 hours ago

Semaglutide linked to lower predicted dementia risk(alz-journals.onlinelibrary.wiley.com)
429 points | 302 commentspage 3
enquirewithin 14 hours ago|
And a doubling in the rate of waking up blind.
juiceland 12 hours ago|
Doubling doesn’t mean much without knowing the base rate.
AFF87 19 hours ago||
We are very early in the semaglutide world, exciting times ahead!
ndr 18 hours ago||
For sure we still need to find out many related outcomes.

Last year it become known that it increases (high relative risk, low absolute risk) non-arteritic anterior ischemic optic neuropathy (NAION), ie sudden, sometimes permanent vision loss.

https://www.ema.europa.eu/en/news/prac-concludes-eye-conditi...

mapontosevenths 18 hours ago|||
To save others the click: It increased the likelihood to 1 in 10,000 in adults with type 2 diabetes.

Diabetics are already more prone NAION. This studies contribution was to show that diabetics on GLP-1's are MORE prone. It does not show that the general population is more prone when taking GLP-1's.

I didn't check to see if other studies prove that.

thrtythreeforty 18 hours ago|||
It is well known that forcing a sudden drop in chronically high average blood glucose (like, from 200+ to a normal ish range) with insulin can cause vision loss. I wonder if it's the same mechanism?
adam_arthur 17 hours ago||
It tends to happen when:

1) You must have a crowded optical disc as a precursor (low cup to disc ratio). Genetic and can be tested

2) You have stiff veins/arteries due to poor metabolic/cardio health

3) when blood pressure drops too much, blood flow can get cut off to the optical nerve temporarily due to reliance on high blood pressure due to 2

4) Due to loss of blood flow, optic nerve swells and closes blood flow into the eye due to 1

adam_arthur 18 hours ago|||
It's also true that having a crowded optical disc is pretty much a required precursor condition to suffering NAION.

Which you can get checked for via a $50 optical scan.

No crowded disc, very little risk.

(Cup to Disc ratio of 0.2ish or less starts to present risk)

tptacek 18 hours ago|||
In addition to being closely associated with the conditions semaglutide treats, NAION is quite rare.
AaronAPU 17 hours ago||
If it reduces inflammation and causes weight loss, I find it impossible to believe you can just stop and not get rebound on both.

Which to me just sounds like every other addictive drug. Paradise while you’re high, and eventually you pay for it.

AndrewDucker 16 hours ago||
Or continue to take it.
pessimizer 15 hours ago||
This is one of those fake stats, where

if among people not taking it you would see 4 out of 100 get dementia within 5 years of when you started measuring,

if they were taking it you'd instead see 3 out of 100 get dementia within 5 years,

and the number is either a projection ("predicted risk") because they didn't actually study it for 5 years,

or the number is a p-hack because they checked every possible thing they could with the 5-year data they had and this was the only interesting thing that they found ("post hoc analysis"),

or both (the projection of a p-hack), which I suspect because they also tell you about the 20-year risk,

and it is a study sponsored by the manufacturers of the drug,

being suggested to cure a disease diagnosed by checklist (rather than any physical test.)

Will that keep it out of the headlines? No, it was written to become a "free" ad that will be published by the people they send enormous amounts of money to, but by their "news" departments.

The best thing we can do for the progress of medicine in the US is to make direct-to-consumer advertising of prescription drugs illegal again. There would be no use for this if the media hadn't been bribed to become cheerleaders for any old shit. It's illegal everywhere in the world other than the US and New Zealand.

TMWNN 9 hours ago|
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