By Nancy Lapid
(Reuters) – Hello, Health Rounds Readers! Today we feature a study that found yet another potential health benefit of GLP-1 drugs, this time following surgery in patients with diabetes. We also report on the best way to treat diabetes in pregnancy, and a discovery of how stress may affect allergic reactions.
GLP-1 diabetes drugs tied to fewer surgery complications
People with diabetes had fewer complications after surgery if they were managing their disease with GLP-1 receptor agonist drugs such as tirzepatide and semaglutide, a recent study found.
Diabetes patients who had been taking tirzepatide, sold by Eli Lilly as Mounjaro, or semaglutide, sold by Novo Nordisk as Ozempic and Rybelsus, experienced 12% lower rates of hospital readmission following surgery, 29% lower rates of wound re-opening and 56% lower odds of blood clots forming at the surgery site than similar patients not using these drugs, researchers reported in Annals of Surgery.
Risks of bleeding and infections were similar regardless of whether patients were taking GLP-1 drugs.
The findings were drawn from medical records on 35,020 operations performed in 13,129 patients with diabetes between February 2020 and July 2023, half of whom were taking GLP-1 drugs. All the patients had similar risk factors for complications, according to the report.
The study does not prove that GLP-1 drugs prevented complications but suggests possible benefits.
“These findings from such a large number of patients and procedures suggest that taking these drugs shouldn’t worsen overall post-surgical complications and may even reduce the likelihood of some of them,” study leader Dr. Jason Spector of NewYork-Presbyterian/Weill Cornell Medical Center said in a statement.
His team is currently trying to determine whether GLP-1 drugs are associated with altered risks of post-surgical complications in patients without diabetes, as semaglutide and tirzepatide are also the active ingredient in the popular weight-loss drugs Wegovy and Zepbound, respectively.
Insulin superior to pills for pregnancy-related diabetes
Diabetes that begins during pregnancy is best managed with insulin injections rather than oral medication, according to new research.
When dietary changes are not enough to control gestational diabetes, many patients prefer to start treatment with metformin, an inexpensive generic oral diabetes medicine, sometimes adding another oral medicine, rather than using insulin, the trial investigators noted in a report published on Monday in JAMA.
The American Diabetes Association recommends using insulin as the first-line therapy to bring blood sugar under control in gestational diabetes, while the UK’s National Institute for Health and Care Excellence recommends metformin.
In an 820-patient trial, researchers set out to prove the pills are just as good as insulin at preventing complications of diabetes during pregnancy. That turned out not to be the case.
Rates of infants born large for gestational age, a complication linked to birth injuries, were 23.9% with oral medication versus 19.9% with insulin.
Oral treatment also was associated with greater risks of dangerously low blood sugar in mothers and in newborn babies.
An editorial published with the report praised the researchers for their “valiant, yet ultimately unsuccessful, attempt” to prove that women can safely opt for the cheaper and easier-to-administer pills.
For now, it said, “insulin reigns supreme.”
How stress makes skin allergies worse
Researchers have uncovered new clues to help understand how psychological stress can aggravate skin allergies.
The stress disrupts immune functions and interferes with the body’s inflammatory responses, they found in studies in mice.
Specifically, psychological stress reduces the ability of specialized immune cells called anti-inflammatory PD-L2-positive macrophages to clear dead cells at the allergy site, according to a report in The Journal of Allergy and Clinical Immunology.
The accumulation of dead cells in the lesions leads to increased infiltration of immune cells called eosinophils, worsening the allergic response, the researchers said.
“This study is the first in the world to demonstrate that stress… disrupts macrophage function, which normally helps suppress allergic reactions, thereby intensifying allergic responses,” study leader Dr. Soichiro Yoshikawa of Juntendo University Graduate School of Medicine in Japan said in a statement.
The impact of psychological stress on immune cells appears to be long-lasting and can affect macrophages produced by the immune system later on, the researchers also found.
“This phenomenon, referred to as ‘stress memory,’ implies that severe stress leaves a lingering imprint on immune cells, influencing their function and contributing to disease development,” Yoshikawa said.
Avoiding stress altogether would be the ideal solution to prevent immune cell dysfunction, the researchers noted. Since that is not always possible, understanding the molecular mechanisms behind stress memory may pave the way for treatments that reverse the effects.
(Reporting by Nancy Lapid; editing by Bill Berkrot)
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