FlexNP
@rnflex.bsky.social
Jack of all trades nurse practitioner, trail runner photographer, coonhound rescuer, lover of glucagon agonism in the liver, kidney and pancreas, fascinated by obesity medicine, retatrutide fan boy
Head to head vs Sema was much closer but still probably slightly better? But yeah it's interesting. I don't have problems drinking but once I started taking these meds it was like I just didn't care as much for alcohol, like I had no desire to even grab a beer anymore for a weekend BBQ
November 11, 2025 at 5:17 PM
Head to head vs Sema was much closer but still probably slightly better? But yeah it's interesting. I don't have problems drinking but once I started taking these meds it was like I just didn't care as much for alcohol, like I had no desire to even grab a beer anymore for a weekend BBQ
CC: @mikejohansenmd.medsky.social
In what might be one of the hilariously beneficial Kaplan Meier curves I've ever seen. TTE study of GLP1 meds and alcohol use disorder with the top left graph being incident of alcohol use tirzepatide vs DPP-4i
dom-pubs.onlinelibrary.wiley.com/doi/full/10....
In what might be one of the hilariously beneficial Kaplan Meier curves I've ever seen. TTE study of GLP1 meds and alcohol use disorder with the top left graph being incident of alcohol use tirzepatide vs DPP-4i
dom-pubs.onlinelibrary.wiley.com/doi/full/10....
November 11, 2025 at 5:04 PM
CC: @mikejohansenmd.medsky.social
In what might be one of the hilariously beneficial Kaplan Meier curves I've ever seen. TTE study of GLP1 meds and alcohol use disorder with the top left graph being incident of alcohol use tirzepatide vs DPP-4i
dom-pubs.onlinelibrary.wiley.com/doi/full/10....
In what might be one of the hilariously beneficial Kaplan Meier curves I've ever seen. TTE study of GLP1 meds and alcohol use disorder with the top left graph being incident of alcohol use tirzepatide vs DPP-4i
dom-pubs.onlinelibrary.wiley.com/doi/full/10....
Primary care is really really hard most days. But when you get notes like this. It makes everything worth it.
November 11, 2025 at 2:31 PM
Primary care is really really hard most days. But when you get notes like this. It makes everything worth it.
Definitely was pretty!
November 10, 2025 at 7:02 PM
Definitely was pretty!
That's the GLP-1 receptor shape!
Here's the actual peptide, it should basically be a big slightly bent alpha helix with a fatty acid sticking off the side. But I just can't find a 3D model unfortunately.
Here's the actual peptide, it should basically be a big slightly bent alpha helix with a fatty acid sticking off the side. But I just can't find a 3D model unfortunately.
November 9, 2025 at 3:30 PM
That's the GLP-1 receptor shape!
Here's the actual peptide, it should basically be a big slightly bent alpha helix with a fatty acid sticking off the side. But I just can't find a 3D model unfortunately.
Here's the actual peptide, it should basically be a big slightly bent alpha helix with a fatty acid sticking off the side. But I just can't find a 3D model unfortunately.
I feel the same about this paper and presentation I saw at Obesity Week 2025. Mechanism with GLP1 reducing mortality is certainly more understandable than just fish oil but they are expensive as heck & getting a large RCT would be difficult.
pubmed.ncbi.nlm.nih.gov/40526425/
pubmed.ncbi.nlm.nih.gov/40526425/
November 9, 2025 at 12:21 PM
I feel the same about this paper and presentation I saw at Obesity Week 2025. Mechanism with GLP1 reducing mortality is certainly more understandable than just fish oil but they are expensive as heck & getting a large RCT would be difficult.
pubmed.ncbi.nlm.nih.gov/40526425/
pubmed.ncbi.nlm.nih.gov/40526425/
On an opposite note of data can be pretty, Lilly posted this post hoc analysis of cardiovascular risk improvements by weight loss percentage from Surmount 1 and the incremental improvements as you lose weight is just pretty to see graphed out
November 9, 2025 at 11:18 AM
On an opposite note of data can be pretty, Lilly posted this post hoc analysis of cardiovascular risk improvements by weight loss percentage from Surmount 1 and the incremental improvements as you lose weight is just pretty to see graphed out
I want to believe.
No benefit from GLP1 meds for movement disorders, but in this retrospective cohort there *is* a clear signal for a possible dementia benefit?!
Maybe? Maybe? First RCT on this question should have topline data in the next month or two
No benefit from GLP1 meds for movement disorders, but in this retrospective cohort there *is* a clear signal for a possible dementia benefit?!
Maybe? Maybe? First RCT on this question should have topline data in the next month or two
November 8, 2025 at 12:31 PM
I want to believe.
No benefit from GLP1 meds for movement disorders, but in this retrospective cohort there *is* a clear signal for a possible dementia benefit?!
Maybe? Maybe? First RCT on this question should have topline data in the next month or two
No benefit from GLP1 meds for movement disorders, but in this retrospective cohort there *is* a clear signal for a possible dementia benefit?!
Maybe? Maybe? First RCT on this question should have topline data in the next month or two
Chattanooga Whiskey again with the amazing stuff.
Bourbon x Limecello.
It's like a sour key lime pie in a bottle in the best way. Great way for me and the wifey to relax after a long week for us both
Bourbon x Limecello.
It's like a sour key lime pie in a bottle in the best way. Great way for me and the wifey to relax after a long week for us both
November 8, 2025 at 12:15 AM
Chattanooga Whiskey again with the amazing stuff.
Bourbon x Limecello.
It's like a sour key lime pie in a bottle in the best way. Great way for me and the wifey to relax after a long week for us both
Bourbon x Limecello.
It's like a sour key lime pie in a bottle in the best way. Great way for me and the wifey to relax after a long week for us both
My GI tract could never handle those even tho a few of the flavors are good!
That being said at Obesity Week conference this week I had my visceral fat measured and uh, it barely exists. Only about 3 pounds of it out of 177lbs and normal skeletal muscle. 🔥🎉
(Visceral fat is extra bad for you)
That being said at Obesity Week conference this week I had my visceral fat measured and uh, it barely exists. Only about 3 pounds of it out of 177lbs and normal skeletal muscle. 🔥🎉
(Visceral fat is extra bad for you)
November 7, 2025 at 7:03 PM
My GI tract could never handle those even tho a few of the flavors are good!
That being said at Obesity Week conference this week I had my visceral fat measured and uh, it barely exists. Only about 3 pounds of it out of 177lbs and normal skeletal muscle. 🔥🎉
(Visceral fat is extra bad for you)
That being said at Obesity Week conference this week I had my visceral fat measured and uh, it barely exists. Only about 3 pounds of it out of 177lbs and normal skeletal muscle. 🔥🎉
(Visceral fat is extra bad for you)
Last day and literally the last lecture that I attended. Eli Lilly with Mazdutide(GLP1/Glucagon)Phase 2 dose finding study. 16mg dose is not viable. Too many side effects.
But the 10mg dose. Viable. Nearly 20% weight loss without plateau. 20% reduction in LDL cholesterol. Onward to phase 3 now.
But the 10mg dose. Viable. Nearly 20% weight loss without plateau. 20% reduction in LDL cholesterol. Onward to phase 3 now.
November 7, 2025 at 4:06 PM
Last day and literally the last lecture that I attended. Eli Lilly with Mazdutide(GLP1/Glucagon)Phase 2 dose finding study. 16mg dose is not viable. Too many side effects.
But the 10mg dose. Viable. Nearly 20% weight loss without plateau. 20% reduction in LDL cholesterol. Onward to phase 3 now.
But the 10mg dose. Viable. Nearly 20% weight loss without plateau. 20% reduction in LDL cholesterol. Onward to phase 3 now.
Last day in Atlanta and I'm about to treat myself with some pain au chocolat y'all
November 7, 2025 at 1:01 PM
Last day in Atlanta and I'm about to treat myself with some pain au chocolat y'all
The 3/6/9 group appears to be the ticket. No plateau at 48 weeks. Definitely lower AE/SE on slow titration. Nice reductions in hsCRP, glucose and insulin. Probably a good alternative to GLP1 meds
November 6, 2025 at 1:58 PM
The 3/6/9 group appears to be the ticket. No plateau at 48 weeks. Definitely lower AE/SE on slow titration. Nice reductions in hsCRP, glucose and insulin. Probably a good alternative to GLP1 meds
I will tease but yes. The low dose and slow titration had minimal GI side effects compared to GLP1 meds
November 6, 2025 at 1:47 PM
I will tease but yes. The low dose and slow titration had minimal GI side effects compared to GLP1 meds
*low whistle* 16-20% weight loss, no plateau at 48 weeks
I'd hate to be working for Novo Nordisk today 😳
I'd hate to be working for Novo Nordisk today 😳
November 6, 2025 at 12:49 PM
*low whistle* 16-20% weight loss, no plateau at 48 weeks
I'd hate to be working for Novo Nordisk today 😳
I'd hate to be working for Novo Nordisk today 😳
I'm here at obesity week and they're about to present this in 30 minutes. There's some concern with DC rate and AE/SE but modify the titration schedule and you've got yet another option. Also no plateau at 48 weeks(!!)
November 6, 2025 at 12:48 PM
I'm here at obesity week and they're about to present this in 30 minutes. There's some concern with DC rate and AE/SE but modify the titration schedule and you've got yet another option. Also no plateau at 48 weeks(!!)
Meanwhile I'm playing the zoom and enhance game on these "beautiful" renal tubules 😂
November 6, 2025 at 2:34 AM
Meanwhile I'm playing the zoom and enhance game on these "beautiful" renal tubules 😂
Me: I wonder why Lilly is running trials for orforglipron (oral GLP-1 med) for hypertension??
Sees this slide today at Obesity Week:
OH.
(that placebo reduction is presumably rescue therapy of prescribing traditional blood pressure meds) So yeah impressive reductions.
Sees this slide today at Obesity Week:
OH.
(that placebo reduction is presumably rescue therapy of prescribing traditional blood pressure meds) So yeah impressive reductions.
November 5, 2025 at 9:23 PM
Me: I wonder why Lilly is running trials for orforglipron (oral GLP-1 med) for hypertension??
Sees this slide today at Obesity Week:
OH.
(that placebo reduction is presumably rescue therapy of prescribing traditional blood pressure meds) So yeah impressive reductions.
Sees this slide today at Obesity Week:
OH.
(that placebo reduction is presumably rescue therapy of prescribing traditional blood pressure meds) So yeah impressive reductions.
Also. Some inflight reading for you. Glucagon agonism and resolving uric acid nephropathy!
November 5, 2025 at 8:21 PM
Also. Some inflight reading for you. Glucagon agonism and resolving uric acid nephropathy!
Ahhh PPAR-GAMMA is synergistic with GIP agonism! All my tirzepatide patients are about to get telmisartan!! Ahhh(sorry nerd moment I had to share, I've suspected this, but apparently it's true*)
*In mice (but should work in humans too)
*In mice (but should work in humans too)
November 5, 2025 at 7:18 PM
Ahhh PPAR-GAMMA is synergistic with GIP agonism! All my tirzepatide patients are about to get telmisartan!! Ahhh(sorry nerd moment I had to share, I've suspected this, but apparently it's true*)
*In mice (but should work in humans too)
*In mice (but should work in humans too)
Maybe it's the nerd in me but this display at the Lilly booth is mesmerizing. It's the 3D structure of all their cardiometabolic molecules in developments. Peptides, small molecules, MABs, and siRNA(the alien tentacles on the top left)
November 5, 2025 at 6:19 PM
Maybe it's the nerd in me but this display at the Lilly booth is mesmerizing. It's the 3D structure of all their cardiometabolic molecules in developments. Peptides, small molecules, MABs, and siRNA(the alien tentacles on the top left)
Just a call out to smart women helping the entire world.
This is Lotte Bjerre Knudsen.
She invented liraglutide and co-invented semaglutide.
She is one of the biggest reasons we have effective anti obesity medications. And her sense of style for this talk is 🤌
This is Lotte Bjerre Knudsen.
She invented liraglutide and co-invented semaglutide.
She is one of the biggest reasons we have effective anti obesity medications. And her sense of style for this talk is 🤌
November 5, 2025 at 2:23 PM
Just a call out to smart women helping the entire world.
This is Lotte Bjerre Knudsen.
She invented liraglutide and co-invented semaglutide.
She is one of the biggest reasons we have effective anti obesity medications. And her sense of style for this talk is 🤌
This is Lotte Bjerre Knudsen.
She invented liraglutide and co-invented semaglutide.
She is one of the biggest reasons we have effective anti obesity medications. And her sense of style for this talk is 🤌
Today's obesity week agenda! More kidney stuff! First talk is by someone who might win a Nobel prize one day(she led the development of liraglutide and then semaglutide, arguably without her we aren't talking GLP1 meds like we do now! Then kidney and CagriSema stuff!
November 5, 2025 at 12:40 PM
Today's obesity week agenda! More kidney stuff! First talk is by someone who might win a Nobel prize one day(she led the development of liraglutide and then semaglutide, arguably without her we aren't talking GLP1 meds like we do now! Then kidney and CagriSema stuff!
While there were a lot of cool displays at Obesity Week this one was really cool. 3D structures of all of Eli Lilly's cardiometabolic molecules in development. They slowly rotated(sorry didn't get video) but very cool to see the differences in small molecule vs peptide vs siRNA drugs
November 5, 2025 at 2:07 AM
While there were a lot of cool displays at Obesity Week this one was really cool. 3D structures of all of Eli Lilly's cardiometabolic molecules in development. They slowly rotated(sorry didn't get video) but very cool to see the differences in small molecule vs peptide vs siRNA drugs