diabetes,-weight-loss-drugs:-do-they-protect-heart,-vascular-health?
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Diabetes, weight-loss drugs: Do they protect heart, vascular health?

ByCorrie Pelc

Share on Pinterest Popular diabetes drugs have been linked with a lower risk of experiencing a second stroke or a heart attack. Image credit: andresr/Getty Images. About 12.2 million new strokes are diagnosed each year. One in four stroke survivors will experience another stroke. Stroke survivors are at an increased risk of developing major heart issues, such as heart attack. A new study says that type 2 diabetes medications GLP-1 agonists and SGLT2 inhibitors may help lower a stroke survivor’s risk of experiencing a subsequent stroke, heart attack, or death, compared to those who did not take these medications. According to the World Stroke Association , one in four adults over the age of 25 will have a stroke during their lifetime, and there are about 12.2 million new strokes diagnosed each year. Previous research shows that one in four stroke survivors will experience another stroke, and people who have a stroke are at a higher risk of developing major heart issues during the first month after their stroke, such as heart attack — clinically known as myocardial infarction. Past studies show that stroke survivors can possibly decrease their secondary stroke and heart attack risk through lifestyle changes — such as moving more, eating a healthy diet, and not smoking — and medications. For this study, researchers analyzed medical data for more than 7,000 adults who had an ischemic stroke — the most common type of stroke caused by a blood clot in the artery that brings blood to the brain — between January 2000 and June 2022. Researchers looked at whether or not study participants had been prescribed either a GLP-1 agonist or SGLT2 inhibitor medication after their initial stroke. “GLP-1 receptor agonists and SGLT2 inhibitors are two types of medications often used to help people with diabetes manage their blood sugar,” M. Ali Sheffeh, MD, an internal medicine resident at the Henry Ford Medical Center in Warren, MI, research scholar in the Cardiovascular Department at the Mayo Clinic in Rochester, MN, and lead author of this study explained to Medical News Today. “They also have benefits for heart and kidney health, which has led to their use in patients with certain heart conditions or those at risk of cardiovascular disease,” Sheffeh continued. “These drug classes have been studied over the last few years in randomized clinical trials and have shown better cardiovascular outcomes in patients with obesity, diabetes, heart failure, and chronic kidney disease,“ he added. After an average follow-up of three years, Sheffeh and his team found that stroke survivor participants taking either a GLP-1 or SGLT2 medication had a 74% lower mortality risk and 84% lower risk of having a heart attack, compared to those not taking these drugs. And participants taking either medication also had a decreased risk of experiencing a secondary stroke, compared to those not taking them. “The current guideline for stroke prevention recommends the use of blood thinners, controlling blood pressure, and cholesterol lowering medication in addition to lifestyle modification in order to decrease the risk of a second stroke,” said Sheffeh. “If our findings are externally validated, that might lead to changing practice and we might start prescribing these medications for patients with stroke to prevent future events,” he pointed out. After reviewing this study, Sandra Narayanan, MD, a board-certified vascular neurologist and neurointerventional surgeon, of the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in this research, told MNT that she was surprised at powerful the positive response was for both agents to reduce the likelihood of achieving the composite endpoint — mortality, heart attack, or recurrent ischemic stroke. “Two major barriers stroke and myocardial infarction patients struggle with are compliance and education,” she continued. Furthermore, “survey-type research addressing prescribing practices might be informative to assess knowledge among prescribers — internists, family physicians, endocrinologists, and stroke neurologists — before and after dissemination of disease-specific studies,” said Narayanan. MNT also spoke with Mir Ali, MD, a board certified general surgeon, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, about this study. “I thought it was an interesting study showing another benefit of these medications, so it’s always good to see medications that are helping,” Ali said. As this study showed a potential benefit of these medications, Ali said it was hard to determine at this point how might GLP-1 and SGLT2 medications be positively impacting the heart. “It would be interesting to see how this is helping patients — if it is an independent effect of just the medication itself, or is it secondary to weight loss or better for glucose control,” he added. “A study designed to kind of tease out these details would be helpful.”

medicare-2025-plans:-5-key-changes-to-part-d,-medicare-advantage-costs
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Medicare 2025 plans 5 key changes to Part D, Medicare Advantage costs

ByCorrie Pelc

Share on Pinterest Big changes to Medicare plans are in store for 2025 as open enrollment is underway. Joe Raedle/Getty Images Medicare is a federal health insurance program for older adults ages 65 and older. Open enrollment for 2025 Medicare plans runs through December 7. Some major changes in 2025 include a new $2,000 out-of-pocket max under Part D, eliminating the plan’s “donut hole” coverage gap, and fewer Medicare Advantage plans. As of January 1st, five big changes will take effect for Medicare — a federal health insurance program for adults ages 65 and older. Every year, senior adults have between October 15th through December 7th to enroll in Medicare or change plans. Part A helps to cover inpatient care in hospitals, skilled nursing facilities, and home health care. Part B is for outpatient coverage, such as diagnosing and treating an illness at the doctor’s office, as well as preventive services, such as vaccines and wellness visits. Part C —also known as the Medicare Advantage plan—is bundled coverage that includes Parts A, B, and sometimes D. Part D provides coverage for prescription medications Medical News Today spoke with three Medicare experts to learn more about the biggest changes coming in 2025 and how they may impact readers. Starting January 1st, there will be fewer Medicare Advantage plans available. “Medicare Advantage Plans are the alternative to receiving their Medicare through Original Medicare,” said Ryan Ramsey, associate director of health coverage and benefits for the National Council on Aging. “These plans are offered by Medicare-approved private companies that must follow rules set by Medicare and provide Medicare Part A (hospital insurance) and Part B (medical insurance) coverage, as well including drug coverage (Part D) in most cases, all under one plan,” Ramsey told MNT. “In most cases, you’ll need to use health care providers who participate in the plan’s network; however, some plans offer non-emergency coverage out-of-network, but typically at a higher cost,” he continued. “These plans may also offer additional extra benefits like vision, dental or fitness and wellness benefits that are not covered by Medicare.” “The number of Medicare Advantage plans that will be available to the average person is expected to decrease by 7%,” Ramsey added. “This may result in less additional benefits being offered, smaller networks within plans, and an increase in overall out-of-pocket costs. However, the number of plans available in 2025 is still in the top three largest since 2010.” Starting on January 1st, a new approach to Medicare Part D will remove the infamous “donut hole” and establish a new hard limit of $2,000 per year for out-of-pocket Part D drug spending. “The Inflation Reduction Act aims to improve Medicare benefits by reducing out-of-pocket costs for prescription drugs,” Kanwar Kelley, MD, JD, co-founder and CEO of Side Health explained to Medical News Today. “This is being done by shrinking the ‘donut hole’ for prescription drug coverage. The ‘donut hole’ refers to the gap between a plan’s initial prescription medication coverage by co-payment or coinsurance and the time when a person meets catastrophic coverage limits where Medicare resumes sharing costs. “While inside of the ‘donut hole,’ an individual must pay for their medications entirely out of pocket. Starting in 2025, the out-of-pocket costs before reaching the catastrophic stage will be capped at $2,000. Until now the limits were set at $8,000. This will mean substantial savings for patients who depend on costly prescription medications.” Another 2025 change impacting Medicare Part D is an anticipated base premium increase. “The Centers for Medicare and Medicaid Services (CMS) has now capped the amount companies are allowed to increase their annual premiums at 6%,” Ramsey noted. “The base beneficiary premium will be $36.78, which is $2.08 more than 2024 and the maximum of a 6% increase.” According to Tim Smolen, Statewide Health Insurance Benefits Advisors (SHIBA) program manager in the Consumer Protection Division of the Washington State Office of the Insurance Commissioner, said the best way to learn more about Part D base premium increases is to use the plan finder tool on the Medicare website. Smolen added: “Broad ranges and base premiums are useful guidelines, but every person’s experience is different. Each person should check their own drugs and pharmacies. It’s possible that each person in a couple might have a different Part D plan.” There will also be a reduction in the number of stand-alone Medicare Part D plans available, according to KFF, a nonprofit focused on health policy. “In 2025, 524 PDPs (Prescription Drug Plans) will be offered across the 34 PDP regions nationwide which is a 26% decrease from 2024,” Ramsey said. “This means that the average beneficiary in each state will have a choice of at least 12 stand-alone drug plans. This could mean a change in formularies, pharmacy networks on plans, and whether your plan has a deductible in 2025.” “There will be a reduction in prescription drug plans under Part D, but this reduction may streamline options in favor of more plans with the built-in price stabilization feature,” Kelley said. “So, though fewer plans will be available, they should be more cost-effective.” And the last big change affecting Medicare in 2025 is an expansion of mental health care and caregiver resources. “Elder care is a huge source of financial burden and stress on families,” Kelley said. “Additional financial support will help reduce that burden and give back time to those looking for caretakers