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David W (aka Flex NP)

@rnflex.bsky.social

495 Following3k Followers

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, thoughts my own not my employers

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@rnflex.bsky.socialOct 12, 2026, 1:56 PM

The parade of new diabetes results continues on. This time it's Survodutide in diabetes. At first blush, the results seem modest but a closer examination reveals some very compelling metabolic benefits, plus another call to end placebo controlled trials for GLP1 meds. Read and share!

@rnflex.bsky.socialOct 12, 2026, 12:11 AM

They don't need it! The egg makes them swell up when dropped in the boiling soup

@rnflex.bsky.socialOct 12, 2026, 12:01 AM

6-8 tablespoons of melted butter, 4 eggs, 3 cups of flours, 1 cup whole milk. Salt and pepper to taste(usually about 1 tsp of each) Mix well until a thick sticky dough forms. Let stand for 30 minutes. Add to hot soup with scooping with a spoon one at a time.

@rnflex.bsky.socialOct 11, 2026, 11:26 PM

For the dumplings?!

@rnflex.bsky.socialOct 11, 2026, 10:42 PM

404 Not Found: GLP1 meds not mentioned as adjunctive hypertensive meds. Cuz they are. Especially if your BP is uncontrolled to start.

@rnflex.bsky.socialOct 11, 2026, 9:03 PM

19 month old took a bite of these dumplings(recipe is wife's family Hungarian butter dumplings) Anyways. 19 month old looked like she saw God after that first bite. Devoured 3 more in rapid succession. Wish I'd have videoed it 😅

@rnflex.bsky.socialOct 11, 2026, 6:15 PM

60 and rainy calls for homemade chicken and dumpling soup from scratch.

@rnflex.bsky.socialOct 11, 2026, 2:40 PM

Maybe they'll restart production now!

@rnflex.bsky.socialOct 11, 2026, 10:42 AM

Many of the OG antidepressants and anti psychotics came about from research into allergy medicine, specifically anti histamines. Also those original antipsychotics can also prevent nausea and vomiting. The human body is weird. Pushing random buttons indeed especially back in the 1940s/50s

@rnflex.bsky.socialOct 11, 2026, 9:33 AM

Fun fact now we have Type II jak2 inhibitors in development. Even more selective than what's currently available

(Of course it's an Eli Lilly drug)

assets.ctfassets.net/cuupgdmwy210...

@rnflex.bsky.socialOct 11, 2026, 9:21 AM

The opposite is true for some drug research. GLP1 was a tantalizing target for like 2 decades before we figured out a med for it. KRAS mutations in cancer are another. Sometimes we know a target but drugging it is extremely difficult!

@rnflex.bsky.socialOct 11, 2026, 9:19 AM

Many of the OG antidepressants and anti psychotics came about from research into allergy medicine, specifically anti histamines. Also those original antipsychotics can also prevent nausea and vomiting. The human body is weird.

@rnflex.bsky.socialOct 10, 2026, 8:40 PM

Oof. That's wild. Rosuvastatin is like 7 cents a pill up here. Usually about 7 USD for a 90 day supply even without insurance.

@rnflex.bsky.socialOct 10, 2026, 7:39 PM

Other one is someone like me. Familial hypercholesterolemia that fails on statins. Statins give me rhabdomyolysis. Or just pure familial hypercholesterolemia for Repatha for example

@rnflex.bsky.socialOct 10, 2026, 7:17 PM

For high risk cardiac patient such as DM2 + prior MI and not at LDL goal with statin + ezetimibe

@rnflex.bsky.socialOct 10, 2026, 12:04 PM

Oh man. Yes yes please. Between BCBS and Hap the insurance plans here are awful. Hap especially denies standard of care stuff ALL the time like GLP1 meds for diabetics or PCSK9I for cardiac patients and on and on

@rnflex.bsky.socialOct 9, 2026, 10:48 PM

When are you going to do more Scishow episodes on GLP1 meds?

I can help cowrite/research because I do a whole blog about it!

the-incretins.beehiiv.com

@rnflex.bsky.socialOct 9, 2026, 10:47 PM

Apparently this is your 40s. Buy fancy French door air fryer/rotisserie/toaster/do it all small appliance. Or maybe it's the 2 small children who demand hot food quickly and this is faster than a full size oven 🙈🤷

@rnflex.bsky.socialOct 9, 2026, 7:07 PM

Well sure but also! Its at least an incremental step towards understanding how obesity and autoimmune diseases are linked. Nerdy me does love that part

@rnflex.bsky.socialOct 9, 2026, 6:45 PM

And even if a drug is on formulary we'll refuse to cover it. Oh and anesthesia charges don't count towards your out of pocket maximum and and and

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