Staying #Up2Date 🚨

1: Myo-Inositol Doesn’t Pay Off in PCOS Pregnancies

A randomized controlled trial (RCT) of 464 pregnant women with polycystic ovary syndrome (PCOS) examined whether myo-inositol could reduce complications such as gestational diabetes, preeclampsia, or preterm birth. Although the supplement is often recommended to improve insulin sensitivity and glycemic control in PCOS, the trial showed no meaningful benefit: daily myo-inositol during pregnancy didn’t lower the risk of gestational diabetes, preeclampsia, or preterm birth.

2: Automated Insulin Delivery Improves Blood Sugar Control in Kids with Type 1 Diabetes

A systematic review and meta-analysis covering 11 pediatric trials evaluated automated insulin delivery (AID) systems in children and young adults with Type 1 diabetes. The research found that AIDs — which titrate insulin based on real-time glucose levels — produced clinically meaningful improvements in glucose management compared with any other insulin regimen. Participants using AIDs saw reductions in HbA1c and spent less time in hypo-or hyperglycemia, and there was no increase in adverse events. Researchers note that future studies should explore how these systems affect quality of life.

3: Elinzanetant Cools Down Hot Flashes in Menopause Trial 

In a RCT of 628 postmenopausal women, elinzanetant — a new non-hormonal therapy — significantly reduced vasomotor symptoms. By week 12, the average daily change from baseline in hot-flash frequency was −5.4 (95% CI, −6.3 to −4.5) with elinzanetant versus −3.5 (95% CI, −4.1 to −2.9) with placebo. Over 52 weeks, the oral therapy also reduced sleep disturbances and improved menopause-related quality of life. These findings suggest elinzanetant could become an important option for managing hot flashes.

Doctor hours, on your terms 🧑‍⚕️

Looking to rethink what remote practice can look like?

Think Research is hiring Primary Care Physicians to join us remotely, using the award-winning VirtualCare™ platform. Expect flexible hours and full admin and clinical support, delivered from wherever you are in Canada.

You’ll see patients via video, audio, or secure chat, manage diagnoses, prescriptions, labs, and referrals — all digitally. Work alongside a team innovating how care gets delivered, while making an impact on patient access.

Who fits? MDs with a Canadian licence and CCFP certification, comfortable with digital tools, and motivated to improve care without drowning in admin.

👉 Interested? See full job & apply here: Think Research Job Opportunity

Diabetes Undetected: A Diagnosis Crisis 🩸

Diabetes is surging worldwide while often going undetected, experts warn.

What happened: About 1 in 9 people across the globe have diabetes, yet nearly half don’t know it, a major new study finds.

Why it matters: The study looked at data from over 200 countries between 2000 and 2023, finding a major gap in diabetes detection. Limited access to healthcare, particularly primary care, is a key factor in why so many cases go unnoticed.

The research shows that young people are far less likely to be diagnosed, with only about 20% aware they have the condition. Meanwhile, a 2024 CMAJ article reports that Type 2 diabetes is rising rapidly among those aged 20 to 29. Screening is still routine for adults 35 and older every 3 years, but some experts now question whether younger adults should be checked more often.

One doctor interviewed by Global News recommended that healthcare providers rely on their clinical judgment when screening younger patients and watch for “yellow flags.” These warning signs include a strong family history of diabetes and excess weight around the abdomen or face.

Because diabetes can develop quietly, recognizing risk factors early is crucial. The disease is often silent for the first 5 years, and if left untreated, it can lead to kidney and heart problems, as well as nerve damage that may result in amputation. Despite the recommended screening age, Diabetes Canada encourages people to advocate for earlier testing if they have concerns.

Bottom line: Diabetes often hides in plain sight, especially in younger adults. Keep an eye out for red and yellow flags, and don’t delay testing when they line up.

Hot Off The Press

1: 🌐 A UN inquiry has delivered its toughest verdict yet on Gaza, accusing Israel of genocide and pointing to leaders’ own words alongside months of bombardment as evidence of intent. Israel called the report “distorted and false,” even as its forces rolled into Gaza City under heavy fire, killing dozens more civilians. For governments still supplying arms or aid, the findings crank up the pressure, and could shape how future courts weigh responsibility.

2: 🍫 Just in time to ruin the fun of your Halloween-size-size Coffee Crisp: a new AHA advisory, reported in JAMA, warns that ultra-processed foods may harm cardiometabolic health — not just from sugar, salt, and fat, but also from additives, altered food structure, and chemicals from packaging. The authors are calling for stronger science and policy. If evidence keeps piling, your Coffee Crisp could wind up behind glass with the smokes 🙃.

3: 🧾 Starting Oct. 1, Canadians who fess up to past tax missteps can get steeper breaks — up to 75% off interest and full penalty forgiveness — under a revamped CRA program. The agency says the forms are simpler, the language plainer, and even people who’ve already received warning letters may qualify. Late disclosures still get some relief, just a bit less. Ottawa’s betting the friendlier approach will bring more taxpayers in from the cold, and cut down on audits and backlogs.

4: 📊 Research ethics boards from Ottawa to Boston to Milan have found a shortcut around formal reviews: they’re letting AI projects use “synthetic” records based on real patient data. According to Nature, they’re skipping their usual oversight in hopes of faster development of diagnostic tools and decision aids. Critics are wary, warning that any flaws or bias hidden in those faux charts could quietly shape diagnoses and treatments, putting patients at risk before anyone spots the problem.

Quick Consult 🧠

Jim Dahle, the physician behind The White Coat Investor, has made a career of helping doctors hold on to more of their hard-earned money. We picked his brain about what it really takes for physicians to retire well and stay financially independent.

What is financial independence?

It’s having enough money to support your lifestyle for life without working. Typically, this means around 25× your annual expenses — so if you spend $100,000 a year, you’d need about $2.5 million; if $200,000, about $5 million.

Has the idea of financial independence for doctors changed in the past decade? 

There is probably a little more interest among docs about financial independence, partly thanks to resources like The White Coat Investor and partly because burnout is higher than ever. Much of that burnout stems from more doctors working as employees rather than owning their practices.

What’s the one money habit that pays off most over a career?

Spend significantly less than you earn. Many doctors spend their entire $300K–$500K income and put nothing away for retirement. 25% of doctors aren't even millionaires at the end of their career, despite earning $10M dollars during their career. We recommend calculating a "savings rate" each year, how much you put toward retirement divided by your total income. If you can get that into the 20% range, you should be able to maintain your chosen standard of living during your retirement years. 

What’s the biggest money mistake doctors make?

A common mistake that doctors make is collecting investments. If your portfolio includes 40 individual stocks, 25 mutual funds, some crypto assets, a few real estate partnerships, a rental property, a whole life insurance policy or two, and a box of Beanie Babies you're probably doing this wrong. You can be a successful, sophisticated investor while owning less than a handful of low-cost, broadly diversified index funds. 

What’s the first money move every doctor should make?

Start by figuring out where you stand. Calculate your income, expenses, assets, and debts to determine your net worth — and check last year’s savings rate. Until you know your numbers, it’s hard to know what changes to make. Investing is a single-player game. You don't need to beat anyone else to win.

Notable Numbers 🔢

95%: of US beers tested contained PFAS, the persistent forever chemicals, according to a recent study. Levels were highest where tap water is already contaminated, proof that local pollution can wind up in everyday places like your pint.

$500 million: Canada’s priciest bread-winning settlement to date. If you bought packaged bread between 2001 and 2021, you might be able to claim your slice of the loaf.

80.51 metres: the distance of Camryn Rogers’s hammer-throw at the World Athletics Championships in Tokyo, a Canadian record and gold medal, landing just shy of the world record of 82.98 metres.

Postcall Picks ✅

📖 Read: this editorial in The Guardian on the fallout from Charlie Kirk’s assassination… and how it could dial up political polarization. 

😄 Laugh: because the uniform may stay the same, but the chaos never stops improvising:

🤑 Save: on your boos and boo-adjacent decor with Michael’s Halloween sale.

👂 Listen: to the newest episode of The Canadian Real Estate Investor and learn what it really takes to be a millionaire in Canada.

🍷 Drink: these 8 distinctive sauvignon blancs that shine with dinner — and perhaps the casual fridge raid.

Relax

First clue: Digestive _____, ~9 meters long in humans and ~45 meters in cows

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your physician friends to beat your time.

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