Staying #Up2Date 🚨

1. Glycosylated hemoglobin (HbA1c) accuracy

In this prospective substudy of 1500 participants, correlations between HbA1c level and average glucose were significantly different in non-Hispanic black participants than in other racial or ethnic groups. Across average glucose values ranging from 100 to 250 mg/dL, HbA1c results were higher in non-Hispanic Black participants than in non-Hispanic white participants by 0.2 to 0.6 percentage points. This may have implications for over-diagnosis/treatment of some non-Hispanic Black patients. 

2. Vitamin D stands for Don’t

The Endocrine Society published updated Vit D supplementation guidelines in 2024, saying that there is no clear benefit from supplementation in asymptomatic individuals with low levels, except in those aged 1-18, pregnant individuals, etc. Routine supplementation is also discouraged, except in pregnant individuals, the elderly (≥75), and those with high-risk prediabetes. Daily dosing of 1000 IU is suggested in older adults. The guidelines emphasize low daily doses over high intermittent doses and advocate for fortified foods or supplements.

3. Testosterone supplementation: yay or nay

In the TRAVERSE trial , 5,200 middle-aged and older men with low testosterone levels <300 ng/dL received testosterone gel or placebo. Since then, several sub-studies showed that testosterone supplementation only modestly improved libido and mood, whereas higher rates of fractures have been reported. Overall, these findings argue against providing testosterone supplementation for age-related testosterone decline.

Robo-Kids 🦿

How new exoskeleton technology is giving kids a leg up

What happened: A Canadian-made exoskeleton is giving kids with health challenges the ability to walk. 

Why it’s interesting: Trexo Robotics, a Mississauga-based company founded in 2016, developed robotic legs designed to help children with mobility issues walk, exercise, and play. Built around an external walker frame, it works by attaching the exoskeleton to the patient's legs, allowing them to exercise and build strength. In November 2024, Trexo celebrated a major milestone: Canadians have taken over 100 million assisted steps using the exoskeleton tech.

The device has been a game changer for children with conditions like cerebral palsy, spinal muscular atrophy, and brain injuries. One family from BC said it supports their child’s torso and helps him lift his legs during physiotherapy. 

But: There’s a catch – a big one. The exoskeleton costs $40,000 and isn’t covered by public health insurance. For many families, that’s a huge financial hurdle.

Some families have turned to social media in hopes of raising funds – the quicker, the better. For children with cerebral palsy, experts say walking must be learned by age 6 or 7, or it’s unlikely they ever will. Early support makes a huge difference: the more children move when they’re young, the more mobile they’ll be as adults.

About 85 children use the exoskeleton, with most families travelling great distances to access it. The Trexo Robotics team is aware of the high cost – one of their employees relied on fundraising to afford the device. 

Bottom line: Despite the high cost, families are determined to make it work. Many families said that, when it comes to their kids’ future, they won’t let a price tag stop them. 

Hot Off The Press

1: 🇨🇦 Trudeau’s resignation has set off a political chain reaction: rivals like Poilievre and Singh were quick to slam his record, while others offered polite thanks and well-wishes. Nobody has officially raised their hand to bid for the top job, but former finance minister Chrystia Freeland and former Bank of Canada governor Mark Carney are rumoured to be in talks. See below for what’s happening with the capital gains tax as a result of prorogation of Parliament.

2: 👁️ Childhood myopia rates have tripled since 1990, and projections suggest over 740 million cases by 2050. A review of 276 studies links this rise to more screen time and less outdoor activity, trends worsened by the pandemic. Even one extra hour outside per week could reduce a child’s risk by 14% — a simple intervention worth recommending.

3: 😷 Whooping cough is making a comeback in Canada, with cases increasing across multiple provinces, including Ontario, Quebec, and New Brunswick. Cases of pertussis hit record lows during the pandemic, but now they’re surpassed pre-pandemic numbers — with over 19,000 reported this year. Experts say the increase is partly due to delays in childhood vaccinations, and warn that it can be especially dangerous for babies if untreated.

4: 🥂 Apologies if this gives you New Year’s Day flashbacks — the results are in, and it turns out alcohol isn’t great for us. In a recent University of Washington study, there’s a surprising twist: alcohol’s social effects might be all in our heads. Researchers found that students who thought they were drinking alcohol showed just as much social interaction as those who actually drank, while those unaware they were drinking alcohol remained subdued. So, the “social magic” of alcohol may have more to do with expectation than chemistry.

Notable Numbers 🔢

37,500: the number of NIH principal investigators in the US who can now double-check their work. This replication initiative, supported by Congress, offers up to $50,000 to researchers to validate studies with big health potential (think testing a heart drug on mice) to see if the results hold up. So far, interest is pretty lackluster, but the NIH hopes this experiment-experiment will pave the way for more reliable science. One catch? The results aren’t public.

1 year: how long Brigitte Cleroux worked as an unlicensed nurse at BC Women's Hospital before getting caught. After treating hundreds of patients with forged credentials, she was sentenced to 7 years in prison for impersonating a nurse, fraud, theft, assault, and more. Cleroux’s crimes span multiple provinces, so her sentencing in BC is adding to her current prison term — without much hope for rehabilitation.

1494: the year syphilis debuted in Europe, sparking centuries of blame games and mysteries about its origins. A new Nature study digs deep (literally) into ancient DNA from pre-Columbian skeletons in the Americas, and suggests that syphilis-causing bacteria were already thriving there before Columbus set sail. The findings also suggest that the disease only became sexually transmitted around the time of European contact.

Mar 24: the date that Parliament will return to session. Until then, the CRA will be continuing to administer the capital gains tax inclusion rate changes (from 50% to 66%). Our suggestion: pay the higher capital gains taxes, which will be refunded if legislation doesn’t pass.*

*not financial advice, talk to a professional

Postcall Picks

🧠 Overcome: “complexity aversion” as you start 2025, which CNBC says is the biggest barrier most people face when building wealth. If you haven’t already, check out this Postcall guide to managing your first $100K.

🛻 Buy: that crazy shiny car you’ve been noticing on the road — Cybertruck deposits have been lowered to $250 CAD.

💪 Fitness: is a goal this year? Here are the trends that experts hate (courtesy of The New York Times).

💊 Prescribe: outdoor time to your vitamin D-deficient patients with the PaRx program. (They get a Parks Canada Discovery Pass.) Instructions here.

🪙 Crypto: interested, but don’t want to get scammed either? A promising application of cryptocurrencies that might become more mainstream in 2025 is stablecoins. (Here is a quick primer ⬇️)

🤣 Laugh: at the service that doesn’t talk about boneless organs:

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