Arch Intern Med 25 Jun 2007 Vol 167

Here is a cohort study suggesting that older women who take serotonin reuptake inhibitors show double the rate of hip bone loss compared with those who take tricyclic antidepressants.
The same appears to apply to older men, and the loss of vertebral bone is even greater. So much for the chalky end-points: now we need some hard ones. Someone needs to collect figures on fracture rates. In the mean time, be aware of this possibly significant drawback to such drugs, particularly in frail old ladies (see editorial).

Do sex hormones help men live longer? The straightforward answer from the Massachusetts Male Aging Study is no. They may in fact tend to make men die sooner, mainly as a result of a small increase in ischaemic heart disease and respiratory disease in the highest centiles of free testosterone.

I’ve never been to Canada, but perhaps plate sizes there are similar to those in the USA, i.e. gross and obesogenic, like the food placed on them. This Canadian trial simply gave obese patients with type 2 diabetes smaller plates to eat off: they lost weight and many needed less medication.

This trial gives a rather untimely plug for rosiglitazone at low dosage, combined with insulin therapy in type 2 diabetes. It reduced HbA1c by 0.3% without short-term ill-effects, but it’s not a strategy that could possibly be recommended until someone has crunched more numbers about these drugs and cardiovascular risk.