Most people think pre-diabetes is just a waiting room for Type 2 diabetes — something you manage, not something you fix. Turns out, that thinking is out of date.Brand new data published in one of medicine's most respected journals shows that people who reversed their pre-diabetes had about half the rate of heart attacks, heart failure, and cardiovascular death over the following decades. In this episode:Episode Highlights- Pre-diabetes can be fully reversed in most people- Reversal cuts heart disease risk by nearly 50%- Just 5–7% weight loss reverses it in 4 in 10 people- Trained muscles pull sugar from blood more efficiently- Where you store fat matters more than how muchChapters:0:00 Intro0:39 What is pre-diabetes?1:17 Key studies2:03 Results: 50–60% lower heart risk2:56 Weight loss3:20 Strength training3:39 Body fat distribution4:15 GLP-1 medications4:46 RecapStudies & Resources:The Lancet Diabetes and Endocrinology (2026) — re-analysis of two decades-long trials showing cardiovascular benefits of pre-diabetes reversalNature Medicine (2025) — found that reducing visceral fat (even without weight loss) reversed pre-diabetes in about 1 in 5 peopleDPP-OS (Diabetes Prevention Program Outcomes Study)Da Qing Diabetes Prevention StudyIf this was useful, subscribing is the best way to support the channel and help it reach more people.Listen & Follow:Spotify: https://podcasters.spotify.com/pod/show/sterlingmdphd/Apple Podcasts: https://apple.co/3y438C9Social & Website:Instagram: https://www.instagram.com/sterlingmdphdX: https://x.com/sterlingmdphdFacebook: facebook.com/sterlingmdphdNewsletter: http://eepurl.com/hQpdqTReferences & Show Notes: http://www.nicksterling.com/Disclaimer:This content is not medical advice, is for general information purposes only, and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.

In this episode, we cover why early atherosclerosis is essentially universal by young adulthood and tests that tell us about cardiovascular risk—beyond a standard lipid panel. We walk through ApoB (and why it can outperform LDL-C in some circumstances), Lp(a) and the case for checking it at least once, inflammation markers like hs-CRP and GlycA, the triglyceride–HDL relationship and TG/HDL ratio, omega-3:omega-6 balance (including an important atrial fibrillation caveat), blood pressure and endothelial stress, plus quick thoughts on homocysteine and coronary calcium scoring.Chapters:00:00 — Why almost everyone has early plaque00:01:01 — ApoB explained 00:02:12 — ApoB vs LDL-C: discordance00:02:38 — Lp(a)00:04:34 — Inflammation: hs-CRP & GlycA00:05:44 — Triglycerides & HDL00:07:19 — Omega-3:6 ratio & Atrial Fibrillation caution00:08:14 — Blood pressure & endothelial stress00:10:03 — Homocysteine & CACSpotify Channel:https://podcasters.spotify.com/pod/show/sterlingmdphd/Social & Website:Instagram - https://www.instagram.com/sterlingmdphdX - https://x.com/sterlingmdphdFacebook - / sterlingmdphdNewsletter - http://eepurl.com/hQpdqTApple Podcasts: https://apple.co/3y438C9References & Show Notes:http://www.nicksterling.com/This content is not medical advice, is for general information purposes only and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.

Scientific knowledge of the gut microbiome has increased exponentially over the last decade. Recently, several studies have suggested that specific strains of bacteria, including Akkermansia muciniphila, are key to supporting the environmental conditions required for other related bacterial strains that facilitate healthy metabolic health. In this video, Colleen Cutcliffe, PhD, co-founder and CEO of Pendulum discusses groundbreaking research around Akkermansia mucinophila, the role of short-chain fatty acids (SCFAs) in stimulating GLP-1 pathways, implications for diabetes management, and how gut bacteria influence inflammation, gut integrity, and overall metabolic health. They also explore how diet, antibiotics, and stress impact the microbiome, potential roles of probiotics in inflammatory bowel disease (IBD), pediatric gut health, and exciting emerging research on the gut-brain axis and neurological conditions like Parkinson's disease. Colleen highlights Pendulum's rigorous scientific approach, including clinical trials and innovative manufacturing practices that ensure product viability and effectiveness.

Promotional code STERLING20 can be applied for 20% off of first membership purchases (https://pendulumlife.com). Please note that Dr. Sterling has no financial affiliation with Pendulum. This code is provided only as a discount to listeners and does not constitute a clinical recommendation or medical advice.

Chapters:

- 00:00 Intro: Gut Microbiome Essentials

- 02:03 Pendulum's Biotech Innovation

- 06:15 GLP-1 & Metabolic Health

- 09:59 Probiotic Industry Insights

- 17:17 Importance of Akkermansia

- 24:17 Clinical Results for Diabetes

- 29:28 Manufacturing Challenges

- 39:13 Diet's Impact on Microbiome

- 43:35 Gut-Brain Connection

- 46:50 Next Steps & Resources

Spotify Channel:

https://podcasters.spotify.com/pod/show/sterlingmdphd/

Social & Website:

Instagram -   https://www.instagram.com/sterlingmdphd

X -   https://x.com/sterlingmdphd

Newsletter - http://eepurl.com/hQpdqT

Apple Podcasts: https://apple.co/3y438C9

References & Show Notes:

http://www.nicksterling.com/

This content is not medical advice, is for general information purposes only and does not constitute the practice of medicine or any other healthcare professional services.  No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.

What are some common side effects of medications like Ozempic and Wegovy? From the front lines of healthcare, we explore adverse effects of these medications based on real-world visits to the emergency department. Learn about common side effects such as nausea, dehydration, and muscle wasting, as well as lesser-known risks like starvation ketosis and mood changes.

In this episode, we explore how ketamine, a dissociative anesthetic with a long history in medical use, is now being investigated for its rapid and sustained effects on depression, anxiety, and PTSD. We discuss its role in promoting neuroplasticity—rewiring the brain's structure to counteract stress-induced atrophy—and review the evidence from clinical trials, including a landmark 2023 meta-analysis. While ketamine shows promise in alleviating depressive symptoms and supporting neural growth, we also address its risks and the importance of professional oversight. Learn how this cutting-edge research is reshaping mental health treatment and what it means for the future of therapy.

In this episode, we talk about a recent study from Nature Aging that suggests aging may not progress in a straight line. Using data from thousands of biological measurements, researchers identified key ages—44 and 60—where changes in aging appear to accelerate. We review what this means for our understanding of aging, how it affects multiple systems in the body, and the potential implications for health and disease. We also discuss what this study tells us—and doesn’t tell us—about the biology of aging and how it could guide future research.

Instagram - https://www.instagram.com/sterlingmdphd

Twitter - https://x.com/sterlingmdphd

Newsletter - http://eepurl.com/hQpdqT

Apple Podcasts: https://apple.co/3y438C9

References & Show Notes: http://www.nicksterling.com/

The content of this podcast is not medical advice, is for general information purposes only, and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. The content of this podcast is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit nicksterling.com/terms for full Terms of Use.