Could Liver-Targeted Insulin Be the Future of Type 1 Diabetes Care? by April Hopcroft for diaTribe.org, 13 November 2023.
Dr. Jeremy Pettus, associate professor of medicine at UC San Diego Health who also has type 1 diabetes, is leading research on insulin that acts directly on the liver. Researchers believe that liver-targeted insulin could better mimic the hormone’s natural action, helping people with diabetes improve glucose control and overall health outcomes.
Simply put, liver-targeted insulin is needed because the insulin injected subcutaneously isn’t a perfect copy of the hormone produced naturally in the body. When you inject insulin into your skin, your body absorbs it slowly. This leads to low amounts in the liver and islet cells of the pancreas, and high amounts of insulin circulating in the bloodstream and in other tissues.
“This is exactly the opposite of normal physiology where concentrations are highest in the islets, then liver, then the periphery,” Pettus said. As a result of low insulin in the liver, the organ releases excess glucose, resulting in high blood sugar. “This is particularly problematic after meals,” Pettus said. “As anyone with type 1 will tell you, controlling the ‘spike’ after meals is almost impossible. This is largely due to our inferior way of delivering insulin.”
The company Diasome is investigating a novel technology to deliver insulin directly to the liver. Diasome’s approach, which is not yet approved by the FDA, involves attaching small molecules to insulin to direct it specifically to the liver in an attempt to mimic normal physiology. The technology has been designed to be used with any commercially available insulin and any delivery option, including pump systems.
Relieving stress in insulin-producing cells protects against type 1 diabetes by Chris Barncard for MedicalXPress.com, 10 November 2023.
Removing a gene that manages stress within insulin-producing beta cells draws helpful attention from the immune system, protecting mice predisposed to type 1 diabetes from developing the disease, a new University of Wisconsin–Madison study shows. The study also found that changes discovered in the modified mouse beta cells are also present in human beta cells that manage to survive the widespread beta-cell death that characterizes type 1 diabetes. This gives the researchers hope that their findings, published in the journal Cell Metabolism, may point to a potential new treatment that could be administered very early in the development of diabetes.
“When we eat, our beta cells produce about 1 million molecules of insulin every minute to help maintain normal blood glucose levels,” says Feyza Engin, a UW–Madison professor of biomolecular chemistry and senior author of the new study. “That is a big and stressful job, especially for a part of these beta cells called the endoplasmic reticulum.”
The endoplasmic reticulum is like the cell’s warehouse staff. It folds the insulin protein molecules that a beta cell produces, packing them for shipping to other parts of the body. If something goes wrong with the protein folding process, the shipping process backs up or even stops, stressing the endoplasmic reticulum. A stress-response gene called Atf6 perks up when a cell is struggling with unfolded proteins. But if Atf6 can’t resolve the protein-folding problem, prolonged stress will eventually kill the cell.
UnitedHealth sued over use of algorithm to deny care for MA members by Rebecca Pifer for HealthCareDive.com, 15 November 2023.
The lawsuit, filed in a Minnesota district court, cites a recent investigation by Stat News finding UnitedHealthcare, the largest MA payer in the U.S., pressured employees to use the algorithm to predict patients’ length of stay, and deny payment if their rehab care extended beyond that date. The lawsuit alleges that the health insurer and its subsidiary, NaviHealth, used an algorithm called nH Predict to systematically deny medical claims from patients recuperating from illnesses in nursing homes.
UnitedHealth and other NaviHealth clients, including health insurer Humana, used nH Predict to deny claims, despite the algorithm having a steep error rate, plaintiffs allege. More than 90% of patient claim denials from nH Predict were overturned following appeal, according to the suit. UnitedHealth denies using nH Predict for coverage determinations. “Coverage decisions are based on CMS coverage criteria and the terms of the member’s plan. This lawsuit has no merit, and we will defend ourselves vigorously,” said a spokesperson.
Dexcom defeats Abbott at UK High Court infringement trial posted on GlobalData.com, 14 November 2023.
Abbott has been defeated at the UK High Court in a patent dispute with Dexcom over patents for their continuous glucose monitor (CGM) devices. The proceedings began when Abbott brought Dexcom before the courts claiming patent infringement for its G7 applicator, a disposable patch for use with its CGM device. (Case: HP-2021-000025). At the same time, Dexcom sought to invalidate Abbott’s patent altogether, counterclaiming over a claim of added matter, arguing that the patent extends its legal remit.
The patent in question, EP 2 549 918, refers specifically to the needle insertion method as part of the disposable patches used by Abbot’s G7 device, which Dexcom disputed as obvious, a legal defense meaning that the invention will have occurred to a skilled manufacturer anyway.
Judge Jonathan Richards concluded: “A Skilled Team in 2010 that was seeking to develop an inserter for a CGM device would start by obtaining a detailed understanding of the Existing CGM Systems. “Obtaining that understanding would include obtaining those devices and ‘tearing them down’ so as to understand the inner workings of the inserter in detail.”
However, whilst the court maintained Abbott’s patent as stands, the court decided to reject the US company’s claim, meaning that Dexcom is free to continue selling its CGM devices in the UK.
Thanksgiving Carb Counts from ChildrenWithDiabetes.com, originally posted 25 November 2020.