Eli Lilly warns of temporary short supply of two insulin products by Meg Tirrell for CNN.com/health, 22 March 2024.

Drugmaker Eli Lilly warned that two of its formulations of insulin would be temporarily out of stock through the beginning of April, citing a “brief delay in manufacturing.”  The 10-milliliter vials of Humalog and insulin lispro injection will be in short supply at wholesalers and some pharmacies, Lilly said in a statement posted online Wednesday, 3/20/24. The company said that prefilled pen versions of those medicines are still available in the US and that it continues to manufacture the 10-milliliter vials “and will ship them as soon as we can.”  Lilly said that the company recognizes “that any supply challenge may cause a disruption in people’s treatment regimens, and we are moving with urgency to address it.”

People who have trouble getting their prescription filled should contact their healthcare provider to discuss switching to the same insulin in a prefilled pen “or other insulin treatment options,” Lilly said. The company also suggested that patients check other pharmacies.  Those who need insulin immediately “and cannot access their healthcare provider for an alternative treatment option should seek emergency care,” Lilly said.

Read more: Eli Lilly warns of temporary short supply of two insulin products

Study shows glucose levels affect cognitive performance in people with type 1 diabetes differently by McLean Hospital for MedicalXpress.com, 18 March 2024.

A new study led by researchers at McLean Hospital (a member of Mass General Brigham) and Washington State University used advances in digital testing to demonstrate that naturally occurring glucose fluctuations impact cognitive function in people with type 1 diabetes (T1D). Results of the study, published in npj Digital Medicine, show that cognition was slower in moments when glucose was atypical—that is, considerably higher or lower than someone’s usual glucose level. However, some people were more susceptible to the cognitive effects of large glucose fluctuations than others.

“In trying to understand how diabetes impacts the brain, our research shows that it is important to consider not only how people are similar, but also how they differ,” said Zoë Hawks, Ph.D., lead author on the paper and research investigator at McLean.

The study showed that cognitive function was impaired when glucose was considerably higher or lower than usual, and this effect was observed for processing speed but not sustained attention. Processing speed may be impacted by short-term, moment-to-moment fluctuations in glucose, whereas sustained attention is impacted by high or low glucose that persists over longer periods.

The researchers also found that people differed from each other in terms of how much glucose fluctuations impacted their cognitive speed, and some people—including older adults and adults with certain health conditions—were much more impacted by glucose fluctuations than others.

Read more: Study shows glucose levels affect cognitive performance in people with type 1 diabetes differently

Once-weekly basal insulin noninferior to once-daily insulin for type 1, type 2 diabetes by Michael Monostra for Healio.com/endocrinology, 19 March 2024.

A once-weekly basal insulin conferred similar changes in HbA1c and time in range as once-daily insulin glargine among adults with type 1 and type 2 diabetes in three phase 2 trials. Insulin efsitora alfa (Eli Lilly) is a once-weekly basal insulin that is currently being investigated in five different patient populations with diabetes in phase 3 trials. 

The results, along with findings from the ONWARDS clinical trials of once-weekly insulin icodec (Novo Nordisk), make once-weekly insulins a potential option for people with type 1 and type 2 diabetes in the future, according to Juan Pablo Frias, MD, chief medical officer of Biomea Fusion.

Key endpoints in all trials include change in HbA1c, time in range, and hypoglycemia from baseline to the end of the study. All five trials are scheduled to be completed by July.

Read more:  Once-weekly basal insulin noninferior to once-daily insulin

Is It Time for Time in Tight Range? by April Hopcroft for diaTribe.org, 13 March 2024.

At a recent ATTD event, diabetes experts discussed the potential benefits of time in tight range, calling for personalized care and education to help achieve tighter blood glucose control.  Time in tight range is defined as glucose levels between 70-140 mg/dL. This metric was developed based on the recognition that high glucose levels over time may be harmful to different body systems, so minimizing time spent in hyperglycemia should be the goal of diabetes care. While newer technologies and medications can dramatically improve glycemic control, time in tight range may be easier said than done. Striving for tighter blood sugar control could introduce further diabetes distress and may not necessarily be right for everyone.

During diaTribe’s Solvable Problems in Diabetes “Is It Time for Time in Tight Range?” panel discussion at ATTD 2024, experts explored the potential benefits of time in tight range, how to begin using this metric, and strategies to further optimize glycemic control. The panel discussion was moderated by Dr. Tadej Battelino, professor of medicine at the University of Ljubljana in Slovenia, and included Dr. Nataša Bratina, pediatric endocrinologist at University Children’s Hospital in Ljubljana, Slovenia; Dr. Natalie Bellini, clinical assistant professor of medicine at Case Western Reserve University in Ohio: Dr. Chiara Fabris, assistant professor at the University of Virginia: Dr. Helena Rodbard, founder and medical director of the Endocrine and Metabolic Consultants Research Center. The key points of their discussions are below:

    • Tighter range targets must be individualized: “Time in tight range isn’t universal,” Dr. Helena Rodbard said. “I would not recommend time in tight range for those with longstanding diabetes, hypoglycemia unawareness, or frailty.” 
    • Why children may be good good candidates for time in tight range: Real-world data presented at ATTD 2024 showed that 50% time in tight range is a reasonable goal for children (aged 15 years or younger) with type 1 diabetesDr. Tadej Battelino emphasized the data that showed greater brain damage with higher glucose levels (above an A1C of 7%). Likewise, research has also shown that spending less time in tight range and time in range was associated with an increased risk of diabetic retinopathy.  
    • Time in tight range is less important for older people with diabetes: At the other end of the spectrum, priorities shift and glycemic targets become less strict as people age. Rodbard said she is happy when her older patients have a time in range of 60-70%, though she noted that clinical judgment is important and requires individualization. Ultimately, avoiding low blood sugar (hypoglycemia) is the number one priority for older people with diabetes, Dr. Natalie Bellini said. Preventing hypoglycemia is especially important due to the risk of becoming unsteady, which increases the chances of falling and sustaining fractures. Time in tight range may need to be set differently as well depending on a variety of factors such as medication use, whether they live alone, hypoglycemia unawareness, and frailty. It’s also important to consider quality of life for older people with diabetes. 
    • Pregnancy as a case study for tighter glycemic control: While time in tight range has yet to become a universal goal in diabetes care, Bellini honed in on one area where it’s already used extensively: pregnancy. Time in range goals for pregnancy in diabetes are stricter to prevent high glucose levels from harming the developing fetus. 
    • Newer medications could help achieve time in tight range: “I wish we had more resources to offer to people with type 1 diabetes,” Rodbard said. “This takes us beyond just insulin, particularly the use of SGLT-2 inhibitors and GLP-1 receptor agonists.”  Rodbard noted that many people with type 1 diabetes have insulin resistance as well as obesity, so GLP-1 receptor agonists could be especially valuable given their powerful weight loss benefits.

Read more: Is It Time for Time in Tight Range?

Cow Hacked with Human DNA Produces Milk Containing High Levels of Human Insulin by Victor Tangermann for Futurism.com, 16 March 2024.

A team of scientists from the University of Illinois Urbana-Champaign and the Universidade de São Paulo, Brazil, have found a radical new way to produce the stuff: a gene-edited cow that produces human insulin in its milk.

“Mother Nature designed the mammary gland as a factory to make protein really, really efficiently,” said University of Illinois animal sciences professor Matt Wheeler, lead author of a new paper published in the Biotechnology Journal. “We can take advantage of that system to produce a protein that can help hundreds of millions of people worldwide.”

As detailed in their paper, the researchers inserted a segment of human DNA coding for the precursor of active insulin called proinsulin into the cell nuclei of ten cow embryos. Out of the ten embryos, one gene-edited calf was born in Brazil. Once matured, the cow was impregnated and stimulated to lactate using hormones. To their surprise, the cow not only produced proinsulin, but even insulin in her milk.

“Our goal was to make proinsulin, purify it out to insulin, and go from there,” Wheeler said in the statement. “But the cow basically processed it herself. She makes about three to one biologically active insulin to proinsulin.”  

“The mammary gland is a magical thing,” he added.

Read more: Cow Hacked with Human DNA Produces Milk Containing High Levels of Human Insulin

Time-restricted eating linked to 91 percent higher risk of cardiovascular death by Tom Howarth for ScienceFocus.com, 18 March 2024.

A major new study of 20,000 adults could rock the scientific consensus on healthy diets, finding that time-restricted eating – a form of intermittent fasting – could significantly increase the chances of death. The new research – presented to the American Heart Association – claims restricting eating to a period of fewer than eight hours per day had a staggering 91 percent higher risk of death due to cardiovascular disease. The study, which evaluated participants’ diets and health outcomes over a maximum of 17 years, failed to identify a single cause of death for which the risk was reduced by restricting eating to an eight-hour window. 

Senior study author Prof Victor Wenze Zhong was surprised by the results, telling BBC Science Focus he “had expected that long-term adoption of eight-hour time-restricted eating would be associated with lower risk of cardiovascular death and even all-cause death”. He added: “Even though this diet has been popular due to its potential short-term benefits, our research clearly shows that, compared with a typical eating time range of 12–16 hours per day, a shorter eating duration was not associated with living longer.”

Despite the compelling statistics, scientists are unsure exactly why time-restricted eating could heighten the risk of cardiovascular death. However, one possible explanation, Zhong said, could be that restricting eating reduces muscle mass.

Read more:  Time-restricted eating linked to 91 percent higher risk of cardiovascular death

New ‘exercise pill’ could replace your need to workout by Noa Leach for ScienceFocus.com, 18 March 2024.

A team of scientists has created new compounds that can mimic the physical boost of a workout, which could form the ingredients of a future supplement. Specifically, the scientists hope to replicate the power of exercise to enhance metabolism and growth – plus improve muscle performance.

“We cannot replace exercise; exercise is important on all levels,” said Bahaa Elgendy, the study’s principal investigator. “But there are so many cases in which a substitute is needed.”  The team, from the Washington University School of Medicine, USA, presented their findings at the spring meeting of the American Chemical Society (ACS).

But, sadly for some, the exercise pill is not just around the corner – as the substitute has only seen success in rodent cells so far.

So how does it work? The team spent 10 years designing a compound that activates specialized proteins known as estrogen-related receptors in the body. These proteins regulate the impacts of exercise on our muscles. The scientists increased the strength of the cells’ response by comparing the impacts of different compounds in the rodents’ RNA. When tested on mice, the team found that the compound increased fatigue-resistant muscle fiber. Afterwards, the rodents’ endurance when running on a treadmill improved.

Read more: New ‘exercise pill’ could replace your need to workout

Weight loss caused by common diabetes drug tied to ‘anti-hunger’ molecule in study by for MedicalXpress.com, 18 March 2024.

An “anti-hunger” molecule produced after vigorous exercise is responsible for the moderate weight loss caused by the diabetes medication metformin, according to a new study in mice and humans. The molecule, lac-phe, was discovered by Stanford Medicine researchers in 2022. The finding, made jointly by researchers at Stanford Medicine and Harvard Medical School, further cements the critical role the molecule, called lac-phe, plays in metabolism, exercise and appetite. It may pave the way to a new class of weight loss drugs.

“Until now, the way metformin, which is prescribed to control blood sugar levels, also brings about weight loss has been unclear,” said Jonathan Long, Ph.D., an assistant professor of pathology. “Now we know that it is acting through the same pathway as vigorous exercise to reduce hunger. Understanding how these pathways are controlled may lead to viable strategies to lower body mass and improve health in millions of people.”

Long and Mark Benson, MD, Ph.D., an assistant professor of medicine at Harvard Medical School, are co-senior authors of the study, which was published in Nature Metabolism. Postdoctoral scholar Shuke Xiao, Ph.D., is the lead author of the study.

Read more: Weight loss caused by common diabetes drug tied to ‘anti-hunger’ molecule in study

HYDRATE … BUT: Your reusable water bottle is likely much dirtier than you think. Here’s how to clean it properly

Research carried out by US water filtration company WaterFilterGuru has shown that if you do not wash your water bottle appropriately and regularly, bacteria and molds can build up on the bottle’s surface and interior that, if swallowed, could potentially make you very ill.

Water, even from the kitchen tap, is not usually sterile, and the growth of bacteria naturally occurs in all noncarbonated waters only a few days after a bottle is filled. If water is stored at room temperature, the longer the bottle is left, the more bacteria will grow. However, refrigerating filled water bottles can help limit microbial numbers. Some of a water bottle’s microbes will come from the water itself, but mostly it comes from the person drinking from it. Our bodies are naturally covered with millions of microbes (the microflora), including the insides of our mouths.

How to wash your water bottle: Although your bottle may be reusable, it does not maintain its own hygiene. This means that you simply cannot refill and reuse the bottle without cleaning it. If you do not wash out your water bottle often, any bacteria and molds that may be present will grow and contaminate whatever liquid you put in it. Then, when you next drink from your bottle, you may notice an odd taste or texture due to the waste products released by the growing microbes. It is therefore important that you regularly clean your bottle like you would any food-related item such as pans or plates.

Thankfully, cleaning your water bottle is necessary but straightforward. Use hot water (over 60°C as this temperature kills most pathogens), add washing-up liquid, swirl it around, and leave for ten minutes. Then rinse it with hot water and allow it to dry – overnight is best, as thorough drying will also help to protect against the growth of microbes.

For more heavy contamination (from long usage without washing), add a half vinegar/half water mixture and soak for several days. Then clean using the methods outlined above. To avoid getting ill from your water bottle, you should ideally clean it with detergent after each use, or at least several times a week. It is also important to clean any lids or attachments such as straws as these can also harbour microbes.

Read more: Your reusable water bottle is likely much dirtier than you think

“Ozempic Babies” are Surprising Women Taking Weight Loss Drugs by Katie Camero for USTToday.com, 21 March 2024.

Women are getting pregnant, in most cases unintentionally, they say, while taking weight loss medications like Ozempic and Mounjaro, despite being on birth control or dealing with years of fertility issues. Facebook groups, Reddit threads, and TikTok videos are connecting women who are pregnant with or already had an “Ozempic baby” or “Mounjaro baby,” as they have come to be called, and want to share their surprise pregnancy experiences. 

Reproductive and obesity medicine experts told USA TODAY that they’re also noticing the trend in their offices, which they say is likely happening for two reasons. First, weight loss is correcting hormonal imbalances caused by obesity and metabolic disorders thus boosting fertility. Second, certain drugs may be reducing the efficacy of birth control pills, increasing the chances of pregnancy.

“It’s true that, from a scientific perspective, these medications may make it easier for people to get pregnant,” said Dr. Allison Rodgers, an OB-GYN and reproductive endocrinologist at Fertility Centers of Illinois. “But people need to be careful because there could be dangerous consequences if taken while pregnant given the drugs can linger in your system.” 

Decades of research have established strong connections between obesity, metabolic disorders such as polycystic ovary syndrome (PCOS) and fertility issues, so it isn’t too surprising to see that weight loss medications — which can help some people drop up to 20% of their body weight — are helping many women with these conditions get pregnant, said Dr. Utsavi Shah, assistant professor of obstetrics and gynecology specializing in obesity medicine at Baylor College of Medicine in Houston. “These weight loss medications are game changers for women with PCOS or infertility, but there’s nothing about them specifically that’s making people more fertile, aside from their interaction with birth control pills,” Shah said. “It’s their effect on weight loss that’s helping regulate their menstrual cycles, thereby increasing their chances of getting pregnant.” 

Read more: ‘Ozempic babies’ are surprising women taking weight loss drugs.

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