Diabetes

Novo Nordisk’s $2.3 billion French investment to enhance obesity drug output

Novo Nordisk has declared a substantial $2.3 billion investment aimed at amplifying the output of its highly sought-after obesity and diabetes medications at its Chartres facility in France, in a move to satiate the escalating demand. This financial injection will notably enhance the manufacturing capabilities for existing products such as Ozempic and Wegovy, alongside other burgeoning obesity treatments, according to the Danish pharmaceutical giant.

Europe is currently grappling with a supply crisis of the diabetes medication Ozempic, which shares the active ingredient semaglutide with the widely acclaimed weight management drug Wegovy—yet to be broadly distributed across Europe.

In response to the off-label consumption of Ozempic, Novo Nordisk has imposed restrictions within the European Union. Concurrently, Germany is considering export prohibitions, while Belgium has already enacted a ban on prescribing the weekly injection for non-diabetes purposes.

Despite efforts by the UK government to restrict the use of Ozempic to non-weight loss purposes in July, a Reuters investigation discovered the drug is still being acquired by individuals without diabetes for weight management.

This announcement follows Novo Nordisk’s recent proclamation of a $6 billion expenditure in Denmark to augment production capabilities. Additionally, this venture represents a significant endorsement for French President Emmanuel Macron’s economic strategies amidst a looming global downturn, aiming to sustain the momentum in reducing French unemployment figures.

President Macron had advocated for this investment during his “Choose France” summit, which reportedly persuaded Novo Nordisk’s CEO Lars Fruergaard Jorgensen to commit to the expansion. The investment also echoes Eli Lilly’s recent decision to construct a $2.5 billion manufacturing plant in Germany, similarly motivated by heightened demand for diabetes and obesity treatments.

Analysts predict the obesity drug market could reach a staggering $100 billion by 2030. Novo Nordisk’s French investment will notably expand its capacity for intricate manufacturing processes, specifically the intricate filling of injection pens with semaglutide, and the subsequent assembly and packaging of these pens.

Though details were scant earlier this month regarding the augmentation of in-house production for Ozempic and Wegovy’s European variant, Novo Nordisk has confirmed that the Chartres expansion has commenced, with completion slated between 2026 and 2028, promising the creation of 500 new job opportunities, adding to the near 2,000-strong workforce currently employed at the factory.

Digital health breakthrough with automated insulin delivery in hospital trials

Recent research indicates that the combination of automated insulin delivery and continuous glucose monitoring could be an effective method for regulating blood sugar levels in hospitalised adults suffering from diabetes.

A collaborative study from Emory University, Stanford University, and the University of Virginia recently published in Diabetes Technology & Therapeutics, involved the utilisation of the Omnipod 5 insulin delivery system in conjunction with the Dexcom G6 continuous glucose monitor (CGM). Over a period of 10 days, 18 hospitalised adult patients with diabetes were observed. On average, during their hospital stay, the participants’ glucose levels remained within the desired range 68% of the time. Notably, these participants utilised the automated insulin delivery system for about 95% of the trial duration.

Dr. Francisco Pasquel, from Emory University School of Medicine, highlighted the study’s implications. He stated, “The combination of an automated insulin delivery system with features suitable for hospital settings, together with real-time remote continuous glucose monitoring, offers a promising approach to optimise glucose management in hospitals. This could substantially reduce the risk of hypoglycemia.”

For this study, participants were adults, 18 years or older, with either type 1 or type 2 diabetes. They were already on insulin therapy upon being admitted to the hospital. Trained medical staff and the research team utilised the automated system and the CGM to regulate each participant’s glucose levels for up to 10 days or until their discharge. The trial also included comparing the CGM’s accuracy with conventional blood glucose tests. Various data points, including medication consumption, blood components, CGM data, and insulin delivery specifics, were meticulously gathered.

By the study’s conclusion on August 8, 2022, 18 adults had participated fully. Out of these, 16 had over 48 hours of active CGM data, which was used for further glycemic analysis. The average blood sugar level recorded was 167 mg/dL. Interestingly, the daily average insulin delivery was 0.21 U/kg, while the total daily insulin dosage averaged at 0.41 U/kg. Participants also suspended insulin for approximately 20% of the time, and there were no occurrences of severe hypoglycemia or diabetic ketoacidosis.

A survey filled out by 16 participants at the end of the study revealed their experiences. All respondents were in favour of using the automated system for managing their glucose levels during their hospital stay. An impressive 94% even expressed a desire to use the system at home. However, 38% found the necessity of using finger sticks for verifying CGM data cumbersome, with 19% showing a preference for solely relying on the CGM.

The research team acknowledged certain limitations to their study, such as the limited participant number and the study’s design. They pointed out that the hands-on approach by the study’s investigators and nurses might not be easily replicated in typical hospital settings. The team advocated for more comprehensive research with randomised controlled trials to validate these preliminary findings and to better understand the broader applicability and effectiveness of automated insulin systems in varied settings.

Cutting-edge AI tool uses x-rays to foresee diabetes risk in patients

Diabetes, a condition commonly diagnosed in adults under 65, has been increasingly observed in the senior population. As the disease advances in this age group, it often brings forth complex healthcare challenges. This highlights the need for early diagnosis, especially among older adults vulnerable to either the onset or exacerbation of diabetes symptoms.

Innovations in artificial intelligence are offering new avenues for early detection of such health conditions. These AI-powered tools, especially effective when handling vast and precise datasets, are revolutionising the early diagnosis landscape.

A trailblazing AI model, pioneered by researchers at Emory University, stands out with its unique approach. This model is engineered to discern early signs of diabetes by analysing X-ray images obtained during various medical assessments. These X-rays were originally captured for diverse medical reasons such as chest discomfort, respiratory issues, or pre- and post-operative evaluations. Notably, the AI model underwent rigorous training using a whopping 270,000 X-rays sourced from nearly 160,000 individuals.

Historically, X-rays haven’t been a standard diagnostic tool for diabetes. However, this groundbreaking AI model demonstrated its proficiency in identifying correlations between the accumulation of fatty tissues in specific body regions and an increased risk of diabetes, as highlighted by the study authors.

As a next step, the research team is keen on fine-tuning the model’s accuracy. Their vision encompasses integrating this AI tool into electronic health record (EHR) systems, aiming to equip physicians and healthcare providers with timely alerts on potential diabetes risks.

To put things in perspective, the Centers for Disease Control and Prevention (CDC) has estimated that an alarming 300,000 elderly individuals are diagnosed with diabetes for the first time annually. Diabetes’s prevalence is soaring, with a staggering 100% increase observed over the past three and a half decades. The Endocrine Society further reveals that nearly a third of the elderly population is grappling with diabetes.

The challenge, however, doesn’t end at diagnosis. Achieving effective diabetes management, especially in long-term care environments, poses significant hurdles. It is alarming to note that certain treatments lead to a heightened hypoglycemia risk, impacting around 35% of patients, as cited by the McKnight’s Clinical Daily. Overmedication is another pressing concern, with a considerable segment of the senior population not receiving timely medication adjustments. Amidst these challenges, the medical community is optimistic about emerging treatments such as SGLT2Is, which are on the cusp of wider adoption in long-term care settings. Furthermore, recent research has illuminated the potential benefits of kombucha tea in regulating blood glucose levels, offering a glimmer of hope in the fight against diabetes.

Study challenges belief that moderate alcohol consumption shields against obesity and type 2 diabetes

Moderate alcohol consumption does not provide protection against conditions such as obesity and type 2 diabetes, according to a recent study, challenging the long-debated notion of potential health benefits associated with light to moderate drinking.

The study investigated whether modest alcohol intake had any positive effects on health—a subject that has divided experts. Researchers analysed data on alcohol consumption from over 400,000 participants and discovered a higher risk of obesity and type 2 diabetes among individuals who consumed more than 14 drinks per week. Notably, this link was more pronounced in women than in men.

Dr. Tianyuan Lu of McGill University in Québec commented on the findings, stating, “Previous research has suggested that moderate drinkers may be less susceptible to developing obesity or diabetes compared to non-drinkers and heavy drinkers. However, our study indicates that even light-to-moderate alcohol consumption, defined as no more than one standard drink per day, does not safeguard against obesity and type 2 diabetes in the general population.”

The study’s results revealed that heavy drinking was associated with increased measures of obesity, such as body mass index, waist-to-hip ratio, and fat mass, as well as an elevated risk of type 2 diabetes.

Importantly, the study did not find any evidence of improved health outcomes related to moderate alcohol consumption in individuals who consumed seven or fewer alcoholic drinks per week.

Dr. Lu concluded by highlighting the significance of the research in promoting awareness of the risks associated with alcohol consumption. The study’s findings aim to inform future guidelines and recommendations regarding alcohol use, with the hope of encouraging healthier behaviours as alternatives to drinking.

For further details, refer to the full study published in JCEM.

Common painkillers linked with heart failure in people with type 2 diabetes

A recent study published in the Journal of the American College of Cardiology suggests that the use of common pain medications such as Advil or Motrin (ibuprofen) may increase the risk of heart failure in people with type 2 diabetes. The study found that NSAIDs (nonsteroidal anti-inflammatory drugs) may lead to first-time hospitalisation for heart failure in patients with type 2 diabetes. This is noteworthy, as these individuals are already known to face an elevated risk of heart failure.

The Danish study included more than 330,000 individuals with type 2 diabetes, of whom 1 in 6 filled at least one NSAID prescription within a year. During a follow-up of almost six years, more than 23,000 subjects were hospitalised with heart failure for the first time, and NSAID use was associated with a 40 percent higher relative risk of first-time heart failure hospitalisation. Ibuprofen and diclofenac were found to increase the risk of heart failure hospitalisation, but not celecoxib and naproxen. There was no association of NSAID use and increased risk in people with well-controlled diabetes. Strong associations were found in people aged 65 and older, while no association was found in those younger than 65. The strongest association was found in very infrequent or new users of NSAIDs. The study highlights the need for education in patients with cardiac risk factors, such as diabetes, on the dangers of over-the-counter medications.

Bariatric surgery may reduce cancer risk in patients with obesity and type 2 diabetes

Research findings derived from a Swedish Obese Subjects (SOS) study, published in Diabetes Care, found that in people with obesity and type 2 diabetes (T2D), bariatric surgery may play a role in cancer prevention. “Durable” remission of T2D is often achieved after weight-loss surgery, further associating it with a reduced cancer risk. 

The study examined long-term outcomes after bariatric surgery versus usual care in people with obesity. Researchers examined outcomes of 701 patients with obesity and T2D at baseline. A total of 393 of these patients (mean age, 48.6 years) underwent bariatric surgery while 308 patients (mean age, 50.5 years) received conventional obesity treatment. The investigators analysed cancer events, reported in the Swedish National Cancer Register, over the median follow-up of 21.3 years.

In patients treated with bariatric surgery, the incidence rate for first-time cancer during the follow-up period was 9.1 per 1,000 person-years (95% CI, 7.2–11.5). In contrast, the incidence rate for first-time cancer in patients treated with usual obesity care was 14.1 per 1,000 person-years (95% CI, 11.2–17.7). The incidence rate for first-time cancer diagnosis was significantly lower in the patients treated with bariatric surgery (adjusted hazard ratio [HR], 0.63; 95% CI, 0.44–0.89; P =.008).

Compared with the control group, bariatric surgery was associated with a significantly reduced incidence of cancer in women, (HR, 0.58; 95% CI, 0.38–0.90; P =.016). However, with bariatric surgery in men, there was no similar association (HR, 0.79; 95% CI, 0.46-1.38; P =.0413). Diabetes remission at 10 years follow-up was also associated with a reduction in cancer incidence (HR, 0.40; 95% CI, 0.22–0.74; P =.003).

The ascertainment of diabetes diagnoses was a limitation of the study, which were based on a single time point measurement and/or the use of a diabetes medication. Additionally, the majority of participants in the surgery group had received vertical banded gastroplasty or banding, which is rarely used today. High postoperative mortality following bariatric surgery was reported during the original SOS study.

“In conclusion, with increasing rates of obesity and diabetes worldwide, a greater emphasis on cancer prevention strategies is needed,” the researchers wrote. “Bariatric surgery may greatly reduce the risk of cancer among patients with obesity and diabetes. Durable diabetes remission seems imperative for cancer prevention in patients with obesity and diabetes.”