diabetes

Posted on Patient Talk

The rising popularity of Ozempic and Wegovy among privately insured patients could exacerbate disparities.

A USC study of prescription data shows that people with Medicaid or Medicare Part D may be missing out on powerful new obesity and diabetes drugs
A study conducted by USC on prescription data indicates that individuals with Medicaid or Medicare Part D plans may not be benefiting from new, effective medications for obesity and diabetes.

A new study from USC suggests that individuals with public insurance who could benefit from new drugs for diabetes and obesity are less likely to receive them compared to those with private insurance.

Prescription fills for the drug known as Ozempic or Wegovy, also called semaglutide, surged by over 400% from January 2021 to December 2023, according to new research in JAMA Health Forum. 

Semaglutide was initially approved for type 2 diabetes and later for weight loss. Studies have shown that it also improves blood pressure and reduces the risk of cardiovascular disease, which are common issues for millions of Americans. However, the majority of prescriptions for semaglutide were given to individuals with private insurance.

“Considering the established cardiovascular advantages of Ozempic and Wegovy for treating diabetes or obesity, and the higher prevalence of diabetes and obesity in Black/Latinx Medicaid and Part D populations, these results indicate that their limited use in Medicaid and Part D could exacerbate disparities in diabetes and obesity outcomes,” explained Dima Qato, who is an associate professor at the USC Mann School of Pharmacy & Pharmaceutical Sciences and a senior scholar at the USC Leonard D. Schaeffer Center for Health Policy & Economics.

“While the media focuses on semaglutide’s anti-obesity effect, we should not overlook its significant role in treating diabetes. This medication has allowed me to help some of my patients reduce their reliance on insulin,” explained Christopher Scannell, a physician and postdoctoral researcher at the Schaeffer Center. He also highlighted the importance of ensuring broader access to these medications beyond just those with private insurance or more comprehensive health plans, as this is an issue of equity affecting a large portion of the U.S. population.

Please take note of the following information:Ozempic and Wegovy are both administered via once-weekly injections. Another form of semaglutide, Rybelsus, is available in the form of a daily pill. Ozempic was approved in 2017, followed by Rybelsus in 2019, both intended for the treatment of type 2 diabetes. Wegovy, approved in 2021, is a higher-dose version specifically designed for weight loss. As for pricing, Ozempic’s sticker price is approximately $1,000 per month, while Wegovy is listed at around $1,350.

For the study, researchers utilized data from IQVIA’s National Prescription Audit PayerTrak, which captures 92% of prescriptions filled and dispensed to individuals at retail pharmacies in the United States.

They calculated monthly medication fills for semaglutide under different drug brands (Ozempic, Wegovy, and Rybelsus) and payment methods (commercial insurance, Medicaid, Medicare Part D, and cash) from January 2021 to December 2023.

  • Please make a note of the following text: In 2023, Medicaid accounted for less than 10% of semaglutide prescriptions across all three drug brands. According to Scannell, access to these drugs through Medicaid is determined at the state level. Whether or not the drugs are covered depends on the budget and politics of your specific location. It’s important to note that Medicaid provides assistance to low-income individuals, the elderly, and some people with disabilities.
     
  • In 2023, Medicare Part D represented 28.5% and 32.9% of Ozempic and Rybelsus fills, respectively. However, it only made up 1.2% of Wegovy fills. It’s important to note that Medicare Part D does not cover drugs for obesity unless a patient also has a co-morbidity such as cardiovascular disease, which both Wegovy and Ozempic can help prevent. 
  • Approximately 1% or less of all semaglutide fills went to people paying cash in 2023.

In the context of treating obesity, Scannell stated, “If Medicare only covers these drugs for patients who have obesity and a co-morbidity, it may force patients who only have obesity to develop additional chronic conditions before they can access the medications. It’s like saying, ‘You have to be sick enough, then we’ll cover that medication for you.’”

The researchers suggested that future studies should investigate how changes in Medicare Part D and Medicaid coverage restrictions impact disparities in access to these important medications. Additionally, further research could explore individual-level variables like age, race, and ethnicity, as well as whether the drugs were prescribed for obesity or diabetes.

Posted on Patient Talk

Reversing insulin resistance in liver cells could treat type 2 diabetes

Although diabetes is a common condition, no cure exists yet. Current therapies can manage blood sugar levels, but they do not address insulin resistance. But now, recent research reported in ACS Nano shows that targeting certain highly reactive molecules in the liver can reverse insulin resistance in human liver cells and diabetic mice, providing a pathway toward a more long-lasting treatment.

Type 2 diabetes occurs when the body is no longer sensitive to insulin, which regulates blood sugar. Currently, no cure exists, and available treatments focus on managing symptoms and blood sugar levels. Some research has suggested that insulin resistance could be caused by reactive oxygen species (ROS), which are highly unstable, oxygen-based molecules primarily produced by the mitochondria, or the “powerhouses of the cell.” A class of drugs known as mitochondrial uncouplers could help inhibit ROS production at its source, rather than merely cleaning up what’s already been made, as conventional, antioxidant-based treatments do. Ultrasmall platinum nanoparticles are another highly efficient ROS scavenger, though their small size causes them to be cleared from the liver too quickly. But, by combining these two strategies into an all-in-one system, a highly effective and long-lasting treatment platform could be created. So, Jingjing Yang, Shaochun Tang, Yujun Song and colleagues wanted to design such a system, using biodegradable “nanoscavengers” that could potentially restore insulin sensitivity and treat type 2 diabetes.

To build the nanoscavengers, the team coated a template with platinum nanoparticles and a layer of silica. Then, the template was removed to form hollow shells, which were loaded with a mitochondrial uncoupler and coated with a lipid bilayer. When mixed with two ROS, hydrogen peroxide (H2O2) and superoxide (O2–), the system reduced them to water and molecular oxygen. In experiments using human liver cells with induced type 2 diabetes, the nanoscavengers continued to clean up ROS, as well as increase glucose uptake, suggesting that the cells’ insulin sensitivity was restored. The researchers then injected nanoscavengers intravenously into a diabetic mouse model. The constructs migrated to the liver, reducing the amount of fat present, restoring normal cellular function and returning blood glucose levels to normal. Symptoms of diabetic nephropathy were reversed nearly completely. The mice showed no signs of body weight changes or damage to their tissues or organs. The researchers say that this work could provide an effective strategy for long-term treatment of diabetes and other metabolic diseases.

Posted on Diabetes

Research reveals how key diabetes drug is made in nature

Sunshine may shield children, young adults from MS

 

Research by Oregon State University has explained how an important type 2 diabetes drug is made in nature, opening the door to improvements in manufacturing through biotechnology.

The findings are particularly important because global demand for the drug, acarbose, is rising along with the incidence of type 2 diabetes – according to the International Diabetes Federation, the disease affects nearly 500 million adults worldwide.

Developed by Bayer, the drug has been on the market under the brand name Precose since 1996. Acarbose comes from soil bacteria but until now the biosynthetic pathway underlying its production – the sequence of steps taken by enzymes to catalyze the chemical reactions responsible for making it – was not known.

Findings of the study, led by Taifo Mahmud of the OSU College of Pharmacy, were published in Nature Communications.

Frequently associated with obesity and low physical activity, type 2 diabetes is a serious metabolic disease that affects roughly one in 10 Americans. Formerly known as adult-onset diabetes, it is a chronic condition affecting the way the body metabolizes glucose, a sugar that’s a key source of energy.

For some patients, that means their body does not properly respond to insulin – it resists the effects of insulin, the hormone produced by the pancreas that opens the door for sugar to enter cells. In the later disease stages, when the pancreas is exhausted, patients don’t produce enough insulin to maintain normal glucose levels.

In either case, sugar builds up in the bloodstream and, if left untreated, impairs many major organs, sometimes to disabling or life-threatening degrees.

Acarbose normalizes blood glucose levels by inhibiting alpha-glucosidase enzymes – it helps keep blood sugar from rising too quickly after someone eats by blocking the breakdown of starchy foods like bread, potatoes and pasta and slowing down the intestinal absorption of some sugars.

Acarbose derives from Actinoplanes bacteria and several other strains of soil bacteria. It was the first alpha-glucosidase inhibitor approved for use in the United States and Europe

“Despite its significant therapeutic importance, how acarbose is made in nature had not been completely understood,” Mahmud said. “Our research not only sheds light on how this high-value pharmaceutical is made in nature but also provides a platform for further improvements of industrial acarbose production – for example, by modifying the DNA of the producing bacteria or through other biotechnological approaches. That means knowing its complete biosynthetic pathway is important from both scientific and industrial points of view.”

What remains unknown, Mahmud added, is why soil bacteria produce acarbose – what purpose does the compound serve for them? Some hypothesize that it plays a role in shuttling sugars between bacteria’s intra- and extracellular spaces or that it protects against the carbohydrate-degrading enzymes of other organisms.

“What exactly the function is for the producing organisms in their natural environment remains an exciting topic for future studies,” he said.

5 Comments Posted on autoimmune conditions, Fibromyalgia, Multiple Sclerosis, Patient Talk

Multiple Sclerosis and Fibromyalgia – is there a connection?




Fibromyalgia and multiple sclerosis

Fibromyalgia and multiple sclerosis

As some readers will know my background was conducting market research with people who suffer from various medical conditions. The main ones were in fact diabetes, cancer, rheumatoid arthritis and multiple sclerosis.

It was only when we started working with a lot of social media in around 2006 that I became commented with members of the fibromyalgia community.




You might also aware that we run various communities on Facebook and Twitter where we encourage discussion on a whole range of subject which are important to people with various conditions.

Over the years there has been a number of questions which come up from time to time. One of which is the relation between multiple sclerosis and fibromyalgia. After all having more than one autoimmune condition is not uncommon.

Indeed one of our members posted this on our page MultipleSclerosisTalk a few days ago “Hi. I just had a quick question. I am currently diagnosed with Fibromyalgia but with this last relapse, I have noticed many new and worsening symptoms, and I’m worried it may be more related to MS. I have a appointment with a neurologist on Tuesday and I was wondering how I should approach this with him. I’m really sick on this because I feel like they don’t really listen to how you feel sometimes. Thank you for any advice.”

Firstly if you do have any advice for this reader please feel free to use the comments box below to share your ideas.

Secondly I’m wondering how common this situation actually is? So I thought it would be useful to run the following poll to see how our readers have been diagnosed in the past.

It would great if you could take part below.





 

Bonnie2405 I think fibro me CFs lupus Lyme and ms are all the same, like polio, some get it small some get it big. If ritbixin works, they may have a cure for all of it, the virus attacks the autoimmune system that goes into overdrive, ritbixin removes all B cells wipes long term memory and the mitochondria has to start building healthy cells all over again freshly removing the virus from our bodies. The drug will be ready within three years are u ready to start recommending it DR because patients are desperate and want to try it they are that desperate.
traceychace Hi my name is Tracey, I was diagnosed with fibro about 3years ago after suffering for many years before hand.
My Dad had MS, my Mom has always said that she thought that’s what I have more than fibro.
My neurologist said that I deffinatley don’t have ms as there is no connection & its not hereditary.
My health seems to be deteriorating quite quickly, does fibro usually deteriorate quickly?
emily89 My mom was diagnosed with ms in her 30’s & im 24 I was just diagnosed with fibromyalgia, my older sister also has fibromyalgia. All of our symptoms are similar the only difference is that in an mri my mom has visible plaque on her brain.
anarivera Hi my name is ana rivera and i have fibromyalgia and i just cant find thevright medication can someone please help !!
RebeccaRaeThomas Go in with a detailed history of all symptoms over time and voice your concerns. Be assertive in getting additional tests. Don’t let them dismiss your concerns.

Barb MacLeod – 1 year ago
Diagnosed with IDDM (Type 1 or Insulin Dependent Diabetes Mellitus) in 1984; Diagnosed with RRMS (Relapsing Remitting Multiple Sclerosis) in 2015. My sister has Type 2 Diabetes diagnosed in 2012. My mother has Fibromyalgia diagnosed in 2014. It is tough being female in our family ! 🙂

Ileana Peters – 2 years ago
I was diagnosed with MS in 2011. i have a cousin that has fibromyalgia. Our symptoms are very similar . Its crossed our minds, she might have been misdiagnosed.

Carole mellor – 3 years ago
I was diagnosed with MS in 2008 and just been diagnosed now with Fibromyalgia the symptoms are very similar

linda Barlow – 3 years ago
Iv just fibormyalgy it’s a very painful ms what symptoms for that.

137 Comments Posted on medical awareness, Patient Talk

Donnee Spencer’s Medical Awareness Butterflies – Which one do you want a copy of?




Donnee's Medical Awareness Butterflies

Donnee’s Medical Awareness Butterflies

Over the last few years Donnee Spencer has produced these amazing awareness butterflies.

As you can see so far she has covered psoriasis, multiple sclerosis, COPD, strokes, Crohns, cancer, autism, fibromyalgia, diabetes and cerebral palsy among others.

The purpose of this blog is three fold.  Firstly simply to showcase Donnee’s brilliant work.

Secondly we are hoping she will be able to send us individual  copies which we can share with our readers on separate posts.   Please use the comments box to let us know which ones you might like posted first.

Finally if you would like Donnee to consider other causes to produce these wonderful images for –  please let us know in the comments box and we will share with her.

Many thanks in advance and many thanks Donnee!