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By Nancy Lapid, Health Science Editor
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Hello Health Rounds readers! There’s been plenty of data showing benefits of Ozempic – the blockbuster drug that’s made headlines for its use in weight-loss – in people with type 2 diabetes, but now we finally share news of a small study that suggests the drug might be helpful in type 1 diabetes, too. We also feature an upcoming presentation at a cardiology meeting that reports on the importance of getting blood pressure measurements when patients are lying down, not just when they are seated. Finally, we report on a wireless implant that researchers hope will eventually be used to flag early signs that a transplant patient’s body is rejecting the new organ.
In breaking news, see these stories from our Reuters journalists: Newer, highly mutated SARS-CoV-2 variant is not as alarming as originally feared; Updated COVID shots generate strong response vs newer variant; Israeli scientists create model of human embryo without eggs or sperm; and AT&T says tests at some lead cable sites show no public health risk.
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- Insulet shares slump on concerns of sales hit from new diabetes drugs
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Blockbuster Ozempic shows promise for type 1 diabetes
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In a small study involving 10 U.S. adults with newly diagnosed type 1 diabetes, the need for multiple daily insulin injections was reduced or eliminated by once-weekly injections of a newer drug, researchers reported on Wednesday in The New England Journal of Medicine.
The drug, semaglutide, is used in Novo Nordisk’s blockbuster drugs Ozempic and Rybelsus for type 2 diabetes and Wegovy for obesity.
In type 1 diabetes, formerly known as juvenile diabetes, the immune system attacks the insulin-making beta cells in the pancreas and destroys them. But many patients still have some insulin reserves in their beta cells when first diagnosed, so researchers wondered if semaglutide – which works by stimulating insulin secretion from beta cells – could replace mealtime insulin doses.
The study participants had all been diagnosed with type 1 diabetes in the past three to six months. Within three months of starting treatment with Ozempic, none of them needed insulin injections at mealtimes, the researchers found. Within six months, seven of the 10 no longer needed their usual injections of “basal” insulin in the morning and at bedtime, the study showed.
“This was maintained until the end of the 12-month follow-up period,” study leader Dr. Paresh Dandona of the University of Buffalo in New York said in a statement.
At the start, the average blood level of hemoglobin A1c (HbA1c), which reflects blood sugar levels over the past 90 days, was 11.7, far above the recommended maximum of 7. The mean HbA1c fell to 5.9 at six months and 5.7 at 12 months.
The most common side effects were nausea and vomiting, and appetite suppression, according to the report.
If the findings in this small case series are confirmed in large randomized controlled trials, Dandona said, “it could possibly be the most dramatic change in treating type 1 diabetes since the discovery of insulin in 1921.”
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High blood pressure can ‘hide’ in seated patients
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People who have high blood pressure only when lying flat have a significantly elevated risk for developing cardiovascular problems, but that risk factor would be missed if doctors check for hypertension only when patients are seated upright, according to researchers.
In a study scheduled for presentation in Boston on Saturday at the American Heart Association Hypertension Scientific Sessions, the researchers tracked 11,369 middle-aged U.S. adults who were participating in a long-term study.
At the start, roughly one in six of those with normal blood pressure while seated had high blood pressure while lying flat on their backs. High blood pressure was defined in this study as having top and bottom measurements of 130/80 mm Hg or higher. Over the ensuing 25 to 28 years, people measured with high blood pressure while lying flat but not while seated had similar elevated risks for cardiovascular problems as those who had high blood pressure when seated.
Compared to people without any hypertension, that group had a 1.6 times higher risk of developing coronary heart disease, a 1.83 times higher risk of developing heart failure, a 1.86 times higher risk of stroke, a 1.43 times higher risk of overall premature death and a 2.18 times higher risk of dying from coronary heart disease.
“If blood pressure is only measured while people are seated upright, cardiovascular disease risk may be missed if not measured also while they are lying supine on their backs,” study leader Duc Giao of Harvard Medical School said in a statement.
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Wireless implant detects early signs of transplant rejection
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A soft and thin device placed on a transplanted kidney could detect very early signs of transplant rejection and wirelessly stream the information to doctors, a preliminary study in animals found.
The implant can detect temperature irregularities associated with inflammation and other body responses that arise with transplant rejection, researchers reported on Thursday in the journal Science.
In rats with transplanted kidneys, the device detected warning signs of rejection up to three weeks earlier than current monitoring methods that use blood tests, according to the study.
“If rejection is detected early, physicians can deliver anti-rejection therapies to improve the patient’s health and prevent them from losing the donated organ,” study co-author John Rogers of Northwestern University in Evanston, Illinois said in a statement. “In worst-case scenarios, if rejection is ignored, it could be life-threatening. The earlier you can catch rejection and engage therapies, the better. We developed this device with that in mind.”
During the transplant surgery, the tiny sensor – just 0.3 centimeters wide, 0.7 centimeters long and 220 microns thick – can be inserted underneath a fibrous layer that encases the kidney, called the renal capsule.
“The capsule keeps the device in good thermal contact with the underlying kidney,” Rogers said. “Bodies move, so there is a lot of motion to deal with. Even the kidney itself moves. And it’s soft tissue without good anchor points for sutures. These were daunting engineering challenges, but this device is a gentle, seamless interface that avoids risking damage to the organ.”
Rogers said his team is also developing ways to recharge the battery so that it can last a lifetime. If the device eventually proves to be safe and effective in human patients, it would likely be beneficial for recipients of other types of organs, too, the researchers said.
This newsletter was edited by Will Dunham.
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