Teen weight issues linked to diabetes
Being overweight and obesity during adolescence are associated with a disproportionately higher risk for cardiovascular disease risk factors, especially prediabetes and diabetes, according to a study published in the journal Pediatrics.
Analyzing data from the “National Health and Nutrition Examination Survey,” researchers found that among adolescents ages 12 to 19 years, the prevalence of prediabetes/diabetes increased from 9% in the 1999 to 2000 NHANES to 23% during the 2007 to 2008 NHANES. While prediabetes/diabetes experienced an increase, the researchers noted that other CVD risk factors — such as prehypertension/hypertension (17% and 13%) and high to borderline-high low-density lipoprotein cholesterol (23% and 19%) — saw no significant change when observed in the 1999 to 2000 NHANES and 2007 to 2008 NHANES.
Another study, released by the Centers for Disease Control and Prevention last April, found that young people with diabetes had much higher medical costs per year than those without it. For nondiabetic youth, costs per year were $1,468, compared with $9,061 for those who had the disease. Much of the extra cost came from prescription drugs and outpatient care. Those with the highest medical costs were treated with insulin, including all those with Type 1 diabetes and some with Type 2. Children and adolescents who received insulin treatment had annual medical costs of $9,333, compared with $5,683 for those who took oral medications.
Finding a multidisciplinary approach to diabetes care
An integrated wellness team approach to diabetes care can help patients not only improve their condition, but also lower their prescription costs, according to new research presented at the American Association of Clinical Endocrinologists’ 21st annual Scientific and Clinical Congress in Philadelphia.
Researchers led by Gary Evans, director of research at Northeast Florida Endocrine and Diabetes Associates, developed a multidisciplinary program that enrolled adult patients with Type 2 diabetes. Patients were counseled in nutritional, fitness and behavioral elements of diabetes management in a customized 16-week curriculum, while their doctors monitored body mass index, weight, HbA1C levels and diabetes medication dependence. Medications were reduced as needed to lower the risk of low blood sugars.
Evans and his fellow researchers found that participants decreased their doses of insulin and oral medication by about 46% and 12%, respectively; reduced their 30-day prescription costs, on average, by nearly $143 per month; and decreased their body mass index by 3.07 and HbA1C by 0.7%. The researchers noted that HbA1C was reduced by an average of 1.3% for patients with a baseline HbA1C of 8% or more.
“The multidisciplinary program creates a time frame that gives patients time to absorb the information, revisit strategies for management and engrave the behaviors into their minds,” Evans said. “Covering those key elements is what it takes for patients to grasp and embrace the strategies to be successful and improve their condition. It is our hope that the success of this curriculum will create a pathway for intensive wellness programs to be recognized as medical benefits for diabetes patients by insurance companies. The only way to be successful with long-term goals is to affect a lifestyle change.”
COPD spurs drug development
Taken together, asthma and chronic obstructive pulmonary disease — which includes chronic bronchitis and emphysema — affect nearly 50 million Americans, or about 15% of the total U.S. population, according to statistics from such organizations as the Centers for Disease Control and Prevention. And combined, the two diseases cause more than 100,000 deaths per year. Fortunately, however, there is a wide range of treatments available for both, many of which work for both diseases.
According to the Pharmaceutical Research and Manufacturers of America, an industry group for branded drug companies, the number of people living with COPD — which, according to the National Institutes of Health, includes 13 million who have it but don’t know it — has spurred a large amount of drug development around the disease. A PhRMA report released in February found that more than 50 drugs currently are in clinical development for treating COPD, ranging from pharmaceutical drugs to stem-cell therapies that attack the biological mechanisms behind the disease. Decision Resources, a market research firm, predicted that the COPD market will grow from $8 billion in 2010 to $13 billion in 2020 in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan.
Some new drugs for the condition already have hit the market. In October 2011, the Food and Drug Administration approved Boehringer Ingelheim’s Combivent Respimat (ipratropium bromide and albuterol sulfate), which is delivered in a propellant-free inhaler that uses a slow- moving mist to deliver the same active ingredients as the Combivent Inhalation Aerosol. The company expected to launch the drug in the middle of this year. In November, generic drug maker Mylan bought rights to a drug delivery platform made by Pfizer that would allow it to manufacture and commercialize generic versions of GlaxoSmithKline’s Advair Diskus and Seretide Diskus (fluticasone propionate and salmeterol).
Meanwhile, despite growth in the COPD market, the asthma market is expected to decrease slightly and remain basically flat. According to another Decision Resources report, the asthma market in the same seven countries the firm used to measure the COPD market is expected to decline from $14.6 billion in 2010 to $14.4 billion in 2020. In contrast with the plethora of new drugs for COPD, the asthma market will see increased competition and generic erosion. For example, Merck’s Singulair (montelukast) had sales of $3.3 billion in 2010, but that figure is expected to drop to $2 billion in the United States, Europe and Japan due to generic competition.