Ever heard of MedCo Health Solutions? It's not a household name like the big pharmaceutical companies Novo, Glaxo etc. However, MedCo, which happens to be in the prescription benefit management business, is a large and powerful company. Now it's about to become even larger: the company is poised to pay $1.5 billion for PolyMedica Corporation, the nation's biggest supplier of diabetes-related products.

According to a Forbes report on the deal, PolyMedica has nearly one million patients using its products. Its product line includes Liberty Healthcare brand, blood glucose test kits and meters, lancet kits, insulin and the like. The Forbes article says the move is basically a smart one on the part of MedCo: it can cash in on the growing demand(14.5 % growth, annually!) for diabetes supplies. MedCo's chief exec, David Snow, told Forbes he anticipates the purchase could make his company (indirectly) the supplier of diabetes treatment products to half of all insured Americans with diabetes.

Factoid: ads for PolyMedica star "Cocoon" and "Seinfeld" actor Wilford Brimley.

A year ago, competitors were out to produce their own versions of Pfizer's Exubera, the inhalable insulin. However, now it's clear that Exubera is a bomb. Yes, a slick new ad campaign might revive its fortunes, so don't count Exubera out of the race quite yet. But it's not likely to be the blockbuster product many thought it could be.

Now the fallout is hurting those companies that were scrambling to compete/cash in by producing their own inhalable insulins. According to a report in Forbes, those same companies are ready to beat a smart retreat. Meanwhile, they're trying to reassure nervous investors. Case in point: MannKind Corp. shares fell nearly ten percent on Monday after it was announced the company could take longer to line up a partner for its inhalable insulin, the Technosphere Insulin System.

Not only that, MannKind postponed the release of its second quarter financial report. Wall Street analysts downgraded the stock, saying its short-term outlook is "challenged" and cited disappointing sales of Exubera as a factor. The outlook could be even worse if it looks like insulin caps will make it to market. As I said in a previous blog on that topic, who wants to tote a bulky inhaler around if you can pop some capsules instead?

Endocrinologist William Petit Jr. and his family were the victims of an utterly shocking crime on Monday. Two men entered the family home in Cheshire, Connecticut, assaulted the family and forced a woman, probably Petit's wife, to drive to an ATM and withdraw money. The burglars later set fire to the house and fled, leaving the family still inside. Dr. Petit survived the ordeal. His wife and two daughters were killed.

Dr. Petit (50) is a prominent diabetes researcher. He is medical director at the Hospital of Central Connecticut in New Britain. The hospital is a Joslin Diabetes Center Affiliate institution. Dr. Petit is also president of the Hartford County Medical Association. He was elected to the American Diabetes Association's Hall of Merit in 1994.

The two men suspected of committing this terrible act were arrested as they left the scene, and they were arraigned Tuesday. Both men have extensive criminal records. The attack has sent the small community of Cheshire (just north of New Haven) reeling. Read more in this report from Forbes. Even those opposed to the death penalty may wish that an exception be made for these two. They have committed a crime that can only be described as monstrous.

Novartis SA reports the U.S. FDA has demanded additional data, including a clinical study in patients with kidney impairment, before giving Galvus its approval. Why the holdup?

The FDA wants more data studying Galvus in patients with impaired kidneys. It had been thought that Galvus might have an advantage because it is not processed by the kidneys, while Januvia is. But another molecule created when the body metabolizes Galvus does build up in the kidney.

In the Feb. 1 issue of The New England Journal of Medicine, David M. Nathan, a Harvard Medical School endocrinologist, noted that it was surprising that the FDA decided to clear Januvia at all, given the "paucity of published data from long-term clinical trials on its safety and efficacy." Nathan is a consultant for Novartis and other drug makers but not Merck.

There are several potential concerns about DPP-4 drugs, clear evidence has not turned up in clinical trials so far. The medicines could affect the immune system, because a receptor on immune cells is very similar to DPP-4. Merck says that Januvia was designed to bind only to the DPP-4 enzyme, reducing the chances of these side effects. Patients with impaired kidneys have more of the drug in their bloodstream and would be more likely to experience side effects.

Japanese scientists have discovered an imbalance that leads to the development of type 2 diabetes in mice. A gene called GCK is responsible for sensing changes in blood glucose levels. Researchers found a molecule known as insulin receptor substrate 2 (IRS2) was shown to influence the beta cell mass increase after GCK sensed an increased in blood glucose levels.

The Journal of Clinical Investigation focused on mice with little increase in beta cell mass regardless of a rise in GCK. Researchers found, in healthy mice, the insulin receptor substrate 2 (IRS2) was shown to influence the beta cell mass increase after GCK first sensed an increased in blood glucose levels.

Before a person becomes diabetic, his or her body tries to compensate for the increasing resistance to insulin by upping the amount of insulin secreted and the mass of insulin-secreting cells (beta cells) in the pancreas. Researchers will look for new ways of increasing beta cell mass to prevent the onset of type 2 diabetes. Here's where I get a little confused - another study conducted a few years ago found evidence that a sucrose-rich diet (SRD) produces an increase in the pancreatic beta-cell mass in the rat. I'm neither a rat, nor a scientist - but I think a meeting of the minds behind these two discoveries might result in some forward-thinking treatments for type 2 diabetes. What compels the IRS2 to defy the command center of GCK? Perhaps another piece is missing from the balance of this equation.

Obviously, developing Type 2 diabetes while you're still a young 'un is bad for your long-term health outlook, period. Here's a specific example of how it might negatively affect you or someone you know: a new study reports that kids or teens who develop T2 diabetes face a high risk of also developing serious kidney problems down the road, including kidney failure and even death.

The study looked at the long-term health records (almost forty years' worth) of Native Americans from a Southwestern tribe. It was found that the incidence of serious kidney disease in people under thirty-five years of age was much higher if they had first developed diabetes while under twenty years of age. That is, higher than for those diagnosed with T2 diabetes as adults, between the ages of twenty and fifty-five. In addition, the death rate for those first diagnosed under the age of twenty was - very scarily - double that for people diagnosed as adults.

To read more, check out this article in Forbes online.

Another day, another depressing health-related news story. Thanks, Forbes, for today's Scary Statistic! With the ominous headline, "Diabetes Brings Earlier Heart Disease, Death," Forbes reports that a new study shows Type 2 diabetics are likely to suffer fatal and non-fatal heart attacks, strokes and other cardiovascular "events" (my favorite health euphemism!) around fifteen years sooner than non-diabetics. Oh, yikes. That is a scary statistic.

The information comes courtesy of researchers at the Institute of Clinical Evaluative Sciences in Toronto, Canada. The results of the study have been published in the latest issue of The Lancet (July 2006). The study found that you can roughly pinpoint the ages at which people cross over into the "moderate risk" and "high risk" categories for heart problems. For diabetics, this crossover point came about fifteen years earlier than for others.

For Type 2 men "moderate risk" was reached at just under thirty-nine years of age, as opposed to age fifty-five for non-diabetic men. "High risk" was reached at around forty-nine years, instead of sixty-two for non-diabetic men. For Type 2 women, "moderate risk" was reached at around forty-six years, as opposed to sixty-two for non-diabetics, while "high risk" for women began at at fifty-six, instead of sixty-nine for non-diabetics.

Worst of all, the researchers report that Type 2 diabetics who were at moderate or high risk for heart disease died an average of eighteen years earlier than non-diabetics.

The solution? Experts say physicians need to take the lead in pushing their Type 2 diabetic patients to get active and lose weight.

Forbes is running an interesting profile of do-it-yourself medicine. It's about all the medical stuff you can do now from the privacy of your own home, before or in addition to visits to your doctor. The article looks at all kinds of tests and devices now available to the public, such as home pregnancy test kits. However, it also examines the technology available to diabetics.

Diabetes is a disease in which self-testing has made great progress, says Dr. Barbara P. Yawn of the University of Minnesota in Minneapolis. This began with the introduction of glucose-monitoring tests. Then came blood glucose meters and testing strips in the 60s. Okay, the blood glucose tests have the "ouch factor" but they are highly effective--much more so than the old urine tests. Also, technology is making the finger pricks required for blood tests less and less painful all the time.