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The first OTC glucose monitors, lack of information from Florida, & time to reframe thinking on menopause

March 6, 2024
Reporter, Morning Rounds Writer
Good morning. We have news on medical devices, longevity disputes, and what we don't know about measles in Florida.

medical devices

FDA allows over-the-counter glucose monitors

Now, for the first time, anyone in the U.S. can buy a continuous glucose monitor without a prescription. Yesterday the FDA authorized Dexcom to sell its monitor, called the Stelo, to adults who don't use insulin. It's aimed at people with type 2 diabetes — and anyone who wants to know how diet and exercise affect their blood sugar levels. Paired with a smartphone app, the device gives readouts every 15 minutes. 

After the first continuous glucose monitor was approved in 2017, people with type 1 diabetes — who can't make insulin to process glucose into energy, which causes sugar to accumulate in their blood  — have relied on the device to monitor blood sugar and sometimes control an insulin pump. There are many more people with type 2 diabetes, meaning they can't make enough insulin or grow insensitive to the hormone. The FDA says people shouldn't make medical decisions based on the device's information without talking with a health care provider. But patients may wind up doing so anyway, STAT's Katie Palmer and Lizzy Lawrence write. Read more.


public health

Florida has disclosed few details on its measles cases, defying public health norms 

This is how measles works: Infected people are contagious in the four days before the telltale rash develops. They can feel sick enough to seek medical care, but their symptoms could elude doctors who've never seen measles before. This is how public health is supposed to work: When a case is identified, local officials warn residents where and when they may have been exposed, urging unvaccinated people to contact a health care provider. 

That's what happened in two Michigan counties on Sunday, but the opposite has been playing out in Florida, where 10 residents and at least four non-residents have been diagnosed with measles in the past month or so. "What's happening in Florida is sort of breaking all the global conventions around measles," Michael Mina, who formerly taught at the Harvard T.H. Chan School of Public Health, told STAT's Helen Branswell. She has more about other implications.


aging

Harvard longevity researcher starts a dogfight with claims for a way to reverse aginghttps___arcmigration-prdweb.bostonglobe.com_r_Boston_2011-2020_2018_05_16_BostonGlobe.com_Business_Images_Walker_051618_xxslowaging_4377x

Craig F. Walker / Globe staff

Renowned Harvard University geneticist and longevity researcher David Sinclair (above) is no stranger to controversy (remember resveratrol?). But his assertion last week that scientists had developed the first pill "proven to reverse aging" in dogs sparked a new firestorm. The miraculous molecules come in a soft, beef-flavored chew but without a published scientific explanation. Sinclair told his 438,000 followers on X they could buy it on the website of Animal Bioscience, a veterinary supplement company he founded and which is headed by his brother, Nick Sinclair.

The company's news release and the tweet have sparked outrage. "Nobody who is serious about science and informed believes this is a milestone," posted Matt Kaeberlein, a biogerontologist who co-directs the Dog Aging Project. Jeffrey Flier, former dean of Harvard Medical School, thanked Kaeberlein, saying in his social media post, "Indeed, quite sadly, there are some snake oil salesmen on the @harvardmed faculty." STAT's Megan Molteni has more, including a response from Sinclair.



closer look

It's time to reframe our thinking on menopause, researchers sayAdobeStock_670615184

Adobe 

Here's the take-home message from today's issue of The Lancet devoted to menopause: Stop treating it like a disease. A series of articles and essays, including the journal's first photo essay (Ponch Hawkes's playful images of naked women at age 50) describe the need for a better understanding of early menopause, mental health, and menopause after cancer. The authors call for better education, more non-medical ways to address menopause, and more research into all available treatments, not just medicines that drug companies promote.

"There are many ways to make it through the menopausal transition with greater comfort … and each of them involves a different set of risks and benefits and effort and cost," said Andrea LaCroix, an author of the essay on empowerment and an epidemiologist at the University of California, San Diego. But there's a scarcity of large and diverse studies comparing treatments head-to-head, she also said. STAT's Annalisa Merelli has more.


health tech

Working with Meta, Headspace heads into VR

If you know Headspace, it's probably for its mindfulness app. Now the digital business is partnering with Meta to launch a meditation app for Quest, which is Meta's virtual reality headset. The new VR app, called Headspace XR and developed with funding from Meta, guides users through meditation, but also through activities like a Tai Chi-inspired movement game to promote well-being. The idea is to engage younger users and, at the same time, help the companies understand how products like these might potentially improve mental health.

Virtual reality treatments, including ones for mental health cleared by the FDA, are becoming more widely available. But Headspace isn't moving into VR for therapy or psychiatry or coaching right away. "I think there's not enough research yet to support that," CEO Russell Glass said. "For us, we see this as a starting point to understand this medium better, really get members in, and learn how it's being used." STAT's Mario Aguilar has more.


cancer

Early in Covid, detection of high-risk GI cancers was delayed, but survival was stable

In our fifth year of the coronavirus pandemic, it's still too early to know the full effects of early 2020's gaps in medical care. Cancer screenings were missed and primary care visits were skipped, two opportunities to spot some early cases. Then-National Cancer Institute Director Ned Sharpless warned there could be 10,000 excess deaths from breast and colorectal cancer over the next 10 years if patients continued to miss screening. (He also wondered if less screening might also mean less overdiagnosis.)

A new study in JAMA Network Open tells us what we know so far about four high-risk GI cancers: esophageal, gastric, primary liver, and pancreatic. While there were 3,000 fewer patients diagnosed from March through May 2020 compared to previous years, those numbers rebounded by July. More people were diagnosed with later-stage cancers, likely because their symptoms rather than a screening test drove them to seek care, but there was no difference in one-year survival curves for patients diagnosed in 2020. The authors call it a "a tribute to the efforts of cancer clinicians" at a time when hospitals and health care were overwhelmed by pandemic upheaval.


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What we're reading

  • WTO proposal for Covid diagnostics and therapeutics waivers is abandoned, STAT
  • Viewpoint: Here's what many digital tools for chronic pain are doing wrong, Nature
  • Novo Nordisk's diabetes drug Ozempic cuts risk of kidney disease progression, trial shows, STAT

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