Finance and Economic

Insulin pumps are used by tens of thousands of teenagers worldwide with Type 1 diabetes, but they can be risky and have been linked to injuries and even deaths, a review by federal regulators finds.

Parents should be vigilant in watching their children’s use of the pumps, researchers from the Food and Drug Administration wrote. They didn’t advise against using the devices. But they called for more study to address safety concerns in teens and even younger children who use the popular pumps.

The federal review of use by young people over a decade found 13 deaths and more than 1,500 injuries connected with the pumps. At times, the devices malfunctioned, but other times, teens were careless or took risks, the study authors wrote.

Some teens didn’t know how to use the pumps correctly, dropped them or didn’t take good care of them. There were two possible suicide attempts by teens who gave themselves too much insulin, according to the analysis.

"The FDA takes pediatric deaths seriously," said the agency’s Dr. Judith Cope, lead author of the analysis. "Parental oversight and involvement are important. Certainly teenagers don’t always consider the consequences."

The pumps are popular because they allow young people to live more normal lives, giving themselves insulin discreetly in public and getting pizza with friends late at night. And they’re a growing segment of diabetes care, with $1.3 billion in annual sales worldwide, said Kelly Close, a San Francisco-based editor of a patient newsletter. She said 100,000 teenagers may be using them.

The pumps are used for those with Type 1 diabetes, which accounts for about 5 to 10% of all diabetes cases and used to be called "juvenile diabetes." The more common form is Type 2, which is often linked to obesity and more often affects adults.

Type 1 affects an estimated 12 million to 24 million people worldwide and occurs when the body attacks insulin-producing cells in the pancreas. Insulin regulates blood sugar levels, which when too high, can lead to heart disease, blindness and kidney damage.

Insulin pumps are the size of a cell phone and worn on a belt or pocket. They send insulin into the body through a plastic tube with a small tip that inserts under the skin and is taped in place. They cost about $6,000 and supplies run $250 a month. Most health insurers cover much of the cost.

Users must tell the device how much insulin to give before each meal, based on the estimated carbohydrates in the meal. The devices also deliver a continuous low level of insulin.

In the FDA study, appearing in the May issue of the journal Pediatrics, the reports of adverse events and deaths in adolescents using the pumps occurred from 1996-2005.

The FDA requires manufacturers to report injuries that could be linked to medical devices 500 fast cash. The authors analyzed reports from patients 12 to 21 years old. They emphasized that the reports aren’t always clear about the cause of death or injury.

The devices provide an alternative to multiple daily injections of insulin by syringe; some come with glucose monitors that reduce the number of times the finger must be pricked to test blood sugar.

While some teenagers want to switch from insulin injections to pump therapy to gain more flexibility in their lives, doctors said device problems such as a blocked tube can lead quickly to dangerous episodes of high blood sugar.

"In a matter of a few hours, all the insulin in the body disappears. Metabolically, the child starts to spiral out of control," said Dr. John Buse, the American Diabetes Association’s president for medicine and science. Kids need to be aware of the risk, monitor their blood sugar and be ready to give themselves an insulin injection.

Dr. Christina Luedke of Children’s Hospital Boston said she carefully screens teenagers and their families before prescribing a pump. She has refused it for some young patients.

"Without appropriate glucose monitoring, the pumps can increase the risk of getting sick more quickly compared to injections," Luedke said. However, she said, proper use makes life more bearable and can improve glucose control.

Teenagers also have problems keeping their diabetes under control with multiple daily insulin injections, doctors and manufacturers said.

"It is a constant struggle for a patient who is an adolescent to stay in control of any therapy," said Steve Sabicer, a spokesman for Minneapolis-based Medtronic Inc (MDT, Fortune 500)., which makes the top-selling insulin pump. The company stands behind the product’s safety and "the many years of clinical evidence that support the benefits of insulin pump therapy," he said.

Other companies with insulin pumps either on the market or in development include Abbott Laboratories (ABT, Fortune 500), Johnson & Johnson’s (JNJ, Fortune 500) Animas Corp., DexCom Inc. (DXCM) and Insulet Corp. (PODD) 

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BNP Paribas has walked away from a possible bid for smaller rival Societe Generale, which has been seen as a takeover target after suffering a rogue-trading scandal.

“Given the persistent rumors, BNP Paribas clarifies that it has ceased to consider a potential tie-up with Societe Generale,” BNP Paribas, France’s biggest listed bank, said in a statement on Wednesday.

“If a French bank that knows the market doesn’t want it, then it’s unlikely that anyone else will,” said Ion-Marc Valahu, head of trading at Amas Bank in Switzerland.

BNP Paribas shares were up around 5 percent in mid-morning while SocGen fell 7 percent. SocGen has a market capitalization of around 30 billion euros ($47.44 billion) while that of BNP Paribas stands at around 56 billion euros.

“It’s obviously bad news for SocGen shareholders. Nevertheless, it was expected and we had anticipated it since BNP would not have taken that much time if it really wanted to make a bid,” said Iris Finance fund manager Michael Sellam, who holds SocGen shares.

A source close to the matter said BNP Paribas came to its decision because of SocGen’s opposition to any tie-up and as BNP would not make a hostile bid faxless payday loans. The announcement means BNP Paribas is prevented from bidding for SocGen for six months.

In January BNP, which narrowly failed to buy SocGen in 1999, said it was looking at its rival. SocGen became vulnerable to a bid after announcing 4.9 billion euros of losses which it said were caused by rogue deals carried out by one of its traders. Jerome Kerviel.

The source said uncertainty in financial markets over the credit crisis and the investigation into Kerviel also contributed to BNP’s decision. 

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E*Trade Financial Corp , the online brokerage crippled by mounting losses at its mortgage business, said it sold about $3 billion in mortgage-backed securities and reduced wholesale borrowing levels by about $3.5 billion.

The company said it ended the year with $190 billion in client assets and $33 billion in cash.

E*Trade on Tuesday told Reuters that it will exit the U.S instant payday loan. institutional sales business eliminating about 30 jobs.
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Georgia Labor Commissioner Michael Thurmond said Friday that Democratic presidential hopeful Hillary Clinton’s plan to deal with the nation’s mortgage crisis could pay dividends here.

Thurmond and Laura Tyson, former chair of President Bill Clinton’s Council of Economic Advisers, told reporters in a conference call that Clinton’s plan would help in Georgia, where the rate of delinquent mortgages was third-highest in the country earlier this year.

Thurmond, who has endorsed Clinton, said the U.S. senator from New York, “has the vision to not only meet the challenge but develop plans and strategies that ultimately will have a very positive impact.”

Clinton’s plan includes:

• A moratorium on foreclosures in the sub-prime market.

“We have such large numbers [of foreclosures], it’s unprecedented,” said Tyson, an economic adviser to Clinton’s campaign.

• A five-year freeze on adjustable rate mortgages.

• And creation of a $5 billion federal fund to help state and local communities deal with the crisis fallout.

“Senator Clinton really saw this problem first, and she has been consistently suggesting solutions,” Tyson said.

All of the candidates in the race for the Democratic nomination have addressed the mortgage situation.

Former U.S fast payday loan no faxing. Sen. John Edwards of North Carolina has railed against what he calls predatory lenders since before the crisis began in early 2007. Edwards has called for national legislation to ban what he says are the worst abuses in the mortgage market: loan-flipping, mandatory arbitration clauses, balloon loans and pre-payment penalties. He would allow predatory lending victims to get new terms for mortgages.

U.S. Sen. Barack Obama of Illinois has proposed the Stop Fraud Act that increases funding for law enforcement to combat mortgage fraud and create criminal penalties for it. He wants to create a fund to help homeowners avoid foreclosure.
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While government statistics show consumer spending is holding steady, some economists fret about the rising level of debt Americans are putting on credit cards, and whether or not they’ll ever be able to pay it off.

The Associated Press reported this week that its analysis of data from credit card lenders shows a big spike in the number of accounts more than 90 days in arrears. That’s the delinquency period when most debt is turned over to collection agencies.

As more consumers fall behind on credit payments, states are grappling with increasing activity of so-called debt counselors and debt settlement services.

In West Virginia, Attorney General Darrell McGraw has won a court order temporarily forbidding a Florida law firm from offering debt settlement services in the state.

McGraw says the firm, Hess Kennedy, of Coral Springs, Florida, claims to assist consumers who are struggling financially to make payments to their creditors. McGraw said he has seen more of this increasingly common, and sometimes controversial business as consumer credit card debt has ballooned in the past few years.

Debt settlers such as Hess Kennedy make repayment plans to help consumers repay outstanding debts, at a deep discount, to avoid being sued or filing for bankruptcy. Monthly payments are then made by consumers to the debt settlers in turn for which the debt settlers claim to negotiate with creditors to reduce the amount of debt owed.

Although debt settlement services are unrestricted in some states, West Virginia’s law regarding debt settlement only permits for-profit companies to charge a monthly service fee of two percent of the payments made by consumers.

Although McGraw’s investigation is incomplete, the attorney general says it appears that Hess Kennedy was charging more than the two percent fee allowed by state law.

“Although the debt settlement approach to debt relief may work for some persons, the service has legal consequences and should only be offered by persons licensed to practice law in West Virginia,” McGraw said.

“My office will continue to scrutinize the debt relief industry in an effort to protect consumers who are already facing dire financial circumstances from paying excessive fees for services that may leave them in worse shape than before.”

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