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The company has said it fixed its practices and now complies with government rules. Roseman, who has been a pharma speaker for about a decade, acknowledged that his expertise comes by way of the training provided by the companies that pay him. But he says that makes him the best prepared to speak about their products, which he prescribes for his own patients. Asked about Roseman‚s credentials, a Glaxo spokeswoman said he is an ‚appropriate‚ speaker.

Although DSHEA is generally viewed as a positive development for companies that sell dietary supplements such as vitamins, minerals, herbs, and similar substances, the legislation imposed new labeling requirements that must be adhered to in order for a product to qualify for the quot;safe harborsquot; established by DSHEA. With respect to labeling, DSHEA amends, for dietary supplements, the Nutrition Labeling and Education Act by providing that quot;statements of nutritional support,quot; also referred to as quot;structurefunction claims,quot; may be used in dietary supplement labeling without FDA pre-approval, provided certain requirements are met. These statements may describe how particular dietary ingredients affect the structure or function of the body, or the mechanism of action by which a dietary ingredient may affect body structure or function, but may not state a drug claim, such as a claim that a dietary supplement will diagnose, mitigate, treat, cure or prevent a disease. A company making a quot;statement of nutritional supportquot; must possess substantiating evidence for the statement, disclose on the label that the FDA has not reviewed the statement and that the product is not intended for use for a disease and notify the FDA of the statement within 30 days after its initial use. In addition, DSHEA allows the dissemination of quot;third party literaturequot; in connection with the sale of dietary supplements to consumers at retail if the publication meets statutory requirements. Under DSHEA, quot;third party literaturequot; may be distributed if, among other things, it is not false or misleading, no particular manufacturer or brand of dietary supplement is promoted, a balanced view of available scientific information on the subject matter is presented and there is physical separation from dietary supplements in stores.

Presence of microalbuminuria or macroalbuminuria. In the DIAD study, SPECT imaging was performed on 522 asymptomatic patients with T2DM to assess the prevalence and clinical predictors of silent myocardial ischemia as well as to assess the adequacy of the ADA screening guidelines for asymptomatic patients. 264 The DIAD study demonstrated that using the ADA guidelines as a screening tool for identifying high-risk patients for CHD failed to identify many disease-laden patients. In fact, just as many low-risk patients had evidence of CHD as high-risk patients.]