HEALTH
Stricter FDA rules have turned getting a fecal transplant into an odyssey
C. diff bacteriaGilda Jones/CDC
For patients with severe Clostridioides difficile infections, one person’s stool is another person’s treasure. Fecal transplants, which amount to a hard reset of the gut microbiome, can be a lifesaver for those whose colons have been overrun by toxin-spewing bacteria. But these treatments have become harder to get due to stricter rules imposed on stool banks by the Food and Drug Administration, writes STAT’s Eric Boodman.
In 2022 and 2023, two companies secured FDA approval for human-excrement-derived drugs to prevent C. diff. recurrence. Shortly after, the agency cracked down on OpenBiome, a nonprofit that acts like a blood bank for stool, ending a longstanding practice of choosing not to enforce certain regulatory requirements. The stool bank soon stopped shipping samples.
Tighter regulation became a major problem for Blanca Morales and her son Mundo, who was suffering from a nasty C. diff infection. Approved therapies aren’t cleared for use in kids, and Morales had to go through a harrowing journey to secure off-label treatment for her child. “None of us said it, but we all feared that Mundo was going to die,” she told Eric, sobbing as she spoke. Read more to understand how this shift in policy has had real consequences for patients.
MEDICINE
Match Day results show impact of immigration policy on budding doctors
Each year, tens of thousands of medical students nervously open envelopes to learn where they’ll spend the next several years of residency, during which they obtain specialized training. For international students, this year’s Match Day, which took place on Friday, came with an additional stressor — federal immigration policy changes, including travel bans and visa processing delays.
The National Resident Matching Program reported that, among non-U.S. citizen students who attended medical school abroad, residency match rates declined to 56.4%, the lowest level observed in five years, meaning nearly half of these applicants didn’t secure a residency position. Among international students who required visa sponsorships, the rate was even lower, 54.4%, while 67.9% of applicants with a green card who’d gone to medical school abroad matched. By comparison, the match rate among fourth-year med students at U.S. schools was 93.5%.
INSURANCE
Diabetes outcomes worsen after patients lose insurance, study finds
Millions of people are set to lose health insurance due to last year’s passage of the One Big Beautiful Act, which contains deep cuts to Medicaid. That will likely result in worse outcomes for patients with diabetes, according to a new study led by researchers at Oregon Health & Science University. Researchers analyzed electronic health records from over 39,000 patients, more than 5,000 of whom had experienced insurance “churn,” defined as two or more consecutive visits to a community health center while uninsured. They found that, compared with those who were insured, people with unstable coverage had higher HbA1C, a measure of blood sugar, and needed more insulin to manage their disease.
Authors of the study, published in the journal JAMA Health Forum, didn’t see evidence that insurance churn was linked with serious complications, such as kidney failure or amputations, but they cautioned that it takes time to see more severe outcomes. “What we’re seeing is an early warning sign. The disease gets harder to manage after insurance loss,” said Nathalie Huguet, the study’s lead author, in a press release.
