where ingredients list can't clarify ambiguity, "manage blood sugar" claim is plausibly misleading

Prescott v. Abbott Laboratories, --- F.Supp.3d ----, 2024 WL 2843092, No. 23-cv-04348-PCP (N.D. Cal. Jun. 5, 2024)

Abbott Laboratories’s Glucerna line of powders and shakes are marketed as scientifically designed for people with diabetes to help manage blood sugar. Plaintiffs alleged that because the products contain sucralose and other additives, the products don’t provide the promised health benefits. They brought the usual California statutory claims. The court accepts the allegations as sufficient, except for standing for injunctive relief.

The challenged language includes “to help manage blood sugar,” “#1 doctor recommended brand,” and “scientifically designed for people with diabetes.” The side label states that the beverages are “designed to help minimize blood sugar spikes in people with diabetes compared to high glycemic carbohydrates.”

one of the challenged products with front label claims

“Online and in stores, Glucerna shakes and powders are placed with health and nutritional supplements near diabetes diagnostic equipment and blood glucose tests. One retailer specifically categorizes Glucerna products as ‘Diabetes Management’ on its website.” Plaintiffs alleged that the artificial sweetener used, sucralose, is associated with obesity, type 2 diabetes (as well as its precursor condition, metabolic syndrome), hypertension, and cardiovascular disease; that sucralose can deregulate blood sugar by disrupting the gut microbiome and killing pancreatic cells that release insulin; and that sucralose can cause cells to become resistant to insulin, which can lead to type 2 diabetes or obesity. Several organizations, including the World Health Organization, have advised against consuming sucralose and other artificial sweeteners. Plaintiffs cited similar scientific findings for the additional ingredients maltodextrin and carrageenan.

They alleged that “#1 doctor recommended brand” and “scientifically designed for people with diabetes” conveyed that Glucerna products “aid in managing blood sugar generally” and are “scientifically capable of the treatment of diabetes or other health conditions.”

Abbott argued that the labels didn’t make such broad claims: they didn’t plausibly advertise that the products were “over-the-counter aids to help manage diabetes and blood sugar generally” and “can be used to regulate, achieve, and manage normal and healthy blood sugar levels.” Instead, the drinks were merely intended as a “snack or meal replacement” formulated “to help minimize blood sugar spikes in people with diabetes compared to high glycemic carbohydrates.”

This was a factual question. And unlike in other cases where an ambiguous label could be easily clarified by reading the ingredient list, the side label explanation about minimizing blood sugar spikes didn’t directly contradict the claims that plaintiffs alleged they took away. “This is not the sort of ambiguity that can be definitively resolved by reference to a back label.” Plaintiffs also  plausibly alleged that the other claims on the front label—that Glucerna products are recommended by doctors and scientifically designed for diabetics—make more sweeping representations about how the products work.

As for the alleged harms of the ingredients, Abbott argued that the studies cited didn’t support the claims and that plaintiffs had layered inference on top of inference. This was a factual question that could not be resolved at this stage. “If the allegations directly contradicted the cited studies plaintiffs’ allegations might fairly be deemed implausible, but that is not the case here.” 

However, plaintiffs’ alleged intent to buy Glucerna products again in the future if they can be sure the products will provide the promised benefits was insufficient; because of the nature ofe the alleged deception, they could easily determine based on the ingredients list whether Glucerna had been reformulated without the challenged ingredients.