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

Prescott v. Abbott Laboratories, --- F.Supp.3d ----, 2024 WL2843092, No. 23-cv-04348-PCP (N.D. Cal. Jun. 5, 2024)

Abbott Laboratories’s Glucerna line of powders and shakesare marketed as scientifically designed for people with diabetes to help manageblood sugar. Plaintiffs alleged that because the products contain sucralose andother additives, the products don’t provide the promised health benefits. Theybrought the usualCalifornia statutory claims. The court accepts the allegations assufficient, except for standing for injunctive relief.

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

one of the challenged products with front label claims

“Online and in stores, Glucerna shakes and powders areplaced with health and nutritional supplements near diabetes diagnosticequipment and blood glucose tests. One retailer specifically categorizesGlucerna products as ‘Diabetes Management’ on its website.” Plaintiffs allegedthat the artificial sweetener used, sucralose, is associated with obesity, type2 diabetes (as well as its precursor condition, metabolic syndrome),hypertension, and cardiovascular disease; that sucralose can deregulate bloodsugar by disrupting the gut microbiome and killing pancreatic cells that releaseinsulin; and that sucralose can cause cells to become resistant to insulin,which can lead to type 2 diabetes or obesity. Several organizations, includingthe World Health Organization, have advised against consuming sucralose andother artificial sweeteners. Plaintiffs cited similar scientific findings forthe additional ingredients maltodextrin and carrageenan.

They alleged that “#1 doctor recommended brand” and “scientificallydesigned for people with diabetes” conveyed that Glucerna products “aid inmanaging blood sugar generally” and are “scientifically capable of thetreatment 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 aidsto help manage diabetes and blood sugar generally” and “can be used toregulate, achieve, and manage normal and healthy blood sugar levels.” Instead,the drinks were merely intended as a “snack or meal replacement” formulated “tohelp minimize blood sugar spikes in people with diabetes compared to highglycemic carbohydrates.”

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

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

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