Pub Date : 2025-03-06DOI: 10.1016/s2213-8587(25)00060-9
Lindsey Smith Tallie, Barry Popkin
No Abstract
{"title":"The promise and pitfalls of “Make America Healthy Again”","authors":"Lindsey Smith Tallie, Barry Popkin","doi":"10.1016/s2213-8587(25)00060-9","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00060-9","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"25 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-05DOI: 10.1016/s2213-8587(24)00371-1
Babak J Orandi, Yusi Chen, Yiting Li, Garyn T Metoyer, Krista L Lentine, Michael Weintraub, Sunjae Bae, Nicole M Ali, Bonnie E Lonze, Christine J Ren-Fielding, Holly Lofton, Akash Gujral, Dorry L Segev, Mara McAdams-DeMarco
<h3>Background</h3>Given the cardiovascular, renal, and survival benefits of GLP-1 receptor agonists for diabetes, these agents could be effective among kidney transplant recipients. However, kidney transplant recipients are distinct from GLP-1 receptor agonist trial participants, with longer diabetes duration and severity, greater end-organ damage, increased cardiovascular risk, and multimorbidity. We examined GLP-1 receptor agonist real-world effectiveness and safety in kidney transplant recipients with diabetes.<h3>Methods</h3>This USA-based retrospective cohort study included kidney transplant recipients with type 2 diabetes at transplantation and Medicare as their primary insurance from a national registry linked with Medicare claims. Post-transplantation GLP-1 receptor agonist use was identified through Medicare claims. Death-censored graft loss was estimated using the Fine-Gray sub-distribution hazard model and extended Cox models were used for mortality and safety endpoints. Models incorporated inverse probability of treatment weights. To further test whether bias could affect the main results, a cohort was created in which each GLP-1 receptor agonist user was matched with a kidney transplant recipient who had not started a GLP-1 receptor agonist, was alive with a functioning graft, and had accrued the same amount of post-transplant survival time.<h3>Findings</h3>Between Jan 1, 2013 and Dec 31, 2020, we identified 44 536 first time kidney transplant recipients with Medicare as primary payer in the 6 months before and at transplantation. 24 192 patients were excluded as they did not have type 2 diabetes. 2328 patients were ineligible (1916 had missing values and 412 used GLP-1 receptor agonists before transplantation). The primary cohort thus consisted of 18 016 kidney transplant recipients with diabetes. Of these patients, 1969 (10·9%) had at least one GLP-1 receptor agonist prescription filled post-transplant. Compared with patients who had not received a GLP-1 receptor agonist, GLP-1 receptor agonist users were younger (median age at transplant 57 years [IQR 49–64] <em>vs</em> 60 years [51–66], p<0·0001) and more likely to be female (786 [39·9%] <em>vs</em> 5645 [35·2%], p<0·0001). Among GLP-1 receptor agonist users, 552 [28·0%] were non-Hispanic White, 703 [35·7%] were non-Hispanic Black, and 568 [28·8%] were Hispanic. The 5-year unadjusted cumulative incidence of death-censored graft loss from a cohort matched on survival time before GLP-1 receptor agonist initiation was 6·0% for GLP-1 receptor agonist users and 10·7% for non-users (Gray's test p=0·004). The 5-year unadjusted cumulative incidence for mortality from a cohort matched on survival time before GLP-1 receptor agonist initiation was 17·0% for GLP-1 receptor agonist users and 25·8% for non-users (log-rank p=0·0006). The 5-year unadjusted cumulative incidence for mortality was 13·5% for GLP-1 receptor agonist users and 19·9% for non-users (log-rank p<0·0001). GLP-1 re
{"title":"GLP-1 receptor agonists in kidney transplant recipients with pre-existing diabetes: a retrospective cohort study","authors":"Babak J Orandi, Yusi Chen, Yiting Li, Garyn T Metoyer, Krista L Lentine, Michael Weintraub, Sunjae Bae, Nicole M Ali, Bonnie E Lonze, Christine J Ren-Fielding, Holly Lofton, Akash Gujral, Dorry L Segev, Mara McAdams-DeMarco","doi":"10.1016/s2213-8587(24)00371-1","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00371-1","url":null,"abstract":"<h3>Background</h3>Given the cardiovascular, renal, and survival benefits of GLP-1 receptor agonists for diabetes, these agents could be effective among kidney transplant recipients. However, kidney transplant recipients are distinct from GLP-1 receptor agonist trial participants, with longer diabetes duration and severity, greater end-organ damage, increased cardiovascular risk, and multimorbidity. We examined GLP-1 receptor agonist real-world effectiveness and safety in kidney transplant recipients with diabetes.<h3>Methods</h3>This USA-based retrospective cohort study included kidney transplant recipients with type 2 diabetes at transplantation and Medicare as their primary insurance from a national registry linked with Medicare claims. Post-transplantation GLP-1 receptor agonist use was identified through Medicare claims. Death-censored graft loss was estimated using the Fine-Gray sub-distribution hazard model and extended Cox models were used for mortality and safety endpoints. Models incorporated inverse probability of treatment weights. To further test whether bias could affect the main results, a cohort was created in which each GLP-1 receptor agonist user was matched with a kidney transplant recipient who had not started a GLP-1 receptor agonist, was alive with a functioning graft, and had accrued the same amount of post-transplant survival time.<h3>Findings</h3>Between Jan 1, 2013 and Dec 31, 2020, we identified 44 536 first time kidney transplant recipients with Medicare as primary payer in the 6 months before and at transplantation. 24 192 patients were excluded as they did not have type 2 diabetes. 2328 patients were ineligible (1916 had missing values and 412 used GLP-1 receptor agonists before transplantation). The primary cohort thus consisted of 18 016 kidney transplant recipients with diabetes. Of these patients, 1969 (10·9%) had at least one GLP-1 receptor agonist prescription filled post-transplant. Compared with patients who had not received a GLP-1 receptor agonist, GLP-1 receptor agonist users were younger (median age at transplant 57 years [IQR 49–64] <em>vs</em> 60 years [51–66], p<0·0001) and more likely to be female (786 [39·9%] <em>vs</em> 5645 [35·2%], p<0·0001). Among GLP-1 receptor agonist users, 552 [28·0%] were non-Hispanic White, 703 [35·7%] were non-Hispanic Black, and 568 [28·8%] were Hispanic. The 5-year unadjusted cumulative incidence of death-censored graft loss from a cohort matched on survival time before GLP-1 receptor agonist initiation was 6·0% for GLP-1 receptor agonist users and 10·7% for non-users (Gray's test p=0·004). The 5-year unadjusted cumulative incidence for mortality from a cohort matched on survival time before GLP-1 receptor agonist initiation was 17·0% for GLP-1 receptor agonist users and 25·8% for non-users (log-rank p=0·0006). The 5-year unadjusted cumulative incidence for mortality was 13·5% for GLP-1 receptor agonist users and 19·9% for non-users (log-rank p<0·0001). GLP-1 re","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"4 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-05DOI: 10.1016/s2213-8587(25)00056-7
Emerging Risk Factors Collaboration/EPIC-CVD/Vitamin D Studies Collaboration. Estimating dose-response relationships for vitamin D with coronary heart disease, stroke, and all-cause mortality: observational and Mendelian randomisation analyses. Lancet Diabetes Endocrinol 2024; 12: e2–11—The appendix of this Article has been corrected as of March 5, 2025.
{"title":"Correction to Lancet Diabetes Endocrinol 2024; 12: e2–11","authors":"","doi":"10.1016/s2213-8587(25)00056-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00056-7","url":null,"abstract":"<em>Emerging Risk Factors Collaboration/EPIC-CVD/Vitamin D Studies Collaboration. Estimating dose-response relationships for vitamin D with coronary heart disease, stroke, and all-cause mortality: observational and Mendelian randomisation analyses.</em> Lancet Diabetes Endocrinol <em>2024;</em> 12: <em>e2–11</em>—The appendix of this Article has been corrected as of March 5, 2025.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"16 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-05DOI: 10.1016/s2213-8587(25)00059-2
Angelo Avogaro
No Abstract
{"title":"What does renal failure teach us about our National Health System?","authors":"Angelo Avogaro","doi":"10.1016/s2213-8587(25)00059-2","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00059-2","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"30 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<h3>Background</h3>Data on tirzepatide in Asian patients with obesity are limited. This study aimed to gain a better understanding of tirzepatide for treatment of Japanese patients with obesity disease (BMI ≥25 kg/m<sup>2</sup> with excessive fat accumulation) as defined by the Japanese Society for the Study of Obesity.<h3>Methods</h3>This was a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial of the efficacy and safety of tirzepatide as an adjunct to lifestyle modifications. Japanese adults with obesity disease (BMI ≥27 kg/m<sup>2</sup> accompanied by ≥2 obesity-related health disorders or ≥35 kg/m<sup>2</sup> accompanied by ≥1 obesity-related health disorders), excluding diabetes, were assigned 1:1:1 via computer-generated random sequence to receive once weekly subcutaneous tirzepatide (10 mg or 15 mg) or placebo. Coprimary endpoints were the mean percent change in bodyweight and the proportion of participants achieving at least 5% bodyweight reduction at week 72, using the efficacy estimand. Efficacy and safety were assessed in the modified intention-to-treat (mITT) population. This study is registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, <span><span>NCT04844918</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>.<h3>Findings</h3>Between May 10, 2021, and June 24, 2023, 413 participants were screened, and 267 were randomly assigned. Due to exclusion of one study site, the mITT population was 225 participants (133 [59%] men and 92 [41%] women, mean age 50·8 [SD 10·7] years), with 73 in the tirzepatide 10 mg group, 77 in the tirzepatide 15 mg group, and 75 in the placebo group, of whom 192 (85%) completed both study and treatment. Estimated treatment differences relative to placebo in change in bodyweight at week 72 were −16·1% (95% CI −18·7 to −13·5; p<0·0001) and −21·1% (95% CI −23·6 to −18·5; p<0·0001) following tirzepatide 10 mg and 15 mg, respectively. At week 72, a higher proportion of participants achieved at least 5% bodyweight reduction with tirzepatide 10 mg (67 [94%] of 71) and 15 mg (73 [96%] of 76) compared with placebo (15 [20%] of 75; both p<0·0001). Cardiometabolic and body composition indices were also improved with tirzepatide. Participants treated with tirzepatide experienced treatment-emergent adverse events more frequently (10 mg: n=61 [84%]; 15 mg: n=66 [86%]) than those who received placebo (52 [69%]), most commonly gastrointestinal symptoms. Study discontinuations due to adverse events were infrequent (placebo: n=3 [4%]; tirzepatide 10 mg: n=1 [1%]; tirzepatide 15 mg: n=0).<h3>Interpretation</h3>In Japanese adults with obesi
{"title":"Efficacy and safety of once-weekly tirzepatide in Japanese patients with obesity disease (SURMOUNT-J): a multicentre, randomised, double-blind, placebo-controlled phase 3 trial","authors":"Takashi Kadowaki, Arihiro Kiyosue, Tomotaka Shingaki, Tomonori Oura, Koutaro Yokote","doi":"10.1016/s2213-8587(24)00377-2","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00377-2","url":null,"abstract":"<h3>Background</h3>Data on tirzepatide in Asian patients with obesity are limited. This study aimed to gain a better understanding of tirzepatide for treatment of Japanese patients with obesity disease (BMI ≥25 kg/m<sup>2</sup> with excessive fat accumulation) as defined by the Japanese Society for the Study of Obesity.<h3>Methods</h3>This was a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial of the efficacy and safety of tirzepatide as an adjunct to lifestyle modifications. Japanese adults with obesity disease (BMI ≥27 kg/m<sup>2</sup> accompanied by ≥2 obesity-related health disorders or ≥35 kg/m<sup>2</sup> accompanied by ≥1 obesity-related health disorders), excluding diabetes, were assigned 1:1:1 via computer-generated random sequence to receive once weekly subcutaneous tirzepatide (10 mg or 15 mg) or placebo. Coprimary endpoints were the mean percent change in bodyweight and the proportion of participants achieving at least 5% bodyweight reduction at week 72, using the efficacy estimand. Efficacy and safety were assessed in the modified intention-to-treat (mITT) population. This study is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, <span><span>NCT04844918</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>.<h3>Findings</h3>Between May 10, 2021, and June 24, 2023, 413 participants were screened, and 267 were randomly assigned. Due to exclusion of one study site, the mITT population was 225 participants (133 [59%] men and 92 [41%] women, mean age 50·8 [SD 10·7] years), with 73 in the tirzepatide 10 mg group, 77 in the tirzepatide 15 mg group, and 75 in the placebo group, of whom 192 (85%) completed both study and treatment. Estimated treatment differences relative to placebo in change in bodyweight at week 72 were −16·1% (95% CI −18·7 to −13·5; p<0·0001) and −21·1% (95% CI −23·6 to −18·5; p<0·0001) following tirzepatide 10 mg and 15 mg, respectively. At week 72, a higher proportion of participants achieved at least 5% bodyweight reduction with tirzepatide 10 mg (67 [94%] of 71) and 15 mg (73 [96%] of 76) compared with placebo (15 [20%] of 75; both p<0·0001). Cardiometabolic and body composition indices were also improved with tirzepatide. Participants treated with tirzepatide experienced treatment-emergent adverse events more frequently (10 mg: n=61 [84%]; 15 mg: n=66 [86%]) than those who received placebo (52 [69%]), most commonly gastrointestinal symptoms. Study discontinuations due to adverse events were infrequent (placebo: n=3 [4%]; tirzepatide 10 mg: n=1 [1%]; tirzepatide 15 mg: n=0).<h3>Interpretation</h3>In Japanese adults with obesi","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"1 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-28DOI: 10.1016/s2213-8587(25)00024-5
Michael A Nauck, Soo Lim
No Abstract
{"title":"Promising treatment options with tirzepatide for Japanese individuals with obesity disease","authors":"Michael A Nauck, Soo Lim","doi":"10.1016/s2213-8587(25)00024-5","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00024-5","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"33 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-26DOI: 10.1016/s2213-8587(24)00373-5
Andreas L Birkenfeld, Michael Bergman
No Abstract
{"title":"Bodyweight loss and remission of type 2 diabetes","authors":"Andreas L Birkenfeld, Michael Bergman","doi":"10.1016/s2213-8587(24)00373-5","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00373-5","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"25 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-26DOI: 10.1016/s2213-8587(24)00346-2
Sarah Kanbour, Rwedah A Ageeb, Rayaz A Malik, Laith J Abu-Raddad
<h3>Background</h3>Bodyweight loss is associated with type 2 diabetes remission; however, the quantitative relationship between the degree of bodyweight loss and the likelihood of remission, after controlling for confounding factors, remains unknown. We aimed to analyse the relationship between the degree of bodyweight loss and diabetes remission after controlling for various confounding factors, and to provide estimates for the effect sizes of these factors on diabetes remission.<h3>Methods</h3>This systematic review and meta-regression analysis followed Cochrane and PRISMA guidelines to systematically review, synthesise, and report global evidence from randomised controlled trials done in individuals with type 2 diabetes and overweight or obesity. The outcome was the proportion of participants with complete diabetes remission (HbA<sub>1c</sub> <6·0% [42 mmol/mol] or fasting plasma glucose [FPG] <100 mg/dL [5·6 mmol/L], or both, with no use of glucose-lowering drugs) or partial diabetes remission (HbA<sub>1c</sub> <6·5% [48 mmol/mol] or FPG <126 mg/dL [7·0 mmol/L], or both, with no use of glucose-lowering drugs) at least 1 year after a bodyweight loss intervention. We searched PubMed, Embase, and trial registries from database inception up to July 30, 2024. Data were extracted from published reports. Meta-analyses and meta-regressions were performed to analyse the data. The study protocol is registered with PROSPERO (CRD42024497878).<h3>Findings</h3>We identified 22 relevant publications, encompassing 29 outcome measures of complete diabetes remission and 33 outcome measures of partial remission. The pooled mean proportion of participants with complete remission 1 year after the intervention was 0·7% (95% CI 0·1–4·6) in those with bodyweight loss less than 10%, 49·6% (40·4–58·9) in those with bodyweight loss of 20–29%, and 79·1% (68·6–88·1) in those with bodyweight loss of 30% or greater; no studies reported on complete remission with 10–19% bodyweight loss. The pooled mean proportion of participants with partial remission 1 year after the intervention was 5·4% (95% CI 2·9–8·4) in those with bodyweight loss less than 10%, 48·4% (36·1–60·8) in those with 10–19% bodyweight loss, 69·3% (55·8–81·3) in those with bodyweight loss of 20–29%, and 89·5% (80·0–96·6) in those with bodyweight loss of 30% or greater. There was a strong positive association between bodyweight loss and remission. For every 1 percentage point decrease in bodyweight, the probability of reaching complete remission increased by 2·17 percentage points (95% CI 1·94–2·40) and the probability of reaching partial remission increased by 2·74 percentage points (2·48–3·00). No significant or appreciable associations were observed between age, sex, race, diabetes duration, baseline BMI, HbA<sub>1c</sub>, insulin use, or type of bodyweight loss intervention and remission. Overall, data were derived from randomised controlled trials with a low risk of bias in all quality domains.
{"title":"Impact of bodyweight loss on type 2 diabetes remission: a systematic review and meta-regression analysis of randomised controlled trials","authors":"Sarah Kanbour, Rwedah A Ageeb, Rayaz A Malik, Laith J Abu-Raddad","doi":"10.1016/s2213-8587(24)00346-2","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00346-2","url":null,"abstract":"<h3>Background</h3>Bodyweight loss is associated with type 2 diabetes remission; however, the quantitative relationship between the degree of bodyweight loss and the likelihood of remission, after controlling for confounding factors, remains unknown. We aimed to analyse the relationship between the degree of bodyweight loss and diabetes remission after controlling for various confounding factors, and to provide estimates for the effect sizes of these factors on diabetes remission.<h3>Methods</h3>This systematic review and meta-regression analysis followed Cochrane and PRISMA guidelines to systematically review, synthesise, and report global evidence from randomised controlled trials done in individuals with type 2 diabetes and overweight or obesity. The outcome was the proportion of participants with complete diabetes remission (HbA<sub>1c</sub> <6·0% [42 mmol/mol] or fasting plasma glucose [FPG] <100 mg/dL [5·6 mmol/L], or both, with no use of glucose-lowering drugs) or partial diabetes remission (HbA<sub>1c</sub> <6·5% [48 mmol/mol] or FPG <126 mg/dL [7·0 mmol/L], or both, with no use of glucose-lowering drugs) at least 1 year after a bodyweight loss intervention. We searched PubMed, Embase, and trial registries from database inception up to July 30, 2024. Data were extracted from published reports. Meta-analyses and meta-regressions were performed to analyse the data. The study protocol is registered with PROSPERO (CRD42024497878).<h3>Findings</h3>We identified 22 relevant publications, encompassing 29 outcome measures of complete diabetes remission and 33 outcome measures of partial remission. The pooled mean proportion of participants with complete remission 1 year after the intervention was 0·7% (95% CI 0·1–4·6) in those with bodyweight loss less than 10%, 49·6% (40·4–58·9) in those with bodyweight loss of 20–29%, and 79·1% (68·6–88·1) in those with bodyweight loss of 30% or greater; no studies reported on complete remission with 10–19% bodyweight loss. The pooled mean proportion of participants with partial remission 1 year after the intervention was 5·4% (95% CI 2·9–8·4) in those with bodyweight loss less than 10%, 48·4% (36·1–60·8) in those with 10–19% bodyweight loss, 69·3% (55·8–81·3) in those with bodyweight loss of 20–29%, and 89·5% (80·0–96·6) in those with bodyweight loss of 30% or greater. There was a strong positive association between bodyweight loss and remission. For every 1 percentage point decrease in bodyweight, the probability of reaching complete remission increased by 2·17 percentage points (95% CI 1·94–2·40) and the probability of reaching partial remission increased by 2·74 percentage points (2·48–3·00). No significant or appreciable associations were observed between age, sex, race, diabetes duration, baseline BMI, HbA<sub>1c</sub>, insulin use, or type of bodyweight loss intervention and remission. Overall, data were derived from randomised controlled trials with a low risk of bias in all quality domains.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"6 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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