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Sodium–glucose co-transporter inhibitors—who would have guessed?
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-14 DOI: 10.1016/s2213-8587(25)00001-4
Anna Norhammar, Viveca Ritsinger
No Abstract
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引用次数: 0
Effect of sotagliflozin on major adverse cardiovascular events: a prespecified secondary analysis of the SCORED randomised trial
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-14 DOI: 10.1016/s2213-8587(24)00362-0
Rahul Aggarwal, Deepak L Bhatt, Michael Szarek, Christopher P Cannon, Lawrence A Leiter, Silvio E Inzucchi, Renato D Lopes, Darren K McGuire, Julia B Lewis, Matthew C Riddle, Michael J Davies, Phillip Banks, Amy K Carroll, Benjamin M Scirica, Kausik K Ray, Mikhail N Kosiborod, David Z I Cherney, Jacob A Udell, Subodh Verma, R Preston Mason, Ph Gabriel Steg
<h3>Background</h3>Sodium–glucose co-transporter (SGLT)-2 inhibitors have shown consistent benefit in improving heart failure-related outcomes but not ischaemic cardiovascular events such as myocardial infarction or stroke. We assessed if the dual SGLT1/2 inhibitor sotagliflozin improves ischaemic outcomes.<h3>Methods</h3>We did a prespecified secondary analysis of the SCORED trial, which was a double-blind, placebo-controlled, randomised clinical trial enrolling patients (aged ≥18 years) with type 2 diabetes, chronic kidney disease (estimated glomerular filtration rate [eGFR] 25–60 mL/min per 1·73 m<sup>2</sup>), and additional cardiovascular risk factors. Patients at 750 sites in 44 countries were randomly assigned (1:1) to oral sotagliflozin or placebo via an interactive response technology system (block size of four; stratified by heart failure-related criteria and geographical region), with participants, investigators, and study staff, including those who assessed outcomes, masked to group assignment. Sotagliflozin treatment was prescribed at 200 mg once a day, with the dose increased to 400 mg once a day within the first 6 months if tolerated. Matching placebo was prescribed at the same treatment frequency as the intervention regimen. A prespecified secondary outcome was total major adverse cardiovascular events (MACE), which was defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke, assessed as first and subsequent events. Other outcomes included total myocardial infarction and total stroke (fatal and non-fatal events) as individual post-hoc endpoints. Outcomes were assessed by intention to treat with competing-risk proportional hazard models in the overall population, and, for total MACE, in prespecified subgroups stratified by baseline demographic and clinical features (sex, age, geographical region, heart failure-related criteria, eGFR, urine albumin–creatinine ratio, and cardiovascular disease history). The SCORED trial was registered at <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>NCT03315143</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>, and was ended early due to loss of funding.<h3>Findings</h3>10 584 patients were enrolled and randomly assigned to sotagliflozin (n=5292 [50·0%]) or placebo (n=5292 [50·0%]) between Dec 8, 2017 and Jan 20, 2020 (median age 69 years [IQR 63–74]; 4754 [44·9%] female patients and 5830 [55·1%] male patients). 5144 (48·6%) patients had a history of cardiovascular disease, of whom 2108 (19·9% of the total population) had a history of myocardial infarction, 946 (8·9%) had a history of strok
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引用次数: 0
Prediabetes: much more than just a risk factor
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-13 DOI: 10.1016/s2213-8587(25)00034-8
No Abstract
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引用次数: 0
Long-term outcomes and challenges of islet transplantation in type 1 diabetes
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-07 DOI: 10.1016/s2213-8587(25)00003-8
Mikael Chetboun, François Pattou
No Abstract
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引用次数: 0
Long-term outcomes of pancreatic islet transplantation alone in type 1 diabetes: a 20-year single-centre study in Italy 1 型糖尿病患者单纯胰岛移植的长期疗效:意大利一项为期 20 年的单中心研究
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-07 DOI: 10.1016/s2213-8587(24)00341-3
Davide Catarinella, Raffaella Melzi, Alessia Mercalli, Paola Magistretti, Stefano Tentori, Chiara Gremizzi, Vera Paloschi, Francesco De Cobelli, Giuseppe Esposto, Sabrina Costa, Antonio Secchi, Rossana Caldara, Paola Maffi, Rita Nano, Lorenzo Piemonti
<h3>Background</h3>Islet transplantation has the potential to cure type 1 diabetes by restoring endogenous insulin production. However, its success relies on balancing improved glycaemic control with the risks of immunosuppressive therapy. This study aimed to evaluate long-term outcomes of islet transplantation alone for type 1 diabetes, focusing on the effects of islet mass and immunosuppressive regimens on graft survival and insulin independence, and weighing glycaemic control benefits against the risks of immunosuppressive therapy.<h3>Methods</h3>This cohort study retrospectively analysed individuals aged 18–67 years with type 1 diabetes who received intraportal islet transplantation alone at IRCCS Ospedale San Raffaele, Milan, Italy. Inclusion criteria comprised adults with type 1 diabetes diagnosed before the age of 55 years with severe recurrent hypoglycaemia or glycaemic instability. Major exclusion criteria included a HbA<sub>1c</sub> of more than 12·5%, a BMI of more than 30 kg/m<sup>2</sup>, and insulin requirements exceeding 1·2 IU/kg per day, along with contraindications to immunosuppressive therapy. Participants were recruited from the hospital's islet transplant registry. Follow-up was conducted through regular clinical visits, with data collected retrospectively. Outcomes assessed included patient survival, graft survival, insulin independence, glycaemic control, and adverse events. Data were analysed using an intention-to-treat method, mixed-effects models, Kaplan–Meier estimates, and Cox and logistic regression to identify factors linked to metabolic success and reduced risks.<h3>Findings</h3>79 patients underwent intrahepatic or intraportal islet transplantation alone between Feb 16, 2001, and June 1, 2023, and received a total of 159 islet infusions, with a median total islet mass of 9637 islet equivalents (IEQ) per kg. Complications were infrequent and mostly involved minor bleeding, with only 3% (two of 79) of patients requiring surgical intervention. Glycaemic control improved significantly after infusion, with a reduction of HbA<sub>1c</sub> by –10·04 mmol/mol (–13·63 to –6·46), and a decrease in daily insulin requirements by –13·35 units per day (–17·04 to –9·65). The intention-to-treat analysis showed a median graft survival (fasting C peptide ≥0·3 ng/mL) of 3·9 years (95% CI 1·6 to 6·2) and 44% (35/79) insulin independence for a median of 6 years (95% CI 2·88 to 9·08). Patients receiving more than 10 000 IEQ/kg with BAS, FK506, and Rapa therapy had a median graft survival of 9·7 years (3·1–16·0) and 73% (16 of 22) insulin independence. Kaplan–Meier estimates indicated graft survival rates of 86% at 1 year, 65% at 5 years, 47% at 10 years, 47% at 15 years, and 40% at 20 years. Overall survival was 92% (73 of 79) over a median follow-up of 13·1 years, with a 20-year survival probability of 84%. Adverse events related to immunosuppressive therapy were reported in 44% (35 of 79) of patients, with allosensitisation rates incr
{"title":"Long-term outcomes of pancreatic islet transplantation alone in type 1 diabetes: a 20-year single-centre study in Italy","authors":"Davide Catarinella, Raffaella Melzi, Alessia Mercalli, Paola Magistretti, Stefano Tentori, Chiara Gremizzi, Vera Paloschi, Francesco De Cobelli, Giuseppe Esposto, Sabrina Costa, Antonio Secchi, Rossana Caldara, Paola Maffi, Rita Nano, Lorenzo Piemonti","doi":"10.1016/s2213-8587(24)00341-3","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00341-3","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Islet transplantation has the potential to cure type 1 diabetes by restoring endogenous insulin production. However, its success relies on balancing improved glycaemic control with the risks of immunosuppressive therapy. This study aimed to evaluate long-term outcomes of islet transplantation alone for type 1 diabetes, focusing on the effects of islet mass and immunosuppressive regimens on graft survival and insulin independence, and weighing glycaemic control benefits against the risks of immunosuppressive therapy.&lt;h3&gt;Methods&lt;/h3&gt;This cohort study retrospectively analysed individuals aged 18–67 years with type 1 diabetes who received intraportal islet transplantation alone at IRCCS Ospedale San Raffaele, Milan, Italy. Inclusion criteria comprised adults with type 1 diabetes diagnosed before the age of 55 years with severe recurrent hypoglycaemia or glycaemic instability. Major exclusion criteria included a HbA&lt;sub&gt;1c&lt;/sub&gt; of more than 12·5%, a BMI of more than 30 kg/m&lt;sup&gt;2&lt;/sup&gt;, and insulin requirements exceeding 1·2 IU/kg per day, along with contraindications to immunosuppressive therapy. Participants were recruited from the hospital's islet transplant registry. Follow-up was conducted through regular clinical visits, with data collected retrospectively. Outcomes assessed included patient survival, graft survival, insulin independence, glycaemic control, and adverse events. Data were analysed using an intention-to-treat method, mixed-effects models, Kaplan–Meier estimates, and Cox and logistic regression to identify factors linked to metabolic success and reduced risks.&lt;h3&gt;Findings&lt;/h3&gt;79 patients underwent intrahepatic or intraportal islet transplantation alone between Feb 16, 2001, and June 1, 2023, and received a total of 159 islet infusions, with a median total islet mass of 9637 islet equivalents (IEQ) per kg. Complications were infrequent and mostly involved minor bleeding, with only 3% (two of 79) of patients requiring surgical intervention. Glycaemic control improved significantly after infusion, with a reduction of HbA&lt;sub&gt;1c&lt;/sub&gt; by –10·04 mmol/mol (–13·63 to –6·46), and a decrease in daily insulin requirements by –13·35 units per day (–17·04 to –9·65). The intention-to-treat analysis showed a median graft survival (fasting C peptide ≥0·3 ng/mL) of 3·9 years (95% CI 1·6 to 6·2) and 44% (35/79) insulin independence for a median of 6 years (95% CI 2·88 to 9·08). Patients receiving more than 10 000 IEQ/kg with BAS, FK506, and Rapa therapy had a median graft survival of 9·7 years (3·1–16·0) and 73% (16 of 22) insulin independence. Kaplan–Meier estimates indicated graft survival rates of 86% at 1 year, 65% at 5 years, 47% at 10 years, 47% at 15 years, and 40% at 20 years. Overall survival was 92% (73 of 79) over a median follow-up of 13·1 years, with a 20-year survival probability of 84%. Adverse events related to immunosuppressive therapy were reported in 44% (35 of 79) of patients, with allosensitisation rates incr","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"11 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367476","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}
引用次数: 0
What is a normal glucose value?
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-06 DOI: 10.1016/s2213-8587(25)00023-3
Viral N Shah, David Kerr
No Abstract
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引用次数: 0
Trends in incidence, metastasis, and mortality from thyroid cancer in the USA from 1975 to 2019: a population-based study of age, period, and cohort effects
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-05 DOI: 10.1016/s2213-8587(24)00310-3
Michelle M Chen, Michael Luu, Wendy L Sacks, Lisa Orloff, Lauren P Wallner, Jon Mallen-St Clair, Susan C Pitt, Allen S Ho, Zachary S Zumsteg

Background

In the USA, the incidence of thyroid cancer increased rapidly for several decades, although some studies have suggested that it has now plateaued or even begun to decrease. We aimed to establish whether incidence in the USA has truly decreased or merely plateaued, and to understand some of the underlying factors driving these changes.

Methods

We conducted a retrospective, population-based study using the National Cancer Institute (NCI)'s Surveillance, Epidemiology, and End Results database and the National Center for Health Statistics database. We used incidence data from these registries obtained between 1975 and 2019, including patients with a diagnosis of thyroid cancer according to the third edition ICD for Oncology (site code C73.9) and malignant histology. We used the NCI's Joinpoint Regression Program to estimate trends in the incidence over time and age-period-cohort modelling to identify the factors influencing these trends.

Findings

Our sample included 91 968 patients with thyroid cancer, of whom 23 467 (25·5%) were men and 68 501 (74·5%) were women. The annual incidence of thyroid cancer increased from 5·0 cases per 100 000 people in 1975 to 14·6 cases per 100 000 people in 2009, before plateauing until 2019. The age-period-cohort analysis suggests that the changes in incidence were primarily due to time period effects. Furthermore, the increase in incidence was most prominent among women aged 40–69 years and men aged 50–79 years. Throughout all time periods, incidence increased with each successive birth cohort among both women and men.

Interpretation

The rise and subsequent plateau in the incidence of thyroid cancer in the USA have been primarily driven by time period effects, likely due to changing patterns in diagnostic pressure. Variations in the incidence of thyroid cancer by age, which increased during the time frame of this study, seem to be driven predominantly by overdiagnosis. Although the incidence of thyroid cancer has plateaued, it remains at peak levels, suggesting that overdiagnosis remains a crucial unresolved public health issue. Further work is needed to help limit the current drivers of overdiagnosis and to implement novel solutions aimed at both physicians, patients, and policy makers.

Funding

None.
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引用次数: 0
Trends in thyroid cancer incidence and overdiagnosis in the USA
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-05 DOI: 10.1016/s2213-8587(24)00343-7
Luigino Dal Maso, Salvatore Vaccarella, Silvia Franceschi
No Abstract
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引用次数: 0
Correction to Lancet Diabetes Endocrinol 2025; 13: 119–33 柳叶刀糖尿病内分泌 2025; 13: 119-33 更正
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-02-03 DOI: 10.1016/s2213-8587(25)00021-x
Yang J, Burrello J, Goi J, et al. Outcomes after medical treatment for primary aldosteronism: an international consensus and analysis of treatment response in an international cohort. Lancet Diabetes Endocrinol 2025; 13: 119–33—In this Article, the spelling of author Ying Song's name was incorrect. In this Article, Jun Yang and Renata Libianto have been added to the affiliation, Department of Endocrinology, Monash Health, Clayton, VIC, Australia. In the panel, the third bullet point under the Clinical outcomes subheading has been changed to a footnote, now cited in the second bullet point under the same subheading. The last sentence of the seventh paragraph of the results section has been corrected to read, “Of the participants with a complete clinical response, 160 (70%) were female, whereas of those with an absent clinical response, 88 (39%) were female.” Appendix 14 of this Article has been corrected. These changes have been made to the online version as of Feb 3, 2025.
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引用次数: 0
Automated insulin delivery postpartum: insights from the AiDAPT study extension
IF 44.5 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-01-27 DOI: 10.1016/s2213-8587(24)00374-7
David N O'Neal, Glynis P Ross
No Abstract
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引用次数: 0
期刊
The Lancet Diabetes & Endocrinology
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