Pub Date : 2025-10-25DOI: 10.1016/s2213-8587(25)00263-3
Sho Katsuragawa, Minh V Le, Peter J Fuller, Jun Yang
{"title":"Post-treatment renin status and cardiovascular, renal, and mortality outcomes in medically treated primary aldosteronism: a systematic review and meta-analysis","authors":"Sho Katsuragawa, Minh V Le, Peter J Fuller, Jun Yang","doi":"10.1016/s2213-8587(25)00263-3","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00263-3","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"21 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145383798","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 : 2025-10-25DOI: 10.1016/s2213-8587(25)00320-1
Giles S H Yeo
{"title":"The importance of science communication surrounding weight-loss drugs","authors":"Giles S H Yeo","doi":"10.1016/s2213-8587(25)00320-1","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00320-1","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"27 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382740","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 : 2025-10-25DOI: 10.1016/s2213-8587(25)00327-4
Peter N Taylor, Malcolm Prentice, Kristien Boelaert, John Lazarus
{"title":"Safeguarding natural intelligence: the case for renewed action on iodine sufficiency in the UK","authors":"Peter N Taylor, Malcolm Prentice, Kristien Boelaert, John Lazarus","doi":"10.1016/s2213-8587(25)00327-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00327-4","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"7 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145383796","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 : 2025-10-25DOI: 10.1016/s2213-8587(25)00249-9
Elisabeth Nowak, Qilin Zhang, Shuo Zhang, Yao Zhao, Hongying Ye, Márcio Carlos Machado, Caio Celio Santiago Moises, Miklós Tóth, Júlia Stark, Kevin C J Yuen, Mark Gurnell, James MacFarlane, Ann McCormack, Mauli Govinna, Aleksandra Gilis-Januszewska, Mari Minasyan, Ilaria Bonaventura, Mauro A Czepielewski, Amandine Ferriere, Monica Gadelha, Andrea M Isidori, Darko Kastelan, Dominique Maiter, Antoine Tabarin, Krystallenia I Alexandraki, Julia Chang, Eric D Frontera, Felicia A Hanzu, Niina Matikainen, Dragana Miljic, Robert Pichler, Vera Popovic, Joanna L Spencer-Segal, Karen Tordjman, Amit Akirov, Marta Araujo-Castro, Emanuela Arvat, Irina Bancos, Fabio Bioletto, Pia Burman, Frederic Castinetti, Mario Detomas, Martin Fassnacht, Richard A Feelders, Athanasios Fountas, Peter Igaz, Sasa Ilic, Kristina Isand, Gregory Kaltsas, Gesine Meyer, Mirko Parasiliti-Caprino, John Newell-Price, Oskar Ragnarsson, Elena Valassi, Greisa Vila, John Wass, Uri Yoel, Maria Fleseriu, Martin Reincke
{"title":"Cycle characterisation and clinical complications in patients with cyclic Cushing's syndrome: insights from an international retrospective cohort study","authors":"Elisabeth Nowak, Qilin Zhang, Shuo Zhang, Yao Zhao, Hongying Ye, Márcio Carlos Machado, Caio Celio Santiago Moises, Miklós Tóth, Júlia Stark, Kevin C J Yuen, Mark Gurnell, James MacFarlane, Ann McCormack, Mauli Govinna, Aleksandra Gilis-Januszewska, Mari Minasyan, Ilaria Bonaventura, Mauro A Czepielewski, Amandine Ferriere, Monica Gadelha, Andrea M Isidori, Darko Kastelan, Dominique Maiter, Antoine Tabarin, Krystallenia I Alexandraki, Julia Chang, Eric D Frontera, Felicia A Hanzu, Niina Matikainen, Dragana Miljic, Robert Pichler, Vera Popovic, Joanna L Spencer-Segal, Karen Tordjman, Amit Akirov, Marta Araujo-Castro, Emanuela Arvat, Irina Bancos, Fabio Bioletto, Pia Burman, Frederic Castinetti, Mario Detomas, Martin Fassnacht, Richard A Feelders, Athanasios Fountas, Peter Igaz, Sasa Ilic, Kristina Isand, Gregory Kaltsas, Gesine Meyer, Mirko Parasiliti-Caprino, John Newell-Price, Oskar Ragnarsson, Elena Valassi, Greisa Vila, John Wass, Uri Yoel, Maria Fleseriu, Martin Reincke","doi":"10.1016/s2213-8587(25)00249-9","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00249-9","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"55 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382742","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 : 2025-10-15DOI: 10.1016/s2213-8587(25)00325-0
Inagaki N, Takeuchi M, Oura T, et al. Efficacy and safety of tirzepatide monotherapy compared with dulaglutide in Japanese patients with type 2 diabetes (SURPASS J-mono): a double-blind, multicentre, randomised, phase 3 trial. Lancet Diabetes Endocrinol 2022; 10: 623–33—Appendix 2 of this Article has been corrected as of Oct 15, 2025.
{"title":"Correction to Lancet Diabetes Endocrinol 2022; 10: 623–33","authors":"","doi":"10.1016/s2213-8587(25)00325-0","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00325-0","url":null,"abstract":"<em>Inagaki N, Takeuchi M, Oura T, et al. Efficacy and safety of tirzepatide monotherapy compared with dulaglutide in Japanese patients with type 2 diabetes (SURPASS J-mono): a double-blind, multicentre, randomised, phase 3 trial.</em> Lancet Diabetes Endocrinol <em>2022;</em> 10: <em>623–33</em>—Appendix 2 of this Article has been corrected as of Oct 15, 2025.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"67 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145295654","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 : 2025-10-14DOI: 10.1016/s2213-8587(25)00260-8
Nicholas Thomas, Danijela Tatovic, Angus Jones, Parth Narendran
New disease-modifying therapies, such as teplizumab, offer opportunities to delay the clinical onset of type 1 diabetes but require islet autoantibody screening to identify individuals at increased risk of progression to diabetes. As type 1 diabetes screening programmes expand, clinicians will increasingly encounter a new group of people: adults who test positive for islet autoantibodies but have not yet been diagnosed with diabetes. Although international guidelines outline management for both children and adults, considerable uncertainties remain, particularly for adults. In adults with islet autoantibody positivity, the lower risk of progression to type 1 diabetes compared with children, combined with the high background prevalence of mild non-autoimmune dysglycaemia, presents substantial challenges for clinical management. This Personal View aims to add clarity to international consensus guidelines, proposing a pragmatic framework for managing adults with islet autoantibody positivity. Although fitting within a UK National Health Service setting, we feel this framework is also relevant to other health systems.
{"title":"Managing adults with screen-detected islet autoantibody positivity: a pragmatic framework","authors":"Nicholas Thomas, Danijela Tatovic, Angus Jones, Parth Narendran","doi":"10.1016/s2213-8587(25)00260-8","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00260-8","url":null,"abstract":"New disease-modifying therapies, such as teplizumab, offer opportunities to delay the clinical onset of type 1 diabetes but require islet autoantibody screening to identify individuals at increased risk of progression to diabetes. As type 1 diabetes screening programmes expand, clinicians will increasingly encounter a new group of people: adults who test positive for islet autoantibodies but have not yet been diagnosed with diabetes. Although international guidelines outline management for both children and adults, considerable uncertainties remain, particularly for adults. In adults with islet autoantibody positivity, the lower risk of progression to type 1 diabetes compared with children, combined with the high background prevalence of mild non-autoimmune dysglycaemia, presents substantial challenges for clinical management. This Personal View aims to add clarity to international consensus guidelines, proposing a pragmatic framework for managing adults with islet autoantibody positivity. Although fitting within a UK National Health Service setting, we feel this framework is also relevant to other health systems.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"9 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145289379","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 : 2025-10-11DOI: 10.1016/s2213-8587(25)00222-0
William G Herrington, Zhaojing J Che, Rebecca Sardell, Alistair J Roddick, Parminder K Judge, Christoph Wanner, Sibylle J Hauske, Stefan Anker, Javed Butler, Gerasimos Filippatos, Milton Packer, Faiez Zannad, Dominik Steubl, Martina Brueckmann, Jennifer B Green, Jonathan R Emberson, Martin J Landray, Colin Baigent, Richard Haynes, Natalie Staplin
Background
Uncertainty remains about effects of sodium–glucose co-transporter-2 (SGLT2) inhibition on kidney outcomes in individuals with slowly progressive chronic kidney disease (eg, low albuminuria) and those at risk of large acute estimated glomerular filtration rate (eGFR) dips on initiation of such treatment. We aimed to explore the effects of empagliflozin on a range of kidney outcomes in these population subtypes.
Methods
In this meta-analysis, we used individual-level data from 23 340 participants in four large placebo-controlled trials (EMPA-REG OUTCOME, EMPEROR-Reduced, EMPEROR-Preserved, and EMPA-KIDNEY) to assess the effects of empagliflozin on conventional and exploratory acute and chronic kidney outcomes. We then assessed whether effects varied by predicted size of the acute eGFR dip on treatment initiation or among other key population subtypes using tests for heterogeneity and trend. The individual-level data were requested from Boehringer Ingelheim (Ingelheim, Germany).
Findings
Compared with placebo, allocation to empagliflozin reduced the risk of a marker of acute kidney injury (a ≥50% increase in serum creatinine in consecutive follow-up samples) by 20% (hazard ratio 0·80 [95% CI 0·72–0·88]; 1573 outcomes), acute kidney injury adverse events by 27% (0·73 [0·63–0·85]; 694 outcomes), a categorical chronic kidney disease progression outcome by 30% (0·70 [0·63–0·78]; 1403 outcomes), and kidney failure by 34% (0·66 [0·55–0·79]; 490 outcomes). Empagliflozin slowed a chronic annual rate of eGFR decline by 64% (95% CI 59–69) and off-treatment dip-free slope—a post-hoc outcome using randomisation and off-treatment eGFR values available in a subset of 10 630 participants—by 64% (54–73). These kidney benefits were similar in subgroups divided by predicted size of acute eGFR dip, and were present irrespective of diabetes or heart failure status, level of kidney function, or albuminuria.
Interpretation
SGLT2 inhibition reduces risk of acute and chronic kidney outcomes irrespective of the size of the acute dip in eGFR. Kidney benefits are evident irrespective of diabetes status, heart failure status, primary cause of kidney disease, and markers of severity of these diseases.
{"title":"Effects of empagliflozin on conventional and exploratory acute and chronic kidney outcomes: an individual participant-level meta-analysis","authors":"William G Herrington, Zhaojing J Che, Rebecca Sardell, Alistair J Roddick, Parminder K Judge, Christoph Wanner, Sibylle J Hauske, Stefan Anker, Javed Butler, Gerasimos Filippatos, Milton Packer, Faiez Zannad, Dominik Steubl, Martina Brueckmann, Jennifer B Green, Jonathan R Emberson, Martin J Landray, Colin Baigent, Richard Haynes, Natalie Staplin","doi":"10.1016/s2213-8587(25)00222-0","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00222-0","url":null,"abstract":"<h3>Background</h3>Uncertainty remains about effects of sodium–glucose co-transporter-2 (SGLT2) inhibition on kidney outcomes in individuals with slowly progressive chronic kidney disease (eg, low albuminuria) and those at risk of large acute estimated glomerular filtration rate (eGFR) dips on initiation of such treatment. We aimed to explore the effects of empagliflozin on a range of kidney outcomes in these population subtypes.<h3>Methods</h3>In this meta-analysis, we used individual-level data from 23 340 participants in four large placebo-controlled trials (EMPA-REG OUTCOME, EMPEROR-Reduced, EMPEROR-Preserved, and EMPA-KIDNEY) to assess the effects of empagliflozin on conventional and exploratory acute and chronic kidney outcomes. We then assessed whether effects varied by predicted size of the acute eGFR dip on treatment initiation or among other key population subtypes using tests for heterogeneity and trend. The individual-level data were requested from Boehringer Ingelheim (Ingelheim, Germany).<h3>Findings</h3>Compared with placebo, allocation to empagliflozin reduced the risk of a marker of acute kidney injury (a ≥50% increase in serum creatinine in consecutive follow-up samples) by 20% (hazard ratio 0·80 [95% CI 0·72–0·88]; 1573 outcomes), acute kidney injury adverse events by 27% (0·73 [0·63–0·85]; 694 outcomes), a categorical chronic kidney disease progression outcome by 30% (0·70 [0·63–0·78]; 1403 outcomes), and kidney failure by 34% (0·66 [0·55–0·79]; 490 outcomes). Empagliflozin slowed a chronic annual rate of eGFR decline by 64% (95% CI 59–69) and off-treatment dip-free slope—a post-hoc outcome using randomisation and off-treatment eGFR values available in a subset of 10 630 participants—by 64% (54–73). These kidney benefits were similar in subgroups divided by predicted size of acute eGFR dip, and were present irrespective of diabetes or heart failure status, level of kidney function, or albuminuria.<h3>Interpretation</h3>SGLT2 inhibition reduces risk of acute and chronic kidney outcomes irrespective of the size of the acute dip in eGFR. Kidney benefits are evident irrespective of diabetes status, heart failure status, primary cause of kidney disease, and markers of severity of these diseases.<h3>Funding</h3>None.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"52 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282719","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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