🚨SURPASS-CVOT: What’s #tirzepatide’s REAL CV benefit vs placebo❓🚨 New Diabetes Care analysis uses imputed placebo comparison from REWIND Tirzepatide vs imputed placebo: 🔹 MACE-3: HR 0.72 (0.55 to 0.94) 🔸 All-cause mortality: HR 0.61 (0.45 to 0.82) ⚠️ Caveats matter: 1️⃣Cross-trial comparison, not direct RCT 2️⃣SGLT2i use 31% vs 0% in REWIND 3️⃣Only 21% of REWIND met SURPASS-CVOT criteria The real question: will regulators grant a CV indication? FDA may agree (they already gave dulaglutide one). But EMA/MHRA never added formal CV indication to dulaglutide despite REWIND. Stakes are high: licence change = guideline change = access change 🔗 doi.org/10.2337/dc26-0298

Systematic review GLP-1RA cessation is associated with a predictable and decelerating pattern of weight regain Plateau below pre-treatment levels, suggesting that partial weight-loss benefit may persist long-term but is substantially attenuated. thelancet.com/journals/eclin…

After what seems like a long time in waiting the HCL competency framework is finally here: doi.org/10.1111/dme.70253 Looking out for linked assessments via DTN Have a fab day 😀 @drpratikc @LDC_tweets @DTN_UK @TrendDiabetes @DSNforumUK

Why Do Patients Discontinue GLP-1 Medications for Obesity? Adherence Challenges ❌ 50% stop treatment within 6 months Top Reasons for Stopping 🤢 Side effects (mainly GI): 36% 🚗 Logistics (travel, time): 24% 💰 Cost & affordability: 23% dom-pubs.onlinelibrary.wiley…

An EASO publication in @NatureMedicine proposes a framework for diagnosing, staging & managing adult obesity. Prof. @busetto_luca highlights the need for comprehensive clinical evaluations beyond BMI. easo.org/professor-luca-buse…

❤️ Weight & HbA1c Reductions associated with mortality & cardiovascular benefits Meta-regression of 44 trials ⚖️ Each 1 kg weight loss = 3.4% ↓ mortality risk 🩸 Each 1% HbA1c ⬇️ = 7.6% ↓ mortality risk 📉 Effects regardless of drug class dom-pubs.onlinelibrary.wiley…

The 'Decision Support Tool' for those living with #T1Diabetes Published January 2024 @NHSEngland Built with many living with #T1D and clinical colleagues in the #T1D space Do use, RT and cascade as you need to! (Also available in Bengali; Polish; Urdu & Punjabi) @BT1DUK @DiabetesUK @kamleshkhunti @GoggleDocs @NHSDiabetesProg @sugarydoc Link: england.nhs.uk/publication/d…

For details see the following papers: pubmed.ncbi.nlm.nih.gov/2780… pubmed.ncbi.nlm.nih.gov/2989… pubmed.ncbi.nlm.nih.gov/3864…

While I’m happy that our 2011 mathematical model was used by @nesta_uk to estimate the step reduction in daily calories would be required to address obesity in the UK, I wish they had read our later studies. Unfortunately, a constant intensity intervention to reduce calorie intake typically results in exponential waning of the effect over time (not a sustained step reduction) and will therefore only result in about 20% of the weight loss they predicted.

The efficacy of intermittent scanning continuous glucose monitoring in the elderly*: A case-control study. *Older people Older people with diabetes benefit from is-CGM. HbA1c drops sustained for 2 years, few stop using it. More support for CGM in older age! #DiabetesCare

Major survey of all Nutritionists and Dietitians in UK! #AcademyNutritionSciences want to hear from every #Nutritionist or #Dietitian What are your research experiences? Please take part, no matter whether you do no research, a little or a lot! qualtrics.kcl.ac.uk/jfe/form…

Retrospective claims data reveals over 20 % of GLP-1 medicine users had nutritional deficiencies diagnosed within one-year of starting GLP-1RA treatment. pdf.sciencedirectassets.com/…

Real-world comparison of semaglutide/tirzepatide (GLP‑1/GLP‑1 GIP) vs bariatric surgery. 📉 In a real-world matched study of 14,152 pts: At 2 years: • Surgery: −25.7% total weight loss (TWL) • GLP-1s (semaglutide/tirzepatide): −5.3% TWL (ITT); −7.6% (per-protocol) • HbA1c drop: Surgery −0.5 pts vs GLP-1s −0.2 pts (p<0.001) ⚖️ Conclusion: Surgery delivers greater, sustained weight loss & better glycemic control vs GLP-1s for eligible patients. soard.org/article/S1550-7289…

💉 GLP-1 meds don’t just curb appetite—sometimes they curb essential nutrients too. - - - 📉 In a study of 460,000 adults on GLP-1s (mostly with T2D): 🔹13% developed nutritional deficiencies in 6 months 🔹22% within 12 months 🔹Vitamin D deficiency was most common (13.6%) 🔹3% experienced muscle loss 🔍 Patients who saw a dietitian were more likely to have deficiencies identified—not because dietitians caused harm, but because they actually looked. 💡 Clinical translation: 🔹Appetite suppression can lower intake of protein, vitamins (D, B12, folate), and minerals. 🔹Without supervision, this can compromise muscle mass, hydration, and metabolic health. 🔹Older adults and those with obesity are especially vulnerable due to baseline deficiencies. Treating obesity isn't just about weight loss—it's about preserving health while losing weight. ✅ That’s why supervised care with physicians registered dietitians is non-negotiable. ✅ Monitor labs (Vit D, B12, iron, folate). ✅ Emphasize protein, strength training, and hydration. 📚sciencedirect.com/science/ar… Credit to @drbutsch and colleagues.

Realigning #diabetes regimens in older adults: a 4S Pathway to guide simplification and deprescribing strategies thelancet.com/journals/landi… #T1D #T2D #olderadults #FREE to read with registration (also FREE) #ADA2025

This is a very good review of type 2 diabetes jamanetwork.com/journals/jam…

today.com/today/amp/rcna2132… #ADASciSessions #ADA2025

Addressing #obesity can help prevent T2D. @EASOobesity acknowledges the importance of addressing obesity as both a risk factor for diabetes — along with CVD and cancer — and a chronic disease in its own right. #EASOpolicy

Standard of Care in 2025 #ADASciSessions #ADA2025

Thrilled to finally share what has kept me occupied these past few months; our @TheLancet Series on early-onset type 2 diabetes is out! Has been an honour to be the Lead Author for this Series brining together global experts; thanks @callam_editor for inviting me People developing #T2D at young ages, lose ~15-20 years of lifespan ☹️ We highlight emerging evidence, major research gaps and emphasise the need for population-level prevention and precision care, both necessary to reverse this concerning trend. The articles are free to access until mid-August, please share widely (@ImperialMDR @ImperialMed @ImperialAHSC @ImperialBRC)! Paper 1: authors.elsevier.com/a/1lJZF… Paper 2: authors.elsevier.com/c/1lJZF… Paper 3: authors.elsevier.com/a/1lJZG… thanks to my fantastic co-authors (tagging the ones on here): @LeeLingLim1 @kamleshkhunti @CCikomola @Andrea_OY_Luk @Poojasachdev_dr @armocida_b