Diabetes Therapy最新文献

{"title":"Cost-Effectiveness of Highly Effective Glucose-Lowering Agents: Do Current Practices Optimize Clinical and Economic Outcomes?","authors":"Meredith Hoog, Alice Minghetti, William J Valentine","doi":"10.1007/s13300-026-01846-8","DOIUrl":"10.1007/s13300-026-01846-8","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in type 2 diabetes (T2D) treatment have expanded therapeutic options, but evidence on optimal treatment sequencing for long-term outcomes remains limited. This study evaluated six common T2D treatment pathways in the US using long-term modeling.</p><p><strong>Methods: </strong>A literature review of guidelines and published data identified 495 treatment sequences across 77 studies. The six most frequently reported pathways were selected for modeling analyses using the PRIME T2D Model. Metformin was first-line therapy in all modeled pathways. Empagliflozin 10 mg (EMPA) was added as second-line therapy in four pathways, followed by either tirzepatide 10 mg (TZP), liraglutide 1.8 mg (LIRA), semaglutide 1.0 mg (SEMA) or dulaglutide 3.0 mg (DULA) as third-line therapy. In two pathways, TZP or SEMA were introduced as second-line agents, followed by EMPA as the third-line therapy. Basal and basal-bolus insulin were fourth- and fifth-line therapies in all analyses. Treatment intensification was modeled every 3 years or when glycated hemoglobin (HbA1c) exceeded 7.5%.</p><p><strong>Results: </strong>When used as third-line treatment, more efficacious agents improved clinical outcomes and increased costs relative to comparators. As the most efficacious third-line therapy, TZP was associated with incremental cost-effectiveness ratios (ICERs) of $50,545, $25,563, and $8,173 per quality-adjusted life years (QALYs) gained versus LIRA, SEMA and DULA, respectively, assuming intensification every 3 years. When used as second-line therapy, more efficacious agents further improved clinical outcomes but also contributed to higher direct costs over patients' lifetimes. Second-line TZP was associated with ICERs of $59,434 per QALY gained versus second-line SEMA, when intensification at HbA1c 7.5% was applied.</p><p><strong>Conclusions: </strong>Initiating more efficacious therapies early in T2D treatment may improve long-term outcomes. Though associated with higher upfront costs, these therapies may reduce complication-related costs over time. Use of modern, efficacious therapies earlier in disease management may be a cost-effective strategy for healthcare payers.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"571-585"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Glycaemic Control with IDegLira in Chinese Adults with Type 2 Diabetes in Real-World Settings: A Retrospective, Database Cohort Study.","authors":"Shanshan Wang, Bei Sun, Dongdong Zhu, Zewei Shen, Xing Zhong, Liming Chen","doi":"10.1007/s13300-026-01852-w","DOIUrl":"10.1007/s13300-026-01852-w","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate glycaemic control and safety in Chinese adults with type 2 diabetes (T2D) receiving fixed-ratio combination of insulin degludec and liraglutide (IDegLira) in real-world clinical practice.</p><p><strong>Methods: </strong>The Tianjin Health and Medical Big Data Super Platform was utilised to assess clinical characteristics, glycaemic control, and safety of Chinese adults with T2D receiving IDegLira between March 5, 2022 and June 30, 2024. The primary endpoint was change in glycated haemoglobin (HbA1c) from baseline to day 180. Secondary endpoints included change in HbA1c by baseline characteristics; change in fasting plasma glucose (FPG), postprandial glucose (PPG), and daily insulin dose; and treatment persistence. Exploratory endpoints included hypoglycaemic events and gastrointestinal adverse events (GI AEs).</p><p><strong>Results: </strong>Eligible participants were included in the full analysis set and safety analysis set (both n = 12,103), and participants receiving IDegLira for 180 days were included in the effectiveness analysis set (n = 3062). The mean (SD) change in HbA1c, FPG, PPG, and insulin dose after 180 days from baseline was - 1.08% (1.87, p < 0.001), - 2.34 mmol/L (3.61, p < 0.001), - 2.10 mmol/L (4.86, p < 0.001), and - 4.95 U/day (21.93, p < 0.001), respectively. Subgroup analyses of HbA1c change demonstrated that IDegLira decreased HbA1c significantly, irrespective of prior treatment, age, most baseline HbA1c, daily insulin dose, and fasting C-peptide quartiles. Median treatment persistence duration was 141.67 days (95% CI 135.67-146.67). Low percentages of patients reported hypoglycaemia (0.7%) or GI AEs (11.1%).</p><p><strong>Conclusions: </strong>IDegLira statistically improved glycaemic control by reducing HbA1c, FPG, and PPG levels in the Chinese population with T2D, with a favourable safety profile.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"603-616"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Outcomes of GLP-1 Receptor Agonists and Tirzepatide Across CKD Stages and Metabolic Phenotypes (Type 2 Diabetes and/or Overweight/Obesity): A Scoping Review.","authors":"Jorge Rico-Fontalvo, Rodrigo Daza-Arnedo, Alicia Elbert, Ricardo Correa-Rotter, Eliana Dina-Batlle, Eduardo Lorca-Herrera, Thyago Proença de Moraes, Vicente Sánchez-Polo, Carlos E Builes-Montaño","doi":"10.1007/s13300-026-01854-8","DOIUrl":"10.1007/s13300-026-01854-8","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus is the leading global cause of chronic kidney disease (CKD) and end-stage renal disease. Although cardiovascular outcomes have improved substantially, renal risk remains high. Glucagon-like peptide 1 (GLP-1) receptor agonists and the dual GLP-1/GIP agonist tirzepatide have demonstrated potential cardiorenal benefits, but renal evidence has not been systematically mapped across CKD stages and metabolic phenotypes. This scoping review aimed to identify and describe clinical evidence on renal outcomes associated with GLP-1-based therapies in adults with type 2 diabetes and/or overweight/obesity, with or without CKD.</p><p><strong>Methods: </strong>Following the Joanna Briggs Institute framework and PRISMA-ScR guidelines (protocol: OSF.IO/SZ87J), we searched PubMed, Embase, and CENTRAL from inception to October 2025. Eligible studies included phase 2-4 randomized controlled trials (RCTs), post hoc RCT analyses, and comparative observational studies reporting kidney outcomes. Data were charted using a structured extraction form with AI-assisted screening and manual validation. Risk of bias and certainty were appraised using RoB 2, ROBINS-I, and GRADE frameworks.</p><p><strong>Results: </strong>Of 607 records identified, 35 studies met inclusion criteria. Randomized evidence supports renal benefits for semaglutide, dulaglutide, and liraglutide, including reductions in composite kidney outcomes and slower eGFR decline. Tirzepatide demonstrated consistent albuminuria reductions and attenuation of eGFR decline compared with insulin glargine. Efpeglenatide, cotadutide, exenatide, and lixisenatide showed class-consistent antiproteinuric effects. Observational data extended findings to real-world and advanced CKD populations. Across agents, renal benefits were partly independent of glycemic and weight effects.</p><p><strong>Conclusion: </strong>GLP-1-based therapies demonstrate consistent renoprotective signals across CKD stages and metabolic phenotypes, particularly in type 2 diabetes. Evidence is strongest for semaglutide and dulaglutide, with emerging data for tirzepatide and other incretin-based agents. These findings provide a structured evidence map to inform future consensus and clinical decision-making.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"499-528"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiota and Metabolic Health: From Dysbiosis to Therapeutics.","authors":"Sabitha Sasidharan Pillai, Ambika P Ashraf","doi":"10.1007/s13300-026-01851-x","DOIUrl":"10.1007/s13300-026-01851-x","url":null,"abstract":"<p><p>The gut microbiota (GM) is a pivotal regulator of host metabolism and a contributor to the pathophysiology of obesity, type 2 diabetes (T2D), and metabolic syndrome (MS). Disruptions in GM composition and function are collectively termed dysbiosis. This review synthesizes current evidence on GM dysbiosis, moving beyond simple taxonomic associations, to examine functional drivers of metabolic dysfunction. Dysbiosis impairs metabolic health through several interconnected pathways: enhanced dietary energy extraction, compromised intestinal barrier integrity leading to metabolic endotoxemia, chronic low-grade \"meta-inflammation,\" and the disruption of circadian rhythms and neuro-immune signaling. Beyond bacteria, dysbiosis of the gut virome and mycobiota may further modulate metabolic risk. Animal and emerging human studies indicate that reduced virome diversity and altered phage-bacteria interactions can amplify dysbiosis, promote inflammatory signaling, and impair metabolic homeostasis. Recognition of GM dysbiosis as a contributor to metabolic disease has prompted development of therapeutic strategies aimed at restoring microbial balance and function. These interventions span a spectrum from established clinical approaches with indirect microbiota effects to experimental therapies designed to directly manipulate microbial composition or activity. We evaluate the clinical readiness of GM-targeted therapies, including dietary patterns, prebiotics, probiotics, and fecal microbiota transplantation. While established metabolic treatments such as glucagon-like peptide-1 (GLP-1) receptor agonists and bariatric surgery significantly reshape the GM, direct microbial manipulations often yield variable results in human trials. We conclude that the future of metabolic management lies in personalized microbiomics, utilizing artificial intelligence and precision-based interventions to restore specific functional microbial deficits tailored to the individual host profile.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"483-497"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Pen Needle Reuse in U.S. Adults with Diabetes: A Cross-Sectional Survey Study on Patterns, Motivations, and Educational Implications.","authors":"Susan Guzman, Natalie Bellini, Lucille Hughes, Pasha Javadi, Camilla Schanche, Maria Muccioli, Lori Berard","doi":"10.1007/s13300-026-01841-z","DOIUrl":"10.1007/s13300-026-01841-z","url":null,"abstract":"<p><strong>Introduction: </strong>Effective insulin therapy relies on proper injection technique and the correct use of insulin delivery devices. Despite recommendations for a single-use device, the pen needle reuse remains common. This study explored pen needle reuse patterns, reasons for reuse, and motivators to changing reuse behavior, in order to provide actionable insights for clinical education and patient-support interventions.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted with 500 U.S. adults with type 1 diabetes (T1D) or type 2 diabetes (T2D) who inject insulin at least twice daily using an insulin pen and use insulin pen needles at least twice before replacing.</p><p><strong>Results: </strong>Approximately 70% of survey participants reported using needles 2-5 times before replacing, and about 30% used them six or more times, with higher reuse among participants with T1D. Despite most participants reporting initial insulin injection education (86.8%), the majority indicated limited follow-up regarding injection practices. Specifically, 73.6% indicated their injection sites were never examined by a healthcare professional (HCP), 72.8% reported their injection technique had never been reviewed, and 66.2% reported their HCP had never asked them about injection site problems. The main reported reasons for needle reuse include convenience (64.2%), habit (46.2%), environmental/waste concern (40.8%), and cost (40.6%). The most motivating educational messages for changing reuse include those around A1c improvement and lipohypertrophy prevention, with the most trusted sources of information being endocrinologists, followed by primary care physicians (PCP), diabetes educators (known in the U.S. as diabetes care and education specialists), and peers.</p><p><strong>Conclusions: </strong>Pen needle reuse is widespread and initial education alone is insufficient. Ongoing reinforcement and messaging from trusted HCPs, particularly around A1c and injection-site outcomes, provide a key opportunity to support behavior change.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"529-546"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal Pain After Bariatric Surgery and the Role of the Gut: A Review.","authors":"Bregje de Louweren, Max Nieuwdorp, Victor E A Gerdes","doi":"10.1007/s13300-026-01844-w","DOIUrl":"10.1007/s13300-026-01844-w","url":null,"abstract":"<p><p>Obesity is a major health concern, affecting over 1 in 8 people worldwide. Bariatric surgery (BS) is currently the most effective long-term treatment for morbid obesity. In addition to sustained weight loss, BS is beneficial in treating obesity related comorbidities including dyslipidemia and type 2 diabetes (T2DM). The beneficial effects of BS are a result of weight loss and surgery-induced shifts in the gut microbiota and its metabolites. At the same time, BS may also lead to complications and side effects. Abdominal pain is one of the most frequently reported complaints after BS with a prevalence of 33.8-54.4% within this patient group. However, in many patients the abdominal pain remains unexplained beyond gallstones, internal herniation, and ulcers. This raises the question whether the gut microbiota itself may play a direct role in the pathophysiology of unexplained abdominal pain. Over the years several studies have shown changes in the gut microbiota and related metabolites after BS. These include increased gut microbial diversity and altered microbial composition after BS. Higher abundances of Proteobacteria and Fusobacteria are reported, while a decrease in butyrate-producing Firmicutes is reported. Along with these changes in microbiota, BS causes higher plasma bile acid levels and altered short-chain fatty acid (SCFA) profiles. These metabolic shifts are believed to support weight control, glucose regulation, and lipid metabolism. More recently, specific microbial taxa and metabolite profiles were linked to abdominal complaints following BS. This suggests that dysbiosis and metabolites may play a role in unexplained abdominal pain after BS.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"465-481"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Glucose Monitoring Before and After Simultaneous Pancreas-Kidney Transplantation: Insights from a Real-World Clinical Setting.","authors":"Antonio J Amor, Clara Solà, Pedro Ventura-Aguiar, Tonet Serés-Noriega, Enrique Montagud-Marrahi, Nerea Antón, Maria Claro, Marc Figueras-Roca, Montserrat Ruiz, Joana Ferrer-Fàbrega, Ramon Rull, Mireia Musquera, Fritz Diekmann, Enric Esmatjes","doi":"10.1007/s13300-026-01849-5","DOIUrl":"10.1007/s13300-026-01849-5","url":null,"abstract":"<p><strong>Introduction: </strong>Simultaneous pancreas-kidney (SPK) transplantation normalizes glycemia in patients with diabetes and end-stage kidney disease, yet data on continuous glucose monitoring (CGM) remain scarce.</p><p><strong>Methods: </strong>We retrospectively analyzed CGM metrics in SPK recipients using FreeStyle Libre 2®, comparing pre- and post-transplant profiles.</p><p><strong>Results: </strong>Among n = 19 recipients, only n = 14 continued CGM use after transplantation (n = 9 continuously during the entire study period). Within 1 month, all CGM metrics improved significantly, including increased time-in-range (54.21 vs. 83.85%) and time-in-tight-range (TITR; 33.45 vs. 69.77%), and reduced glucose variability (p < 0.05 for all comparisons), with stability over 24 months. Optimal graft function was associated with superior CGM outcomes, notably higher TITR and lower mean amplitude of glycemic excursions (MAGE; p < 0.05). However, hypoglycemia-related targets were not consistently achieved despite otherwise optimal graft performance.</p><p><strong>Conclusions: </strong>SPK transplantation was linked to rapid and sustained improvement in CGM profiles. These findings underscore CGM's value for monitoring graft function and support its integration into post-transplant care to optimize metabolic outcomes.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"617-626"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Cohort Study of Semaglutide in Adults with Type 2 Diabetes Using an Electronic Health Records Database in Tianjin, China.","authors":"Shanshan Wang, Ping Hu, Zewei Shen, Liming Chen","doi":"10.1007/s13300-026-01848-6","DOIUrl":"10.1007/s13300-026-01848-6","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate changes in clinical parameters among adults with type 2 diabetes (T2D) after initiating subcutaneous semaglutide in Chinese clinical practice.</p><p><strong>Methods: </strong>SCHOLAR was a retrospective cohort study using data from the Tianjin regional electronic health records database, including adults with T2D who initiated once-weekly semaglutide (full analysis set [FAS]). Endpoints included change in glycated hemoglobin (HbA_1c) and proportion with HbA_1c < 7.0% at month 6 (primary)/12 (secondary); lipids, medication classes, and safety (exploratory endpoints).</p><p><strong>Results: </strong>Among 26,859 individuals (FAS), mean ± SD age was 57 ± 13 years, and duration of T2D was 4 ± 3 years. Individuals with HbA_1c measurements at baseline and month 6 (n = 3055; baseline HbA_1c 7.65%) and 12 (n = 2897; baseline HbA_1c 7.75%) were included in the HbA_1c analyses. Mean change (95% CI) in HbA_1c was - 0.65%-points (- 0.71, - 0.59) at month 6, and - 0.47%-points (- 0.53, - 0.41) at month 12 with semaglutide (both p < 0.0001). The proportion of individuals with HbA_1c < 7.0% was 40.4%, 57.9%, and 49.8% at baseline, month 6, and month 12, respectively. Additionally, for individuals with HbA_1c ≥ 7.0% at baseline (mean HbA_1c 8.59%), mean HbA_1c change (95% CI) at month 6 was - 1.17%-points (- 1.25, - 1.08) (p < 0.0001). Total cholesterol, low-density lipoprotein cholesterol, and triglycerides significantly decreased after 12 months with semaglutide (p < 0.05). Among individuals with continued semaglutide use, mean daily insulin dose, and number of combined oral antidiabetic, antihypertensive, and lipid-lowering medication classes reduced after 6/12 months (all p < 0.05). In the FAS, constipation, diarrhea, and abdominal discomfort were the most frequently reported adverse events (1.73%, 0.91%, and 0.89%, respectively).</p><p><strong>Conclusions: </strong>Initiating once-weekly semaglutide was associated with significant improvements versus baseline in glycemic control and lipids in people with T2D from Tianjin, China. Safety of semaglutide was similar to the established safety profile per adverse events assessment.</p><p><strong>Clinical trials registration: </strong>NCT06351748.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"587-602"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of Research: Safety and Effectiveness of Concomitant iGlarLixi and SGLT-2i Use in People with T2D During Ramadan Fasting: A SoliRam Study Sub-analysis.","authors":"Mohamed Hassanein, Rachid Malek, Saud Al Sifri, Rakesh Kumar Sahay, Mehmet Akif Buyukbese, Khier Djaballah, Lydie Melas-Melt, Inass Shaltout","doi":"10.1007/s13300-025-01827-3","DOIUrl":"10.1007/s13300-025-01827-3","url":null,"abstract":"<p><p>This is a summary of the original article \"Safety and effectiveness of concomitant iGlarLixi and SGLT-2i use in people with T2D during Ramadan fasting: a SoliRam study sub-analysis.\" iGlarLixi is a fixed-ratio combination of insulin glargine 100 U/ml and glucagon like peptide 1 receptor agonist (GLP-1RA) lixisenatide which has demonstrated its effectiveness of improving glycemic parameters and reducing body weight with low risk of hypoglycemia incidence in adults with type 2 diabetes (T2D) who were previously sub-optimally controlled with oral antidiabetic drugs (OADs) alone or in combination with basal insulin or GLP-1RA. This sub-analysis of the SoliRam study assessed the safety and effectiveness of concomitant iGlarLixi and sodium/glucose cotransporter 2 (SGLT-2i) use with or without other OADs in adults with T2D who fasted during Ramadan. Participants were divided into two groups: SGLT-2i-users and SGLT-2i-non-users. The findings showed low incidence of severe and/or symptomatic documented hypoglycemia, improved glycemic control, and body weight benefits, irrespective of SGLT-2i use. No serious adverse events were reported in either group. The sub-analysis concluded that the concomitant iGlarLixi and SGLT-2i therapy, with or without other OADs, was demonstrated to be a safe treatment for people with T2D during Ramadan fasting.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"313-316"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern Management of CKM Syndrome: Use of GLP-1 Receptor Agonists in a Multidisciplinary Setting-Expert Group Recommendations from Kuwait.","authors":"Waleed A Aldahi, Abdullah Alenezi, Thamer Alessa, Rashed Alhamdan, Khaldoon A Al-Humood, Ahmed Alqallaf, Torki Alotaibi, Heba Alrajab, Abdulmuhsen M Alshammari, Anas M Alyousef, Asrar Alsayed Hashem, Manfredi Rizzo","doi":"10.1007/s13300-025-01838-0","DOIUrl":"10.1007/s13300-025-01838-0","url":null,"abstract":"<p><p>Obesity, type 2 diabetes (T2D), cardiovascular disease (CVD), and chronic kidney disease (CKD) are overlapping conditions that drive premature morbidity and mortality worldwide. Care remains siloed and reactive despite shared risk factors and strong evidence for early intervention. To support integrated disease management, the American Heart Association (AHA) recently introduced the concept of cardiovascular-kidney-metabolic (CKM) syndrome, recognizing the bidirectional links between metabolic, kidney, and cardiovascular health. Kuwait faces one of the highest burdens of CKM-related diseases globally. Three-quarters of adults are overweight or have obesity, and 28% have diabetes, both of which are leading causes of mortality and health system strain. Yet multidisciplinary care remains limited, and innovative pharmacotherapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), are underused. A panel of Kuwaiti endocrinologists, cardiologists, and nephrologists convened to assess barriers to optimal CKM care and define practical recommendations. Discussions focused on current gaps in screening, care coordination, provider education, and access to therapies. Evidence on GLP-1 RAs was reviewed, considering the demonstrated benefits for weight loss, glycemic control, cardiovascular outcomes, and CKD progression. The expert group agreed that multidisciplinary, risk-stratified, and patient-centered approaches are urgently needed. Recommendations include earlier screening and diagnosis, improved integration across specialties, healthcare provider upskilling, public awareness campaigns, and broader access to GLP-1 RAs. Semaglutide was highlighted as a clinically valuable option owing to its broad efficacy and safety profile. Adopting a CKM care model tailored to Kuwait's specific challenges, with appropriate use of GLP-1 RAs, can reduce disease burden, improve outcomes, and increase healthcare system efficiency. The local implementation of evidence-based, cross-specialty strategies is key to altering the trajectory of CKM syndrome in high-risk populations.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"373-389"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}