The Lancet Diabetes & Endocrinology最新文献

{"title":"What REDEFINE 5 signals for obesity trials in Asia and beyond","authors":"Yu Mi Kang, Vanita R Aroda","doi":"10.1016/s2213-8587(26)00012-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00012-4","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"7 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708650","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}

{"title":"Efficacy and safety of co-administered cagrilintide and semaglutide versus semaglutide alone in adults with overweight or obesity with or without type 2 diabetes in Japan and Taiwan (REDEFINE 5): a multicentre, randomised, active-controlled, phase 3a trial","authors":"Toshimasa Yamauchi, Niels-Peter Becker, Christoffer Andersen Hagemann, Kuo-Chin Huang, Arihiro Kiyosue, Soo Lim, Yukiko Onishi, Ananda Kosuvaripalli, Tomoko Takano, Yasushi Ishigaki","doi":"10.1016/s2213-8587(25)00402-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00402-4","url":null,"abstract":"<h3>Background</h3>The combination of cagrilintide and semaglutide has been shown in global studies to induce reductions in bodyweight. We assessed the efficacy and safety of a fixed-dose combination of cagrilintide 2·4 mg and semaglutide 2·4 mg versus semaglutide 2·4 mg for weight management in an east Asian population.<h3>Methods</h3>This double-blind, parallel-group, phase 3a trial (REDEFINE 5) was conducted across 21 sites (community, hospital) in Japan and one site in Taiwan. We included participants aged at least 18 years with a BMI of at least 27 kg/m<sup>2</sup> and at least two obesity-related complications, or with a BMI of at least 35 kg/m<sup>2</sup> and at least one obesity-related complication (per the Japan Society for the Study of Obesity guidelines), with or without type 2 diabetes. Participants were randomly assigned (1:1) to once-weekly subcutaneous injections of cagrilintide–semaglutide or semaglutide (both escalated to 2·4 mg), plus lifestyle intervention, for 68 weeks. Randomisation was done centrally using an interactive web response system and stratified according to planned CT scan, BMI of at least 35 kg/m<sup>2</sup>, and type 2 diabetes status. Participants, site staff, investigators, and study funder were all masked to active study treatments. The primary endpoint was relative change in bodyweight from baseline to week 68. Efficacy analyses were done in all participants who underwent randomisation, using the trial product estimand (ie, assuming the treatment was taken as intended, regardless of dose) as the primary estimand. Missing data at week 68 were imputed. Safety analyses were done in all participants who underwent randomisation and received at least one dose of trial product. This trial 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>NCT05813925</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 is complete.<h3>Findings</h3>Between April 3, 2023, and Sept 15, 2023, we screened 355 individuals; 331 were randomly assigned to cagrilintide–semaglutide (n=164) or semaglutide (n=167). 226 (68%) participants were male and 105 (32%) were female; 80 (24%) had type 2 diabetes. 17 (10%) participants discontinued cagrilintide–semaglutide and ten (6%) discontinued semaglutide. The estimated mean change in bodyweight from baseline to week 68 was −18·4% (SE 0·7) in the cagrilintide–semaglutide group versus −11·9% (0·7) in the semaglutide group (estimated treatment difference [ETD] −6·5 percentage points [95% CI −8·4 to −4·6]; p<0·0001). Adverse events were reported by 143 (87%) of 164 participants in the cagrilintide–semaglutide group and","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"224 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708651","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}

{"title":"Secondary causes of diabetes: a crossroad of endocrinology and oncology","authors":"Nicholas Ken-Yoong Hee MBBS, Quan-Hziung Lim MBBS, Prof Kamlesh Khunti FMedSci, Ying-Guat Ooi MBBS, I-Weng Yen MD, Marniza Saad MD, Prof Elif I Ekinci PhD, Prof Hung-Yuan Li PhD, Prof Shireene R Vethakkan MD, Prof Juliana C N Chan MD, Prof Lee-Ling Lim PhD","doi":"10.1016/s2213-8587(26)00027-6","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00027-6","url":null,"abstract":"Cancer and diabetes share a bidirectional relationship, with cancer increasingly recognised as an associated factor of diabetes, both from the disease itself and its treatments. In this Review, we aim to: (1) summarise the distinct mechanisms of dysglycaemia arising from cancer and neuroendocrine tumour treatments, including targeted therapies such as PI3K–AKT–mTOR inhibitors, antibody–drug conjugates, immune checkpoint inhibitors, corticosteroids, and somatostatin receptor ligands; (2) examine the often overlooked aspect of the secondary cause of diabetes as an early manifestation of cancer; and (3) highlight research gaps and encourage a collaborative care approach to manage the rising rate of dysglycaemia as a result of cancer and its evolving treatments. To address the first two objectives, we incorporate relevant case vignettes to contextualise the discussions.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"130 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147681085","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}

{"title":"Low visceral fat and kidney disease risk in men with diabetes","authors":"Carmine Zoccali, Francesca Mallamaci","doi":"10.1016/s2213-8587(26)00045-8","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00045-8","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"24 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147681082","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}

{"title":"Sex-specific and BMI-specific associations between visceral fat and diabetic kidney disease in patients with diabetes: a large-scale multicentre prospective cohort study","authors":"Juan Shi MD, Prof Dong Zhao MD, Jing Wang MD, Prof Yufan Wang MD, Qijuan Dong MD, Jiahang Hu MD, Prof Yubo Sha MD, Ying Peng MD, Yuancheng Dai MD, Qidong Zheng MD, Fengmei Xu MD, Haiyun Lan MD, Bangqun Ji MD, Prof Li Li MD, Prof Hongmei Qiu MD, Ranhua Jiang MD, Rong Tang MD, Prof Shen Qu MD, Liu Yang MD, Tingyu Ke MD, Sheli Li MD, Zhiyun Zhao MD, Prof Yifei Zhang MD, Prof Weiqing Wang MD, MMC and ChinaMAP Collaborative Group","doi":"10.1016/s2213-8587(26)00001-x","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00001-x","url":null,"abstract":"There are few large-scale prospective studies on directly measured visceral fat area (VFA) and diabetic kidney disease, with inconsistent findings across sex and BMI. We aimed to investigate the association between VFA and incident diabetic kidney disease risk and to examine how this association differs by sex and BMI.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"316 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147681084","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}

{"title":"World Autism Awareness Day: autism and metabolic health","authors":"","doi":"10.1016/s2213-8587(26)00079-3","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00079-3","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"20 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597964","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}

{"title":"From survival to freedom: redefining success in type 1 diabetes.","authors":"Lorenzo Piemonti","doi":"10.1016/S2213-8587(26)00003-3","DOIUrl":"10.1016/S2213-8587(26)00003-3","url":null,"abstract":"<p><p>Type 1 diabetes has shifted from a condition once associated with early mortality to a chronic disease owing to the development of intensive insulin therapy, continuous glucose monitoring, and hybrid closed-loop systems. Despite near-normoglycaemia becoming an attainable target, residual excess mortality and cardiovascular risk persist. These outcomes are thought to reflect the long-term biological legacy of earlier dysglycaemia, including metabolic and epigenetic memory associated with inflammatory and vascular vulnerability. As survival for people with type 1 diabetes lengthens, morbidity increasingly shifts towards cognitive decline, depression, infections, and cancer, whereas the lived burden of daily disease management remains high. As evidence suggests that further reductions in HbA_1c do not translate into proportional improvements in outcomes at the population level, the next therapeutic frontier becomes physiological resilience: interventions that restore endogenous regulation, reduce glycaemic variability, and dampen inflammatory stress, thereby approximating a more physiological metabolic state. β-cell replacement-via pancreas or islet transplantation and emerging stem cell-derived implants-should be judged less by mean HbA_1c and more by durability, safety, C-peptide preservation, time in (tight) range, and validated patient-reported outcomes. Regulatory and economic frameworks must consequently embrace multidimensional benefits. Within this evolving framework, success is measured not only by longer survival, but also by improved physiological control achieved with minimal toxicity and reduced cognitive burden. This Personal View argues for reframing therapeutic success in type 1 diabetes by shifting the focus from glycaemic metrics alone to the restoration of endogenous regulation and physiological resilience-outcomes operationalised as sustained metabolic stability, protection from severe hypoglycaemia, and a substantial reduction in cognitive and therapeutic burden.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"356-362"},"PeriodicalIF":36.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322460","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}

{"title":"Combined associations of GLP-1 receptor agonists and a healthy lifestyle with cardiovascular outcomes among individuals with type 2 diabetes: a prospective cohort study.","authors":"Xuan-Mai T Nguyen, Yanping Li, Sébastien Czernichow, Nathalie Rassy, Serena C Houghton, Bing Lu, Yuk-Lam Ho, Brian R Charest, Dong D Wang, David R Gagnon, John Michael Gaziano, Walter C Willett, Peter W F Wilson, Kelly Cho, Frank B Hu","doi":"10.1016/S2213-8587(25)00395-X","DOIUrl":"10.1016/S2213-8587(25)00395-X","url":null,"abstract":"<p><strong>Background: </strong>The long-term combined effects of lifestyle habits and GLP-1 receptor agonists on cardiovascular outcomes are unknown. We aimed to examine the combined association of GLP-1 receptor agonist use and adherence to eight lifestyle habits with cardiovascular outcomes.</p><p><strong>Methods: </strong>We did a prospective cohort study of individuals with type 2 diabetes enrolled within the US Veterans Affairs' Million Veteran Program between Jan 10, 2011, and Sept 30, 2023. Participants had no previous history of myocardial infarction, stroke, or advanced chronic kidney disease. The eight low-risk lifestyle habits assessed were a higher quality diet, being physically active, not smoking, restful sleep, no heavy alcohol intake, good stress management, social connection and support, and no opioid use disorder. We assessed the risk of major adverse cardiovascular events (MACE), defined as non-fatal stroke or myocardial infarction, or cardiovascular death, according to GLP-1 receptor agonist use and low-risk lifestyle habits using Cox proportional hazard regression models.</p><p><strong>Findings: </strong>Of the 963 753 veterans enrolled, a total of 98 261 participants were included in the study with 632 543 person-years of follow-up, during which 10 443 people developed MACE. Multivariable-adjusted hazard ratio (HR) of MACE was 0·40 (95% CI 0·30-0·54) when comparing participants adhering to all eight low-risk lifestyle habits to those adopting one habit or less. Multivariable-adjusted HR of MACE was 0·84 (0·76-0·92) when comparing users of GLP-1 receptor agonists with non-users. Participants using GLP-1 receptor agonists and adhering to six to eight low-risk lifestyle factors had a 43% lower risk of MACE than did those with three or fewer low-risk lifestyle factors and no GLP-1 receptor agonist use (0·57; 0·46-0·71).</p><p><strong>Interpretation: </strong>Adherence to low-risk lifestyle habits combined with GLP-1 receptor agonist use was associated with a greater reduction in MACE risk than either approach alone, underscoring the importance of integrating lifestyle modification with pharmacotherapy in type 2 diabetes management.</p><p><strong>Funding: </strong>Department of Veterans Affairs.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"317-326"},"PeriodicalIF":36.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322434","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}

{"title":"Correction to Lancet Diabetes Endocrinol 2025; 13: 935–48","authors":"","doi":"10.1016/s2213-8587(26)00078-1","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00078-1","url":null,"abstract":"<em>Lingvay I, Bergenheim SJ, Buse JB, et al. Once-weekly semaglutide 7·2 mg in adults with obesity and type 2 diabetes (STEP UP T2D): a randomised, controlled, phase 3b trial.</em> Lancet Diabetes Endocrinol <em>2025;</em> 13: <em>935–48</em>—In this Article, the total triglycerides concentration in table 1 has been corrected to 1·9 mmol/L; table 2 has been corrected to show that the supportive secondary endpoint of BMI (kg/m²) was assessed in 291 patients in the semaglutide 7·2 mg group; and the exploratory endpoint of the proportion of patients with a decrease in lipid-lowering medication was assessed in 0 of 103 participants in the semaglutide 2·4 mg group. In figure 2, panel B, the data labels for placebo and semaglutide 2·4 mg have been amended to align with the respective data points; in panel C, the p value for the bodyweight reduction threshold ≥20% has been corrected to p=0·006 and the p value for the bodyweight reduction threshold ≥25% has been deleted; and in panel D, the 95% CI for the bodyweight reduction threshold ≥10% (semaglutide 7·2 mg <em>vs</em> semaglutide 2·4 mg) has been corrected, the p value for the bodyweight reduction threshold ≥20% has been corrected to p=0·0003, and the p value for the bodyweight reduction threshold ≥25% has been deleted. In table 3, the 95% CI for the relative risk ratio for semaglutide 7·2 mg versus placebo for gastrointestinal adverse events has been corrected; and the 95% CI for the absolute risk difference for semaglutide 7·2 mg versus placebo for malignant neoplasms (in-trial) has also been corrected. Appendix 4 has also been corrected. These corrections have been made to the online version as of March 31, 2026.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"52 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147586135","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}

{"title":"Prevalence of early-stage type 1 diabetes in young adults: a population-based cohort study","authors":"Marie Standl, Marlon Scholz, Elisabeth Thiering, Monika Gappa, Tamara Schikowski, Peter Achenbach, Anette-G Ziegler","doi":"10.1016/s2213-8587(26)00034-3","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00034-3","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"52 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147536538","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}