{"title":"Hashimoto's thyroiditis: two decades on.","authors":"Leonidas H Duntas, Grigoris Effraimidis","doi":"10.1016/S2213-8587(26)00189-0","DOIUrl":"https://doi.org/10.1016/S2213-8587(26)00189-0","url":null,"abstract":"<p><p>Hashimoto's thyroiditis is the most common cause of primary hypothyroidism in iodine-sufficient regions and is characterised by immune-mediated injury to thyroid follicular cells. Its pathophysiology involves an interplay of genetic susceptibility, environmental exposures, and epigenetic modifications that disrupt immune tolerance, promoting T-cell mediated thyroid injury and thyroid autoantibody production. The disease can progress from euthyroid autoimmunity to subclinical and overt hypothyroidism, with substantial variation in its course. Clinical manifestations vary with the extent of thyroid dysfunction and inflammatory activity. Diagnosis relies on clinical assessment, thyroid function testing, thyroid autoantibody measurement, and ultrasonography when indicated. Management centres on levothyroxine replacement for overt hypothyroidism, with an individualised approach to subclinical disease. Thyroidectomy is reserved for selected indications, whereas emerging immunomodulatory strategies remain investigational. This Review synthesises developments over the past two decades in the epidemiology, natural history, aetiopathogenesis, diagnosis, and management of Hashimoto's thyroiditis, and considers emerging mechanistic insights and approaches to precision medicine that might inform future disease-modifying therapies.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":""},"PeriodicalIF":36.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128926","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":"Redrawing the lines for the management of obesity in Asia.","authors":"Bernard Khoo","doi":"10.1016/S2213-8587(26)00155-5","DOIUrl":"10.1016/S2213-8587(26)00155-5","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"794-795"},"PeriodicalIF":36.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707762","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":"IL-2 and immunoregulatory therapies in newly diagnosed type 1 diabetes","authors":"S Alice Long,Cate Speake","doi":"10.1016/s2213-8587(26)00236-6","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00236-6","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"24 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089121","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":"Diabetes and the role of primary care: a global perspective","authors":"Partha Kar,Harini Sathanapally,Pablo Aschner,Leonard Baatiema,Alice Cheng,Yashdeep Gupta,Clare Hambling,Ronald Ma,Samuel Seidu,Kamlesh Khunti","doi":"10.1016/s2213-8587(26)00214-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00214-7","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"36 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089119","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}
Srikanth Bellary, Muhammad Ali Karamat, Anthony H Barnett
{"title":"Type 2 diabetes management: weekly combination therapy comes of age?","authors":"Srikanth Bellary, Muhammad Ali Karamat, Anthony H Barnett","doi":"10.1016/S2213-8587(26)00165-8","DOIUrl":"10.1016/S2213-8587(26)00165-8","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"795-797"},"PeriodicalIF":36.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764029","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":"Less can be more: the 2026 Endocrine Society Guideline for precision care in central precocious puberty.","authors":"Sasha R Howard","doi":"10.1016/S2213-8587(26)00193-2","DOIUrl":"10.1016/S2213-8587(26)00193-2","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"799-801"},"PeriodicalIF":36.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671120","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}