The Lancet Diabetes & Endocrinology最新文献

{"title":"Insulin and health systems in global low-resource settings.","authors":"Sze May Ng","doi":"10.1016/S2213-8587(26)00128-2","DOIUrl":"10.1016/S2213-8587(26)00128-2","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"704-705"},"PeriodicalIF":36.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399685","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":"Safety and tolerability of orforglipron in Japanese people with type 2 diabetes","authors":"Michael A Nauck, Michael Horowitz","doi":"10.1016/s2213-8587(26)00182-8","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00182-8","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"38 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754775","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":"Long-term safety of oral orforglipron in Japanese participants with type 2 diabetes (ACHIEVE-J): a multicentre, randomised, open-label, parallel-group phase 3 trial","authors":"Daisuke Yabe, Toshihiko Shiraiwa, Hiroyuki Ugai, Masakazu Takeuchi, Ryo Suzuki","doi":"10.1016/s2213-8587(26)00138-5","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00138-5","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"18 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754776","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":"Toxic chemicals: the fight for planetary health","authors":"Talha Burki","doi":"10.1016/s2213-8587(26)00215-9","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00215-9","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"15 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754778","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":"Toxic chemicals: the fight for planetary health.","authors":"Talha Burki","doi":"10.1016/S2213-8587(26)00215-9","DOIUrl":"https://doi.org/10.1016/S2213-8587(26)00215-9","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":""},"PeriodicalIF":36.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760152","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":"Obesity medications versus metabolic bariatric surgery: the debate goes on.","authors":"Tricia M M Tan","doi":"10.1016/S2213-8587(26)00124-5","DOIUrl":"10.1016/S2213-8587(26)00124-5","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"619-621"},"PeriodicalIF":36.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273473","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":"Out of touch medical care.","authors":"The Lancet Diabetes Endocrinology","doi":"10.1016/S2213-8587(26)00164-6","DOIUrl":"10.1016/S2213-8587(26)00164-6","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"617"},"PeriodicalIF":36.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370428","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":"A quarter-century of progress: innovations in lipid medicine that transformed cardiovascular prevention.","authors":"Lluís Masana, Josep Ribalta, Daiana Ibarretxe","doi":"10.1016/S2213-8587(26)00102-6","DOIUrl":"10.1016/S2213-8587(26)00102-6","url":null,"abstract":"<p><p>This TimeCapsule reviews the major transformations in lipid metabolism and cardiovascular disease prevention during the first quarter of the 21st century and their impact on clinical practice. From late 20^th century paradigms to current state-of-the-art strategies, the field has consolidated statins as foundational therapy while establishing the clinical benefit of non-statin agents and introducing biological therapies into cardiovascular disease prevention. These developments support the paradigm that lowering LDL-cholesterol levels earlier and sustaining this over time translates to greater reductions in cardiovascular risk. More recently, RNA-targeted and DNA-targeted approaches have enabled the modulation of proteins, such as PCSK9, lipoprotein(a), apolipoprotein C-III, and ANGPTL3. The traditional concept of HDL-cholesterol being considered a good cholesterol has been challenged, whereas the causal relevance of lipoprotein(a) has gained recognition. New metrics-including non-HDL-cholesterol, apolipoprotein B, triglyceride-rich remnants, or remnant cholesterol-are increasingly integrated into residual risk assessment. A growing sex-specific perspective has refined cardiovascular research and care. Despite robust evidence, the proportion of patients meeting their recommended targets remains unacceptably low. Implementation science seeks to address this persistent evidence-practice gap. In parallel, artificial intelligence is reshaping scientific methodologies and is poised to transform the understanding and management of lipid-related cardiometabolic disease.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"693-702"},"PeriodicalIF":36.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206567","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":"1-year outcomes of semaglutide, tirzepatide, and sleeve gastrectomy in obesity in type 2 diabetes: a retrospective cohort study.","authors":"Daniel B Leslie, Brian T Steffen, Eric Wise, Lyn M Steffen, Kristi Kopacz, Darin Ruanpeng, David R Jacobs, Sayeed Ikramuddin","doi":"10.1016/S2213-8587(26)00030-6","DOIUrl":"10.1016/S2213-8587(26)00030-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Type 2 diabetes and obesity are prevalent, inter-related conditions for which treatment options have expanded substantially, yet direct real-world comparisons of modern pharmacological and surgical interventions remain scarce. We aimed to compare 1-year weight loss, glycaemic outcomes, and selected safety outcomes associated with semaglutide, tirzepatide, and sleeve gastrectomy among adults with obesity and type 2 diabetes in real-world clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cohort study using Epic Cosmos, a de-identified electronic health record dataset from 1633 hospitals and 37 900 clinics across 280 health systems in the USA. Adults with a BMI of at least 35 kg/m&lt;sup&gt;2&lt;/sup&gt; and HbA&lt;sub&gt;1c&lt;/sub&gt; above 6·4% who initiated at least 12 months of therapy with semaglutide or tirzepatide and attaining maintenance doses, or who underwent sleeve gastrectomy, were eligible for inclusion. The primary outcome was attainment of at least 20% bodyweight loss and HbA&lt;sub&gt;1c&lt;/sub&gt; below 5·7% at 1 year after the index date. Multivariable logistic regression estimated adjusted probabilities and relative risks, adjusting for age, sex, race, baseline HbA&lt;sub&gt;1c&lt;/sub&gt;, BMI, Charlson Comorbidity Index, Social Vulnerability Index (SVI 2020), and baseline medication burden for diabetes, lipids, and hypertension. Prespecified safety outcomes included emergency department visits and new prescriptions for gastro-oesophageal reflux disease or nausea within 1 year of the index date. The primary composite outcome was analysed among patients with both follow-up weight and HbA&lt;sub&gt;1c&lt;/sub&gt; available in the 9-month to 15-month window. Emergency department visits were analysed in the final analysis cohort (ie, patients meeting all inclusion and exclusion criteria and with available baseline and 9-month to 15-month weight and HbA&lt;sub&gt;1c&lt;/sub&gt; measurements) and medication-based safety outcomes were analysed descriptively using outcome-specific available data denominators without imputation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;A total of 468 712 patients with at least 365 consecutive days of semaglutide or tirzepatide prescriptions and 238 028 patients undergoing sleeve gastrectomy were identified in Epic Cosmos. After applying prespecified inclusion and exclusion criteria, 45 649 patients met inclusion criteria; after exclusion of 556 patients with missing Charlson Comorbidity Index data, 45 093 were included in the primary outcome analysis: 33 482 (74·3%) treated with semaglutide, 4178 (9·3%) treated with tirzepatide, and 7433 (16·5%) who underwent sleeve gastrectomy. The adjusted probability of attaining the primary composite outcome of at least 20% bodyweight loss and HbA&lt;sub&gt;1c&lt;/sub&gt; below 5·7% at 1 year was 3·0% (95% CI 2·8-3·2) for semaglutide, 13·2% (12·2-14·3) for tirzepatide, and 24·0% (22·9-25·1) for sleeve gastrectomy. Emergency department visits within 1 year were more frequent after sleeve gastrec","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"638-648"},"PeriodicalIF":36.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273426","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":"Safety of biopsy in phaeochromocytoma and paraganglioma: an international, multicentre, retrospective cohort study.","authors":"Liang Zhang, Gautier Tisserand, Yanting Shen, Mahdi Salehi, Laurence Amar, Yunying Cui, Renata Świątkowska-Stodulska, Sophie Moog, Jun Liu, Sriram Gubbi, Henrik Falhammar, Tomaz Kocjan, Peter Igaz, Julien Hadoux, William F Young, Hanna Remde, Anna Babińska, Valeria de Miguel, Felix Beuschlein, Longfei Liu, Serena Palmieri, Jingjing Jiang, Alessa Fischer, Jeena Varghese, Ana Carreira, Mirko Parasiliti-Caprino, Svenja Nölting, Yue Zhou, Tamara Prodanov, Irina Bancos, Martin Fassnacht, Camilo Jimenez, Hussam Alkaissi, Anli Tong, Karel Pacak, Joakim Crona","doi":"10.1016/S2213-8587(26)00033-1","DOIUrl":"10.1016/S2213-8587(26)00033-1","url":null,"abstract":"<p><strong>Background: </strong>Biopsy of phaeochromocytomas and paragangliomas (PPGLs) is discouraged due to the perceived risk of catecholamine-related complications. However, a systematic review showed that this recommendation is primarily supported by case reports. We aimed to assess the safety of percutaneous biopsy in patients with PPGLs.</p><p><strong>Methods: </strong>This international, multicentre, retrospective study included patients of any age with PPGLs referred to participating centres who had had percutaneous core-needle biopsy or fine-needle aspiration. Biopsies of head and neck paragangliomas were excluded. Participating centres completed standardised data-collection forms. The primary outcome was biopsy-related mortality rate for all patients who had biopsies performed at participating centres, given that biopsies done elsewhere that had fatal outcomes would be unlikely to be referred. Secondary outcomes included the incidence of serious catecholamine-related and non-catecholamine-related complications among all included patients.</p><p><strong>Findings: </strong>Between Sep 1, 1993, and May 31, 2025, 222 patients (110 [50%] female, 112 [50%] male) underwent 234 biopsies in 19 hospitals across 11 countries. 139 (67%) of 207 patients had elevated epinephrine or norepinephrine (or metabolites) and 27 (12%) of 232 biopsies were preceded by the administration of α-adrenoceptor blockade. One (mortality rate 0·9% [95% CI 0·0-5·1]) of 106 biopsies led to death due to biopsy-related infection. Serious catecholamine-related complications occurred after four (1·7% [0·5-4·3]) of 233 biopsies and included tachyarrhythmia, hypertensive crisis, and cardiogenic shock. No serious catecholamine-related complications occurred in patients without catecholamine excess (n=59), receiving fine-needle aspiration (n=46), or after biopsy of metastatic lesions (n=114). Serious non-catecholamine-related complications occurred after ten (4·3% [2·1-7·8]) of 233 biopsies, mainly bleeding and infection.</p><p><strong>Interpretation: </strong>Percutaneous biopsy of PPGLs was associated with a low mortality rate. Serious complication rates were also low, most of which were not catecholamine-related. These findings challenge current recommendations that biopsy should be avoided in suspected or confirmed PPGLs, and instead support a personalised, risk-benefit-based approach to the procedure.</p><p><strong>Funding: </strong>Cancerfonden.</p><p><strong>Translations: </strong>For the Chinese and French translations of the abstract see Supplementary Materials section.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"630-637"},"PeriodicalIF":36.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876328","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}