The Lancet Diabetes & Endocrinology最新文献

{"title":"Endocrine-neuropsychological interplay underpinning maternal postpartum depression.","authors":"Tatia M C Lee, Aidan K Y Chan, Chi-Ho Lee","doi":"10.1016/S2213-8587(26)00158-0","DOIUrl":"10.1016/S2213-8587(26)00158-0","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"624-626"},"PeriodicalIF":36.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340670","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":"Temporal changes in cortisol secretion and their association with long-term outcomes in benign adrenal incidentalomas: a retrospective cohort study","authors":"Onnicha Suntornlohanakul MD, Giuseppe Reimondo PhD, Marco Ghislieri PhD, Luigi Petramala PhD, Kimberly Coscia MD, Ivana Kraljevic PhD, Anna Perini MD, Filippo Ceccato PhD, Serena Palmieri PhD, Lakshmi Rengarajan MD, Malgorzata Bobrowicz PhD, Barbara Altieri PhD, Leili Rahimi MD, Joanna Matrozova PhD, Maria Elena Aloini MD, Diego Rivas-Otero MD, Magnus Löndahl PhD, Ljiljana V Marina PhD, Krystallenia I Alexandraki PhD, Henrik Falhammar PhD, Nuria Valdés Gallego PhD, Valentina Morelli PhD, Anna Angelousi PhD, Grethe Å Ueland PhD, Prof Andrea M Isidori PhD, Duarte Pignatelli PhD, Vittoria Favero MD, Verena Theiler-Schwetz PhD, Francesco Circosta PhD, Lorenzo Tucci MD, Mirjana Đukić MD, Soraya Puglisi MD, Giulia Bovo MD, Alessandra Mangone MD, Cristina L Ronchi PhD, Adrianna Gladka MD, Mario Detomas MD, Vladimir Vasilev PhD, Adriana D Servello MD, Francesca Donnarumma MD, Cristina Botto MD, Yasir S Elhassan PhD, Miomira Ivović MD, Ola Lindgren PhD, Edelmiro Menéndez Torre PhD, Antonio Stigliano PhD, Prof Irina Bancos MD, Prof Urszula Ambroziak MD, Prof Giovanna Mantovani, Prof Carla Scaroni MD, Prof Darko Kastelan PhD, Guido Di Dalmazi MD, Prof Claudio Letizia MD, Prof Timo Deutschbein MD, Prof Massimo Terzolo MD, Prof Martin Fassnacht MD, Valentina Agostini PhD, Alessandro Prete PhD","doi":"10.1016/s2213-8587(26)00098-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00098-7","url":null,"abstract":"Mild autonomous cortisol secretion (MACS), the most common hormonal abnormality in adrenal incidentalomas, is associated with increased cardiometabolic risk. MACS is defined by cortisol concentrations higher than 50 nmol/L after a 1-mg overnight dexamethasone suppression test (1-mg DST). The prognostic value of a single test remains uncertain. We examined longitudinal changes in 1-mg DST results, cumulative cortisol exposure, and their associations with cardiometabolic outcomes and mortality.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"6 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148402070","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 comparison of the effects of tirzepatide and dulaglutide on major kidney events in people with type 2 diabetes: pre-specified exploratory analyses of the SURPASS-CVOT trial.","authors":"Sophia Zoungas, David D'Alessio, Imre Pavo, Deepak L Bhatt, John B Buse, Stefano Del Prato, Steven E Kahn, A Michael Lincoff, Darren K McGuire, Michael A Nauck, Steven E Nissen, Naveed Sattar, Bernard Zinman, Antonio Ceriello, Lars Stechemesser, Ann Verhaegen, Jonathan C Broder, Rory Wolfe, Debra Miller, Hiroshi Nishiyama, Xiaomei Wang, Govinda Weerakkody, Russell J Wiese, Stephen J Nicholls","doi":"10.1016/S2213-8587(26)00032-X","DOIUrl":"10.1016/S2213-8587(26)00032-X","url":null,"abstract":"<p><strong>Background: </strong>In the SURPASS-CVOT trial, tirzepatide, a dual incretin agonist that targets the glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, was shown to be non-inferior to dulaglutide for the primary composite cardiovascular outcome in people with type 2 diabetes and atherosclerotic cardiovascular disease. Here, we report the results of a pre-specified exploratory analysis of SURPASS-CVOT that aimed to assess major kidney events in the overall population, low-to-moderate-risk chronic kidney disease population, and high-risk chronic kidney disease population.</p><p><strong>Methods: </strong>SURPASS-CVOT was a randomised, active comparator-controlled, double-blind trial that enrolled people with type 2 diabetes and atherosclerotic cardiovascular disease at 640 sites in 30 countries. Participants aged 40 years or older with type 2 diabetes and atherosclerotic cardiovascular disease, HbA<sub>1c</sub> between 7% and 10·5%, and a BMI of 25 kg/m<sup>2</sup> or greater were randomly assigned 1:1 to once-weekly blinded subcutaneous injection of either tirzepatide up to 15 mg or dulaglutide 1·5 mg. Annual visits included assessment of serum creatinine, cystatin C, and urine albumin-to-creatinine ratio (UACR). High-risk chronic kidney disease was defined by an estimated glomerular filtration rate (eGFR) of 60 mL/min per 1·73 m<sup>2</sup> or greater and UACR greater than 300 mg/g; eGFR 45 mL/min per 1·73 m<sup>2</sup> to less than 60 mL/min per 1·73 m<sup>2</sup> and UACR greater than 30 mg/g; or eGFR less than 45 mL/min per 1·73 m<sup>2</sup>, with eGFR calculated with the CKD-Epidemiology Collaboration serum creatinine-cystatin C equation. The primary composite kidney outcome was time to first occurrence of persistent macroalbuminuria, persistent reduction in eGFR of 50% or greater, end-stage kidney disease (eGFR <15 mL/min per 1·73 m<sup>2</sup> or initiation of chronic kidney replacement therapy), or death from kidney disease.</p><p><strong>Findings: </strong>Between May 29, 2020, and June 27, 2022, 16 979 participants were screened and 13 299 (2948 with high-risk chronic kidney disease) were randomly assigned. After excluding 134 participants randomly assigned in error, 6586 were assigned to tirzepatide and 6579 were assigned to dulaglutide. At baseline, 4142 (32·0%) of 12 954 participants had microalbuminuria and 1491 (11·5%) of 12 954 had macroalbuminuria, and 2928 (22·5%) of 13 004 had an eGFR less than 60 mL/min per 1·73 m<sup>2</sup>. After a median follow-up of 4·0 (IQR 3·7-4·4) years, the risk of the primary composite kidney outcome in the overall population was 23% lower with tirzepatide than with dulaglutide (396 [6·0%] vs 498 [7·6%] events, hazard ratio 0·77 [95% CI 0·68 to 0·88], p=0·0002) and was similarly reduced in those with low-to-moderate-risk chronic kidney disease (195 [4·0%] vs 283 [5·6%], 0·70 [0·58 to 0·84], p=0·0001) and those with high-risk chronic kidney disease (185 [12·","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"544-557"},"PeriodicalIF":36.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876333","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":"Genetics of pancreatic agenesis: a 21-year international cohort study.","authors":"Kathryn E Hinton, Sarah E Flanagan, Jayne A L Houghton, Andrew T Hattersley, Nick D L Owens, Elisa De Franco","doi":"10.1016/S2213-8587(26)00072-0","DOIUrl":"10.1016/S2213-8587(26)00072-0","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"539-541"},"PeriodicalIF":36.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145114","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":"Are we closer to surpassing residual renal risk in type 2 diabetes?","authors":"Janaka Karalliedde","doi":"10.1016/S2213-8587(26)00101-4","DOIUrl":"10.1016/S2213-8587(26)00101-4","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"534-536"},"PeriodicalIF":36.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876261","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":"Type 1 diabetes intervention clusters in resource-limited settings: a systematic review and economic evaluation.","authors":"Sanjay Basu, Jessica Hanae Zafra-Tanaka, David Beran","doi":"10.1016/S2213-8587(26)00002-1","DOIUrl":"10.1016/S2213-8587(26)00002-1","url":null,"abstract":"<p><strong>Background: </strong>Over 9 million people are living with type 1 diabetes globally, with a disproportionate burden in resource-limited settings where access to care remains constrained. Individual interventions have shown modest benefits, but coordinated intervention clusters could achieve greater health impact. We aimed to evaluate the cost-effectiveness of intervention clusters for type 1 diabetes management in resource-limited settings.</p><p><strong>Methods: </strong>We conducted a systematic review (PRISMA 2020) searching PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, Global Health Database, and WHO Global Health Library from Jan 1, 2000 to Aug 31, 2024, for type 1 diabetes interventions. We identified 89 studies evaluating four categories of individual interventions: diabetes self-management education and support, glucose monitoring technologies, task shifting to trained non-physician providers, and mobile health technologies. Through a Delphi process with 15 international experts, we validated three intervention clusters: integrated care delivery models, technology-enhanced self management, and public-private partnership models. We developed a microsimulation model to: project 10-year outcomes; 10 year outcomes from the point of intervention initiation in HbA<sub>1c</sub>, severe hypoglycaemia incidence, diabetic ketoacidosis incidence, microvascular and macrovascular complications, and health-related quality of life; and costs using WHO CHOICE methodology. Costs are expressed as percentage of gross domestic product per capita for cross-country comparability. The study is registered with PROSPERO (CRD420251066740).</p><p><strong>Findings: </strong>We identified 89 studies (20 734 participants). Individual interventions achieved HbA<sub>1c</sub> reductions of 0·32-0·89% (3·5-9·7 mmol/mol). Mobile health showed favourable cost-effectiveness at INT$1788 (95% CI 1342-2456) per quality-adjusted life-year (QALY), representing 7·2% (5·4-9·8) of gross domestic product per capita in low-income countries. Intervention clusters achieved greater health impact than individual interventions: integrated care delivery generated 264·6 QALYs (198·5-330·7) per 1000 patients ($60 023 [45 018-78 029] per QALY); public-private partnership generate 281·5 QALYs (211·1-351·9; $60 624 [47 291-77 956] per QALY); and technology-enhanced self management generate 238·5 QALYs (178·9-298·1; $158 360 [123 456-201 234] per QALY). Clusters exceeded WHO thresholds for low-income settings but remained cost-effective for upper-middle and high-income countries, per World Bank classifications.</p><p><strong>Interpretation: </strong>Mobile health interventions show cost-effectiveness across income settings where supporting infrastructure exists. Intervention clusters provide greater health impact but require higher investment. These findings support evidence-based resource allocation considering both cost-effect","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"570-580"},"PeriodicalIF":36.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950049","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":"Is weight cycling clinically harmful?","authors":"Faidon Magkos, Norbert Stefan","doi":"10.1016/S2213-8587(26)00037-9","DOIUrl":"10.1016/S2213-8587(26)00037-9","url":null,"abstract":"<p><p>Worldwide, approximately half of the general population is actively attempting to lose weight. However, weight loss is typically followed by substantial weight regain, often leading to repeated cycles of loss and gain of bodyweight. Weight cycling has been suggested to be metabolically harmful, in that it could lead to greater rebounds in fat mass and smaller regains in lean (muscle) mass, thereby promoting sarcopenia, lowering metabolic rate, and exacerbating obesity and its metabolic complications (eg, glucose intolerance). In this Personal view, we critically evaluate evidence from studies in humans and animals investigating whether weight cycling has adverse effects on bodyweight, body composition, energy metabolism, and metabolic function. We also briefly discuss potential strategies to mitigate weight regain and its consequences. Overall, the current evidence does not support a causal link between weight cycling per se and clinical harm in people with obesity. Most of the adverse effects reported are likely circumstantial, possibly because of ageing, unintentional weight loss, reverse causality, earlier onset of obesity, repeated obesogenic exposures, or longer cumulative exposure to obesity. Available evidence suggests that the benefits of intermittent weight reduction-such as improved metabolic markers, cardiovascular health, and quality of life-outweigh the potential risks associated with weight fluctuation.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"594-607"},"PeriodicalIF":36.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943395","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 2024; 12: 545-57.","authors":"","doi":"10.1016/S2213-8587(26)00121-X","DOIUrl":"10.1016/S2213-8587(26)00121-X","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"e10"},"PeriodicalIF":36.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876315","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":"Rethinking prophylactic central neck dissection in clinically node-negative papillary thyroid cancer.","authors":"Dana M Hartl, Martin Schlumberger","doi":"10.1016/S2213-8587(26)00071-9","DOIUrl":"10.1016/S2213-8587(26)00071-9","url":null,"abstract":"<p><p>Papillary thyroid cancer is associated with a high rate of lymph node metastases, mainly in the form of small metastases in the central compartment. Even when present, these metastases are most often undetected by preoperative ultrasound (clinically node-negative or cN0) and only identified by systematically performing a prophylactic central neck dissection. However, even in the absence of prophylactic central neck dissection to remove these metastases, clinically detected recurrence in lymph nodes occurs in fewer than 10% of patients, which explains the controversy surrounding the procedure. Clinical data have not shown an advantage in survival, although some studies point to an incremental reduction in regional recurrence rates with a concomitant increase in morbidity in temporary hypoparathyroidism. Thus, over the past decade, guidelines have kept the option of prophylactic central neck dissection open for discussion, leaving clinicians to make these decisions. Resolving this issue remains a challenge due to the difficulties inherent in implementing randomised trials in a surgical setting. This Personal View aims to summarise the current controversy and evidence surrounding prophylactic central neck dissection and to suggest new directions for research.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"608-616"},"PeriodicalIF":36.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876311","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":"Bearing metabolism in mind: towards integrated care.","authors":"The Lancet Diabetes Endocrinology","doi":"10.1016/S2213-8587(26)00137-3","DOIUrl":"10.1016/S2213-8587(26)00137-3","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"533"},"PeriodicalIF":36.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158241","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}