The Lancet Diabetes & Endocrinology

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Your leading source of international, cutting-edge research, review, and opinion in clinical #diabetes and #endocrinology. IF=36·3. 🌐 thelancet.com/journals/landia/home

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The Lancet Diabetes & Endocrinology@thelancetendo· 15d

A growing population of individuals with type 1 #diabetes living into older adulthood underscores the need for health systems to address the organisational, societal, and care challenges associated with #ageing with the condition www.thelancet.com/journals/lan... #T1D #olderadults #aging #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· 15d

By linking digestion, metabolism, and cardiovascular health, #incretin-based therapies do more than just regulate blood sugar; they help reduce morbidity and mortality and are becoming a core component of modern diabetes care www.thelancet.com/journals/lan... #obesity #diabetes #GLP-1 #GIP #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· 15d

Obesity is increasingly managed with medications as disease-modifying therapies, reflecting its role as a gateway disease driving metabolic, cardiovascular, reproductive, neuropsychiatric, and mechanical conditions thelancet.com/journals/lan... #obesity #GLP-1 receptor agonists #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· 17d

New—Energy drink ban: putting children's health first thelancet.com/journals/lan... #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· 17d

New—Soaring #GLP-1 receptor agonist use thelancet.com/journals/lan... #weightloss #obesity #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· 20d

Despite advances, #familial #hypercholesterolaemia remains an underdiagnosed and untreated condition, with an urgent need for the design and implementation of effective models of care www.thelancet.com/journals/lan... #HeFH #HoFH #ASCVD #MedSky #EndoSky #CardioSky

The Lancet Diabetes & Endocrinology@thelancetendo· 21d

Within less than a decade, neutralising monoclonal antibodies targeting PCSK9 were developed and implemented in clinical practice www.thelancet.com/journals/lan... #LDL #cholesterol #lipid-lowering therapies #FREE to read with registration (also FREE) #MedSky #EndoSky #CardioSky

A transition from daily oral small molecules to long-acting biologic and nucleic acid-based therapies, including monoclonal antibodies, RNA-targeted agents, immunisation strategies, and gene-editing technologies, delivered subcutaneously or intravenously at extended intervals. Despite this temporal representation, new small molecules and other oral therapies continue to be actively developed, reflecting ongoing innovation across both oral and long-acting treatment platforms.

The Lancet Diabetes & Endocrinology@thelancetendo· 24d

Obesity treatment is expected to shift gradually from a one-size-fits-all approach towards more personalised medicine, in which the obesity phenotype and presence of related conditions will determine the treatment strategy www.thelancet.com/journals/lan... #obesity #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· 24d

#Addison's disease is the manifestation of #adrenal #glucocorticoid & #mineralocorticoid deficiency from T-cell mediated destruction of the adrenal cortex, & is the commonest cause of primary adrenal insufficiency in adults www.thelancet.com/journals/lan... primary #adrenal #insufficiency #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· 25d

Action is needed not only by health-care practitioners, but also by people with #diabetes, and the health-care system including policy makers to improve the mental health of people with diabetes thelancet.com/journals/lan... #T1D #T2D #GDM #mentalhealth #MedSky #EndoSky #PsychSky

The Lancet Diabetes & Endocrinology@thelancetendo· 27d

Medical #nutrition therapy delivered by a registered #dietitian is central to #obesity care and complements #incretin-based therapies www.thelancet.com/journals/lan... #GLP-1 receptor agonists dual GLP-1–GIP receptor agonists #FREE to read with registration (also FREE) #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· 27d

Initial and subsequent choices of therapies for #osteoporosis should be based on the trial evidence of anti-fracture efficacy and the safety of each medication www.thelancet.com/journals/lan... #OpenAccess #MedSky #EndoSky #RheumSky

Periods of continuous drug administration are shown as solid bars for oral bisphosphonates or anabolic drugs. The timing of infusions of zoledronate (for treatment of osteoporosis) or injections of denosumab are shown with vertical arrows. Adapted from Reid and Bolland.36

The Lancet Diabetes & Endocrinology@thelancetendo· 28d

Worldwide, approximately half of the general population is actively attempting to lose weight. However, #weightloss is typically followed by substantial weight regain, often leading to repeated cycles of loss and gain of bodyweight www.thelancet.com/journals/lan... #weight #cycling #yo-yo #dieting

Typical patterns of weight regain after weight loss induced by lifestyle modification (including low-calorie diets, physical activity, and behavioural therapy), VLCD, and incretin-based pharmacotherapies. For lifestyle treatments, a maximum weight loss of 5% from baseline was assumed, followed by a regain of 5–19% per year over 5 years (green area). For VLCD treatments, a maximum weight loss of 15% from baseline was assumed, followed by a regain of 45% per year over 2 years. For incretin drugs, a maximum weight loss of 20% from baseline was assumed, followed by a regain of 60% over the first year. Within one year after discontinuation of treatment, approximately 75% of patients who lost weight by lifestyle modification and approximately 95% of those who lost weight by VLCD or incretin therapies regain some weight. VLCD=very-low-calorie diets.

The Lancet Diabetes & Endocrinology@thelancetendo· 28d

Even in the absence of prophylactic central neck dissection to remove metastases, clinically detected recurrence in lymph nodes occurs in less than 10% of patients, which explains the controversy surrounding the procedure www.thelancet.com/journals/lan... #papillary #thyroid #cancer #EndoSky #OncSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 14

Read our August Issue, featuring advances in lipid-lowering therapies, phaeochromocytomas and paragangliomas, sleeve gastrectomy, type 2 diabetes, postpartum depression, diabetic foot ulcers, CGM, obesity medications & much more tinyurl.com/mwfu4c6m #MedSky #EndoSky #CardioSky #GastroSky #PsychSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 13

We contend that future ADA Standards of Care & IDF Global Clinical Practice Recommendations should integrate #intermittent #fasting into clinical practice guidelines as one of several evidence-based lifestyle approaches to treat type 2 #diabetes & #prediabetes www.thelancet.com/journals/lan... #T2D

Figure showing the timing of food intake during alternate-day fasting, the 5:2 diet, and time-restricted eating (illustrated here with an 8-h eating window). Shaded segments of the clock roughly represent periods of food consumption. For alternate-day fasting and the 5:2 diet, the shaded segment on the fasting day clock represents a suggested eating window of 1700–1900 h; however, on fasting days, meals can be consumed either in a single sitting or distributed across the day, according to individual preference.

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 12

Hyperprolactinaemia can also result from #dopamine antagonist drug effects and reduced prolactin clearance with liver or kidney disease with loss of feedback regulation www.thelancet.com/journals/lan... #hyperprolactinaemia #prolactinomas #pituitary #adenomas #MedSky #EndoSky

Colour coding indicates likely effect of each medication on prolactin. Observed prolactin elevations are not consistent in all patients. GnRH=gonadotropin-releasing hormone. H2=histamine 2. MAO=monoamine oxidase. SNRI=serotonin and norepinephrine reuptake inhibitors. SSRI=selective serotonin reuptake inhibitors. *The effect of oral contraceptives on prolactin concentrations is controversial.

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 11

High cumulative doses of exogenous #glucocorticoids lead to a spectrum of side-effects, in particular increased #fracture risk www.thelancet.com/journals/lan... #glucocorticoid-induced #osteoporosis #OpenAccess #MedSky #EndoSky #RheumSky

Glucocorticoids act via the glucocorticoid receptor on bone cells. Glucocorticoids increase bone resorption via direct and indirect effects on osteoclasts, including reduced rates of apoptosis and enhanced differentiation via increased availability of RANKL, produced by osteoblasts and osteocytes. Additionally, glucocorticoids inhibit the differentiation of mesenchymal stromal cells to osteoblasts and stimulate their differentiation into adipocytes. Moreover, proliferation and differentiation of osteoblasts is inhibited, whereas apoptosis, senescence, and ferroptosis in osteoblasts and osteocytes are enhanced, thereby, limiting mechano-sensing of bone. Finally, glucocorticoids also reduce the number of H-type vessels, which are positively coupled to bone formation. The enzyme 11β-HSD type 1 (activating) and 11β-HSD2 (inactivating) regulates locally the bioavailable cortisone. Functional mutations in the genes encoding these enzymes might affect susceptibility for glucocorticoids in various tissues. Extra-skeletal effects of glucocorticoids include cataracts, catabolism of skeletal muscle, and increased propensity of falls. 11β-HSD=11β-hydroxysteroid dehydrogenase.

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 11

All patients with #Addison’s disease should be given a #steroid emergency card and provided with and trained to use a #glucocorticoid injection kit www.thelancet.com/journals/lan... primary #adrenal insufficiency #MedSky #EndoSky

(A) National Health Service Steroid emergency card (UK). (B) European Society of Endocrinology bilingual steroid emergency card with German translation and QR code. In North America, a medical alert bracelet or necklace is used.

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 10

Contrary to previous assumptions, mortality and morbidity after the #biopsy of #PPGLs appear to be predominantly attributable to causes other than #catecholamine excess www.thelancet.com/journals/lan... #phaeochromocytomas #paragangliomas #OpenAccess #MedSky #EndoSky #OncSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 10

This EASO–EFAD–ECPO Consensus Statement outlines pragmatic #nutritional, #functional, and #psychological considerations during #incretin-based therapy treatment www.thelancet.com/journals/lan... #GLP-1 receptor agonists dual GLP-1–GIP receptor agonists #FREE to read with registration (also FREE)

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 3

By linking digestion, metabolism, & cardiovascular health, #incretin-based therapies do more than just regulate blood sugar; they help reduce morbidity and mortality & are becoming a core component of modern diabetes care www.thelancet.com/journals/lan... #GLP-1 #GIP #T2D #obesity #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 2

Ready to share your #DiabetesResearch with millions globally? Explore our author resources for a seamless submission process, and start your publication journey with us today: hubs.li/Q04mkDC40 #Endocrinology #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 2

Behind every paper is a community. To every author who trusted us with their research and every peer reviewer who gave their time and expertise—thank you! Together, we are advancing the best science for better lives. Learn about our peer review process: hubs.li/Q04mCzF70

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 2

New—Innovation is key to transforming future #obesity care www.thelancet.com/journals/lan... #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jul 2

New—Out of touch medical care thelancet.com/journals/lan... #FREE to read #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jun 29

While many benefits of #obesity medications are mediated by weight loss, accumulating evidence indicates important weight loss-independent effects, particularly with #GLP-1 receptor agonist-based therapies www.thelancet.com/journals/lan... #weightloss #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jun 24

Five common mental health problems can affect adults living with type 1 diabetes, type 2 diabetes, or gestational diabetes: fear of hypoglycaemia, diabetes distress, depression, disordered eating, and sleep disorders thelancet.com/journals/lan... #T1D #T2D #GDM #MentalHealth #EndoSky #PsychSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jun 24

New—Diabetic foot ulcer prevention in Kuwait thelancet.com/journals/lan... #diabetes #FREE to read #MedSky #EndoSky

The Lancet Diabetes & Endocrinology@thelancetendo· Jun 24

New—High cost and poor availability of continuous glucose monitoring in low-income and middle-income countries thelancet.com/journals/lan... #CGM #diabetes #FREE to read #MedSky #EndoSky