30-Second Takeaway
- CGM in insulin-treated older adults with dementia was linked to lower hospitalization and mortality than SMBG.
- Multifactorial risk-factor control in type 2 diabetes nearly normalized life expectancy versus non-diabetic controls.
- PCSK9 inhibitors outperformed statins for composite cardiovascular, renal, and mortality outcomes in high-risk type 2 diabetes.
- Underweight in type 2 diabetes carried higher mortality risk than even severe obesity, with a strong dose–response gradient.
- Environmental climate vulnerability independently contributed to incident type 2 diabetes beyond traditional risk factors.
Week ending December 6, 2025
Reducing mortality and cardiometabolic risk across the diabetes spectrum: monitoring, weight, lipids, and environment
CGM vs SMBG in insulin-treated older adults with dementia: lower hospitalizations and mortality
In this Medicare cohort of 2022 insulin-treated adults ≥66 years with ADRD, CGM users had fewer all-cause hospitalizations than SMBG users (HR 0.86; 95% CI 0.76–0.96). CGM use was also associated with substantially lower all-cause mortality (HR 0.57; 95% CI 0.48–0.67). Point estimates suggested fewer hypoglycemia hospitalizations and falls with CGM, but these differences were not statistically significant. Hyperglycemic crisis events were numerically higher with CGM (HR 1.38; 95% CI 0.99–1.94), although this did not reach statistical significance.
Multidomain risk-factor control in T2D narrows the life expectancy gap
Across nationwide cohorts from China, the US, and the UK, only 6.8%–16.0% of adults with T2D achieved ≥5 guideline risk-factor targets. At age 50, individuals with T2D and ≤1 risk factor above target lived 6–9 years longer than those with ≥5 uncontrolled factors. Those with ≤1 uncontrolled factor had life expectancy comparable to matched controls without T2D. Healthy lifestyle behaviors plus HbA1c control contributed most to life expectancy gains, outweighing other metabolic targets.
PCSK9 inhibitors vs statins in T2D: fewer CV, renal events and deaths
This TriNetX propensity-matched study compared 20,489 T2D patients on PCSK9 inhibitors with 20,489 on statins during 5-year follow-up. PCSK9 inhibitor use was associated with a lower composite of all-cause mortality, MACE, and MAKE (HR 0.75; 95% CI 0.70–0.81). Secondary outcomes favored PCSK9 inhibitors, including reduced all-cause mortality (HR 0.65; 95% CI 0.60–0.705), MACE (HR 0.83; 95% CI 0.76–0.90), and MAKE (HR 0.70; 95% CI 0.61–0.81). Benefits were consistent across most subgroups and seen for alirocumab and evolocumab, but not clearly for inclisiran, likely due to small numbers.
Diabetes markedly increases sudden cardiac death rates and life-years lost
Using nationwide Danish data from 2010, investigators identified 6862 sudden cardiac death (SCD) cases, including 97 with T1D and 1149 with T2D. SCD incidence rates were 3.7-fold higher in T1D and 6.5-fold higher in T2D compared with the general population. Average life expectancy was 14.2 years shorter in T1D and 7.9 years shorter in T2D, with 3.4 and 2.7 years, respectively, attributable specifically to SCD. Elevated SCD risk persisted across age groups but showed the greatest relative excess in younger individuals with diabetes.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.