30-Second Takeaway
- GLP-1 RAs show modeled primary CVD prevention benefits in high‑risk obesity without diabetes, but evidence remains nonrandomized.
- Canagliflozin attenuates excess HF/CV death risk seen with low-normal sodium intake in T2D CKD, with renal benefit regardless of sodium.
- In dialysis, HbA1c and glycated albumin track CGM glycemia reasonably but both show clinically important, distinct biases.
- GLP-1 agonists improve weight, HbA1c, BMI z-score, and SBP in adolescents with obesity or type 2 diabetes, with comparable safety to control.
- Emerging β-cell functional and imaging metrics may refine staging and treatment-response assessment in type 1 diabetes trials.
Week ending March 14, 2026
New data on GLP-1–based cardiometabolic prevention, glycemic assessment in dialysis, and β-cell–focused tools for type 1 diabetes
GLP-1 RA persistence and switching in adults with obesity but no diabetes
This cohort study evaluated GLP-1 receptor agonist switching, adherence, and 12‑month persistence in adults with overweight or obesity without diabetes. The analysis characterizes how often patients remain on their initial GLP-1 RA versus switch agents during the first treatment year. It also quantifies adherence over 12 months, informing realistic expectations for long-term weight management in non-diabetic populations. These data may aid counseling and payer discussions as off-label GLP-1 RA use for obesity expands.
Modeled GLP-1RA primary prevention benefit in high-risk obesity without CVD
This study emulated GLP-1RA therapy in 200,012 adults without established CVD using risk-factor changes from SELECT applied to contemporary survey cohorts. Among 21,720 individuals with BMI ≥27 kg/m² and SCORE2 risk ≥7.5%, 10‑year CVD incidence was 13.82% without treatment. Emulated GLP-1RA therapy reduced projected 10‑year CVD incidence to 10.83%, an absolute reduction of 2.99% and relative reduction of 22%. Absolute benefits were larger in men, while relative reductions were similar by sex, and benefits attenuated in nonobese and lower-risk groups. Modeled effects diminished when reduced adherence was assumed, underscoring the importance of real-world persistence. These findings support GLP-1RA trials in primary prevention for carefully selected high-risk obese patients without diabetes.
Canagliflozin offsets HF/CV risk of low-normal sodium intake in T2D CKD
This post hoc CREDENCE analysis examined dietary sodium and canagliflozin effects on cardiorenal outcomes in 2,573 participants with T2D and CKD. In placebo-treated patients, low-normal sodium intake increased cardiovascular death or heart failure hospitalization versus high sodium (adjusted HR 1.56). Canagliflozin reduced this composite risk in the low-normal sodium group (adjusted HR 0.48), but not in the high sodium group. Sodium intake did not influence renal outcomes, while canagliflozin lowered renal risk in both sodium-intake strata. Neither sodium intake nor canagliflozin affected all-cause mortality in this analysis. The data suggest avoiding overly low sodium intake in T2D CKD and highlight canagliflozin’s ability to blunt associated HF/CV risk.
Glycemic biomarkers vs CGM in maintenance dialysis: accuracy and bias
In 251 dialysis patients, HbA1c, glycated albumin, and fructosamine were compared with 10‑day Dexcom G6 Pro CGM mean glucose. All three markers correlated with CGM glycemia, with stronger correlations for HbA1c and glycated albumin than for fructosamine. HbA1c showed bias from erythropoiesis-stimulating agent dose, BMI, hemoglobin, and serum albumin. Glycated albumin and fructosamine were biased by dialysis modality, vintage, residual kidney function, and BMI. Despite strong correlations, substantial covariate-dependent bias indicates no single biomarker is universally reliable in dialysis. Clinicians should interpret HbA1c and glycated albumin alongside clinical context and, when possible, CGM data.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.