Endocrinology

Nationwide Korean cohort links CGM use in adult type 1 diabetes to lower complications and mortality

In 17,018 Korean adults with type 1 diabetes on intensive insulin, CGM users had substantially fewer major complications than nonusers. CGM use was associated with markedly lower risks of DKA, ESKD, CVD, and all-cause mortality, with adjusted hazard ratios around 0.3–0.4. Severe hypoglycemia incidence was similar between groups, but among CGM users, severe hypoglycemia frequency fell by 61.5% after initiation. Within CGM users, DKA and CVD-related hospitalizations or ED visits decreased by about 50–60% after starting CGM. 1

GLP-1 agonists as adjuncts in type 1 diabetes improve weight and hyperglycemia with more side effects

This meta-analysis of 18 studies evaluated GLP-1 agonists as adjuncts to insulin in type 1 diabetes. Compared with controls, GLP-1 agonists produced greater weight loss and modest HbA1c reductions, plus less time in hyperglycemia. Time in hypoglycemia and stimulated C-peptide did not differ, suggesting beta cell preservation is unlikely with current use. Total adverse events were higher with GLP-1 agonists, consistent with known gastrointestinal tolerability issues. 2

Fasting plasma glucose outperforms HbA1c for type 2 diabetes diagnosis, with region-specific optimal cutoffs

This systematic review and meta-analysis pooled 58 population-based studies including 276,203 adults without known diabetes. Using 2-hour OGTT as reference, fasting plasma glucose showed higher diagnostic accuracy than HbA1c across regions. The overall optimal FPG cutoff was 6.3 mmol/L, yielding approximately 73% sensitivity and 91% specificity. The optimal HbA1c threshold around 6.5% had lower sensitivity but similar specificity, and evidence certainty was low. 3

Once-daily low-dose prednisolone vs thrice-daily hydrocortisone in adrenal insufficiency shows metabolic and bone advantages

This double-blind crossover trial compared once-daily morning prednisolone 2–5 mg with standard thrice-daily hydrocortisone in adults with adrenal insufficiency. Over two 4-month treatment periods, prednisolone slowed bone turnover relative to hydrocortisone, lowering multiple bone resorption and formation markers. Prednisolone also yielded more favorable changes in cardiometabolic parameters, including weight and glycemic indices, without worsened subjective wellbeing. 4