Endocrinology

Individual GLP-1RAs and SGLT2is show similar cardiovascular effectiveness as second-line T2D therapy

In a multinational cohort of 1,245,211 metformin-treated adults with type 2 diabetes, six GLP-1RAs and four SGLT2 inhibitors were compared head-to-head. Across agents and classes, risks of 3-point and 4-point MACE were broadly similar in on-treatment and total follow-up analyses. Semaglutide and empagliflozin had comparable 3-point MACE (HR 1.05; 95% CI 0.79–1.39) and 4-point MACE (HR 0.95; 95% CI 0.81–1.12). Results were consistent in patients with established cardiovascular disease and passed extensive confounding diagnostics. 1

Antihyperglycemic classes differ in protection against major adverse liver outcomes in T2D

This network meta-analysis pooled 46 observational studies including 7,124,845 adults with type 2 diabetes to compare antidiabetic classes for major adverse liver outcomes. Thiazolidinediones were least associated with hepatocellular carcinoma, with substantially lower hazards than DPP-4 inhibitors, GLP-1RAs, insulin, and sulfonylureas. For hepatic decompensation and complications, GLP-1RAs showed the lowest hazards across comparisons, while SGLT2 inhibitors were least associated with cirrhosis and liver-related mortality. GLP-1RAs also ranked best for variceal bleeding and encephalopathy, and SGLT2 inhibitors for liver-related death. 2

Early-pregnancy central obesity predicts GDM, hypertensive disorders, and postpartum dysglycemia beyond BMI

In a cohort of 3,055 pregnant individuals, early-pregnancy waist-based indices were related to gestational and postpartum cardiometabolic outcomes. Central obesity measures showed a dose–response relationship with gestational diabetes, hypertensive disorders, and postpartum prediabetes or diabetes and chronic hypertension. Associations persisted after BMI adjustment, indicating risk information beyond general adiposity. Among those with healthy prepregnancy BMI, central obesity nearly doubled GDM risk and increased postpartum dysglycemia and hypertension hazards. 3

Video endocrinology visits match in-person HbA1c outcomes; e-consults and audio-only lag

This VA retrospective cohort included 21,847 adults with type 2 diabetes and HbA1c ≥8% undergoing an initial endocrinology consultation by different modalities. Overall, 49.5% achieved HbA1c <8% at six months. Compared with in-person visits, e-consults (aOR 0.77; 95% CI 0.71–0.83) and synchronous telemedicine overall (aOR 0.86; 95% CI 0.80–0.93) had lower odds of success. Sensitivity analysis showed audio-only telemedicine underperformed (aOR 0.78; 95% CI 0.71–0.86), whereas video telemedicine was similar to in-person care (aOR 0.98; 95% CI 0.88–1.09). 4