🚨SURPASS-CVOT: What’s #tirzepatide’s REAL CV benefit vs placebo❓🚨
New Diabetes Care analysis uses imputed placebo comparison from REWIND
Tirzepatide vs imputed placebo:
🔹 MACE-3: HR 0.72 (0.55 to 0.94)
🔸 All-cause mortality: HR 0.61 (0.45 to 0.82)
⚠️ Caveats matter:
1️⃣Cross-trial comparison, not direct RCT
2️⃣SGLT2i use 31% vs 0% in REWIND
3️⃣Only 21% of REWIND met SURPASS-CVOT criteria
The real question: will regulators grant a CV indication?
FDA may agree (they already gave dulaglutide one). But EMA/MHRA never added formal CV indication to dulaglutide despite REWIND.
Stakes are high: licence change = guideline change = access change
🔗 https://t.co/RNq8kdU0Ry
Systematic review
GLP-1RA cessation is associated with a predictable and decelerating pattern of weight regain
Plateau below pre-treatment levels, suggesting that partial weight-loss benefit may persist long-term but is substantially attenuated.
https://t.co/0M89a0YC9M
After what seems like a long time in waiting the HCL competency framework is finally here:
https://t.co/76TIn8vwtI
Looking out for linked assessments via DTN
Have a fab day 😀
@drpratikc@LDC_tweets@DTN_UK@TrendDiabetes@DSNforumUK
An EASO publication in @NatureMedicine proposes a framework for diagnosing, staging & managing adult obesity. Prof. @busetto_luca highlights the need for comprehensive clinical evaluations beyond BMI.
https://t.co/ILz9QzWUpb
❤️ Weight & HbA1c Reductions associated with mortality & cardiovascular benefits
Meta-regression of 44 trials
⚖️ Each 1 kg weight loss = 3.4% ↓ mortality risk
🩸 Each 1% HbA1c ⬇️ = 7.6% ↓ mortality risk
📉 Effects regardless of drug class
https://t.co/5ma5Yf9UkO
While I’m happy that our 2011 mathematical model was used by @nesta_uk to estimate the step reduction in daily calories would be required to address obesity in the UK, I wish they had read our later studies. Unfortunately, a constant intensity intervention to reduce calorie intake typically results in exponential waning of the effect over time (not a sustained step reduction) and will therefore only result in about 20% of the weight loss they predicted.
The efficacy of intermittent scanning continuous glucose monitoring in the elderly*: A case-control study.
*Older people
Older people with diabetes benefit from is-CGM. HbA1c drops sustained for 2 years, few stop using it.
More support for CGM in older age!
#DiabetesCare
Major survey of all Nutritionists and Dietitians in UK!
#AcademyNutritionSciences want to hear from every #Nutritionist or #Dietitian
What are your research experiences? Please take part, no matter whether you do no research, a little or a lot!
https://t.co/YYuIw5qcsJ
Retrospective claims data reveals over 20 % of GLP-1 medicine users had nutritional deficiencies diagnosed within one-year of starting GLP-1RA treatment. https://t.co/UNDbW7pD9j
Real-world comparison of semaglutide/tirzepatide (GLP‑1/GLP‑1+GIP) vs bariatric surgery.
📉 In a real-world matched study of 14,152 pts:
At 2 years:
• Surgery: −25.7% total weight loss (TWL)
• GLP-1s (semaglutide/tirzepatide): −5.3% TWL (ITT); −7.6% (per-protocol)
• HbA1c drop: Surgery −0.5 pts vs GLP-1s −0.2 pts (p<0.001)
⚖️ Conclusion: Surgery delivers greater, sustained weight loss & better glycemic control vs GLP-1s for eligible patients.
https://t.co/64QjVFoZ4J
💉 GLP-1 meds don’t just curb appetite—sometimes they curb essential nutrients too.
- - -
📉 In a study of 460,000+ adults on GLP-1s (mostly with T2D):
🔹13% developed nutritional deficiencies in 6 months
🔹22% within 12 months
🔹Vitamin D deficiency was most common (13.6%)
🔹3% experienced muscle loss
🔍 Patients who saw a dietitian were more likely to have deficiencies identified—not because dietitians caused harm, but because they actually looked.
💡 Clinical translation:
🔹Appetite suppression can lower intake of protein, vitamins (D, B12, folate), and minerals.
🔹Without supervision, this can compromise muscle mass, hydration, and metabolic health.
🔹Older adults and those with obesity are especially vulnerable due to baseline deficiencies.
Treating obesity isn't just about weight loss—it's about preserving health while losing weight.
✅ That’s why supervised care with physicians + registered dietitians is non-negotiable.
✅ Monitor labs (Vit D, B12, iron, folate).
✅ Emphasize protein, strength training, and hydration.
📚https://t.co/zFOUF6CKcv
Credit to @drbutsch and colleagues.
@sotonDSN Wouldn't be surprised if there's a rubber stamp and ink pad for trotting off "patient is non compliant" in the records of those alienated by these outdated attitudes. They paid for the sign..?
Realigning #diabetes regimens in older adults: a 4S Pathway to guide simplification and deprescribing strategies https://t.co/4QtA0DIyTa
#T1D#T2D#olderadults#FREE to read with registration (also FREE)
#ADA2025
Addressing #obesity can help prevent T2D.
@EASOobesity acknowledges the importance of addressing obesity as both a risk factor for diabetes — along with CVD and cancer — and a chronic disease in its own right.
#EASOpolicy