Cardiovascular outcomes, heart failure, cardio-renal protection, hypertension, and lipid-lowering trials in diabetes and endocrinology.
An RCT finds combining exercise with broccoli sprout supplementation improves apolipoproteins in type 2 diabetes, mainly driven by exercise. PICO summary and expert commentary.
The DAPAHEART follow-up finds 4 years of dapagliflozin improves coronary flow reserve and reduces epicardial fat in type 2 diabetes. PICO summary and expert commentary.
An RCT finds five weeks of aquatic exercise improves blood pressure and fitness within-group in type 2 diabetes, but shows no advantage over control. PICO summary and commentary.
An RCT finds interdisciplinary care with family empowerment improves blood pressure, glucose, and quality of life in comorbid hypertension and diabetes. PICO summary and commentary.
The Swedish Obese Subjects (SOS) study demonstrated that bariatric surgery is associated with a 29% reduction in adjusted all-cause mortality compared with conventional obesity treatment over an average 10.9 years of follow-up, with reductions in both cardiovascular and cancer deaths, providing the first prospective controlled evidence for the long-term survival benefit of surgical weight loss.
The Look AHEAD trial demonstrated that intensive lifestyle intervention targeting weight loss in overweight or obese adults with type 2 diabetes did not reduce cardiovascular events over 9.6 years despite clear differences in weight, fitness, and glycaemic control, establishing a critical negative result that informed the rationale for pharmacological obesity treatment with greater weight loss efficacy.
The SELECT trial demonstrated that semaglutide 2.4 mg reduces 3-point MACE by 20% in overweight or obese adults with pre-existing cardiovascular disease and no diabetes, becoming the first obesity pharmacotherapy trial to demonstrate a hard cardiovascular endpoint benefit and establishing GLP-1 receptor agonism as a cardiovascular intervention in non-diabetic obesity.
The REWIND trial demonstrated that dulaglutide reduces 3-point MACE in a broad type 2 diabetes population of which 69% had no established cardiovascular disease, with a significant 24% reduction in nonfatal stroke and consistent renal benefit, extending GLP-1 receptor agonist cardiovascular protection into a primary prevention context.
The SUSTAIN-6 trial demonstrated that once-weekly semaglutide reduced 3-point MACE by 26% in high-cardiovascular-risk type 2 diabetes, driven primarily by a significant 39% reduction in nonfatal stroke, while identifying a retinopathy complication signal attributable to rapid glucose lowering in patients with pre-existing retinopathy.
The LEADER trial demonstrated that liraglutide significantly reduced 3-point MACE and cardiovascular mortality in patients with type 2 diabetes and high cardiovascular risk, becoming the first GLP-1 receptor agonist CVOT to demonstrate superiority and characterising an atherosclerotic rather than heart failure protection profile distinct from SGLT2 inhibitors.
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