Evidence summaries and landmark trials across type 1, type 2, prevention, glycaemic control, complications, and diabetes technology.
The INTE-COMM Lancet trial finds community-based care matches facility care for stable HIV, diabetes, and hypertension in sub-Saharan Africa. PICO summary and expert commentary.
A clamp-based RCT finds metformin does not reduce hepatic insulin resistance in type 1 diabetes, arguing against its use as an insulin-sensitiser. PICO summary and commentary.
The CREDENCE trial demonstrated that canagliflozin reduced the composite of end-stage kidney disease, doubling of serum creatinine, or renal or cardiovascular death by 30% in patients with type 2 diabetes and albuminuric chronic kidney disease, becoming the first dedicated renal outcomes trial to demonstrate that an SGLT2 inhibitor could substantially slow the progression of diabetic nephropathy.
A sham-controlled trial finds tibial nerve neurodynamic techniques improve neuropathy severity and quality of life in diabetic neuropathy, without changing nerve conduction. PICO summary and commentary.
The DECLARE-TIMI 58 trial demonstrated that dapagliflozin did not reduce 3-point MACE compared with placebo but significantly reduced the composite of cardiovascular death or hospitalisation for heart failure, driven entirely by a 27% reduction in heart failure hospitalisation, in the largest and most broadly representative SGLT2 inhibitor cardiovascular outcomes trial conducted to date.
The FINE-ONE NEJM trial finds finerenone reduces albuminuria in type 1 diabetes and CKD, a surrogate-based extension of its type 2 benefits. PICO summary and commentary.
A small crossover trial finds a BCAA, HMB, and zinc supplement increases muscle mass and lowers inflammation in dialysis patients, but not physical performance. PICO summary and commentary.
The CANVAS Programme demonstrated that canagliflozin reduced major adverse cardiovascular events by 14% in patients with type 2 diabetes at high cardiovascular risk, but identified an approximately twofold increase in lower-extremity amputation risk, primarily at the toe or metatarsal level, requiring careful patient selection and monitoring.
The EMPA-REG OUTCOME trial demonstrated that empagliflozin reduced cardiovascular death by 38% and heart failure hospitalisation by 35% in patients with type 2 diabetes and established cardiovascular disease — the first glucose-lowering agent to show a mortality benefit in a cardiovascular outcomes trial.
A three-year follow-up finds most people who reached diabetes remission via intermittent calorie restriction maintained it without ongoing intervention. PICO summary and commentary.
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