Drug-class and individual-agent evidence: GLP-1 receptor agonists, SGLT2 inhibitors, and the major trials behind semaglutide, tirzepatide, and related therapies.
A small biomarker RCT finds empagliflozin reduces the renal tubular marker KIM-1 in diabetic heart failure with preserved ejection fraction, with no effect on other biomarkers. PICO summary and commentary.
A 20-week RCT finds adding empagliflozin improves glucose, kidney function, neuropathy symptoms, and nerve conduction velocity in type 2 diabetes, though amplitude and exam scores were unchanged. PICO summary and commentary.
A subgroup analysis finds adding Control-IQ+ automated insulin delivery to GLP-1 agonist therapy lowers HbA1c and improves time in range without weight gain in insulin-treated type 2 diabetes. PICO summary and commentary.
An RCT finds adding a ketogenic diet to dulaglutide improves glucose, lipids, insulin resistance, sleep, and quality of life more than dulaglutide alone in type 2 diabetes. PICO summary and commentary.
A 2-year pragmatic open-label trial finds once-weekly semaglutide modestly outperforms physician-chosen alternatives on HbA1c targets, with a year-1 weight advantage that fades by year 2. PICO summary and commentary.
A phase-1 crossover study in healthy Korean volunteers found a fixed-dose enavogliflozin/gemigliptin combination pharmacokinetically equivalent to the separate tablets, with food delaying only the time to peak. PICO summary and expert commentary.
A small mechanistic trial in youth-onset type 2 diabetes finds metformin and liraglutide shift gut bacteria and bile acids; bile-acid metabolites, not microbiota shifts, track with glucose. PICO summary and commentary.
A clamp study finds tirzepatide preserves the glucagon defence against hypoglycaemia but delays cortisol/noradrenaline and lowers symptom scores, while awareness is unchanged. PICO summary and commentary.
A lipidomics analysis from the randomised EmDia trial finds empagliflozin remodels plasma lipids in type 2 diabetes, raising beneficial LPCs but also harmful ceramides. PICO summary and commentary.
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