PURPOSE OF REVIEW: This review summarizes recent evidence on continuous glucose monitoring (CGM) in adults with type 2 diabetes mellitus (T2D), focusing on clinical effectiveness, patient-reported outcomes, disparities i...PURPOSE OF REVIEW: This review summarizes recent evidence on continuous glucose monitoring (CGM) in adults with type 2 diabetes mellitus (T2D), focusing on clinical effectiveness, patient-reported outcomes, disparities in use, and policy and economic considerations. RECENT FINDINGS: Studies from 2020 to 2025 show that CGM use in T2D is associated with consistent improvements in glycosylated hemoglobin (HbA1c), time in range, and diabetes self-management across insulin and non-insulin treatment regimens. Emerging observational data suggest reductions in mortality and health care utilization, and cost-effectiveness analyses consistently demonstrate that CGM represents a high-value intervention across payer settings. Despite these benefits, CGM uptake remains variable, with persistent disparities by age, race, and ethnicity, insurance coverage, and care setting. CGM is an effective and cost-effective tool for T2D management, but inequities in access limit its impact. Future research should address implementation in safety-net and primary care settings, evaluate over-the-counter CGM, and assess long-term clinical and health system outcomes.
Plush SL, Litwin P, Han S
… +4 more, Bryant RV, Kumar S, Kaazan P, Day AS
Curr Diab Rep
· 2026 Jun · PMID 42313343
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PURPOSE OF REVIEW: Adults with inflammatory bowel disease (IBD) demonstrate a high prevalence of obesity, metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiometabolic comorbidities. Cardiovascular...PURPOSE OF REVIEW: Adults with inflammatory bowel disease (IBD) demonstrate a high prevalence of obesity, metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiometabolic comorbidities. Cardiovascular disease (CVD) is a leading cause of mortality in IBD. This review examines cardiometabolic and obesity screening, and management within IBD models of care to optimise chronic disease management. RECENT FINDINGS: Obesity prevalence in IBD has increased to 40%. Chronic systemic inflammation driven by visceral adiposity, proinflammatory cytokine production, insulin resistance and vascular endothelial dysfunction represent a unifying mechanism linking IBD, MASLD and CVD. Proactive management of cardiometabolic risk is not prioritised within traditional IBD service models. Therapeutic approaches to manage obesity and lower CVD risk in this cohort with concurrent optimisation of IBD control include dietary and lifestyle intervention through to anti-obesity pharmacotherapy and bariatric procedures. Integrated multidisciplinary models of care that leverage existing infrastructure and shared-care partnerships with primary care, proactive risk identification and management strategies should be adopted within specialist IBD services. As obesity, MASLD and CVD emerge as major contributors of morbidity and mortality in IBD, failure to systematically address cardiometabolic risk represents a critical gap in contemporary IBD care. Embedding proactive screening and multidisciplinary management within existing IBD infrastructure offers immediate actionable opportunity to improve long-term outcomes beyond inflammatory control.
PURPOSE OF REVIEW: Climate change is progressively recognized as an emerging determinant of metabolic health outcomes, particularly in relation to diabetes mellitus. This review summarizes mechanistic and epidemiological...PURPOSE OF REVIEW: Climate change is progressively recognized as an emerging determinant of metabolic health outcomes, particularly in relation to diabetes mellitus. This review summarizes mechanistic and epidemiological evidence linking climate-related exposures to diabetes outcomes: namely, 1) heat stress, 2) air pollution, and 3) extreme weather-related disruption of diabetes care. RECENT FINDINGS: Warming temperatures, worsening air quality, and more frequent extreme weather events are intensifying exposures that disproportionately affect populations with pre-existing chronic diseases; patients with diabetes may be at the center of climate-related vulnerability. While the greatest burden of diabetes is shouldered by countries in the Global South, these same regions are also at the front lines of climate change, facing extreme environmental conditions. Together, diabetes and climate change can converge to create compounding pressures on already strained public health systems in the world's most climate-vulnerable regions. Using global case studies from climate-vulnerable settings, we show the pathways through which diabetes outcomes and climate change can be connected highlighting the need for climate-informed diabetes prevention and management.
Raptis D, Chiotis S, Papamichalis T
… +3 more, Bekiari E, Tsapas A, Karagiannis T
Curr Diab Rep
· 2026 Jun · PMID 42277362
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PURPOSE OF REVIEW: Recently developed once-weekly basal insulin analogs, including insulin icodec and insulin efsitora alpha (efsitora), aim to improve treatment adherence and patient convenience compared with daily basa...PURPOSE OF REVIEW: Recently developed once-weekly basal insulin analogs, including insulin icodec and insulin efsitora alpha (efsitora), aim to improve treatment adherence and patient convenience compared with daily basal insulin. This systematic review and meta-analysis evaluated the efficacy and safety of once-weekly basal insulin analogs compared with daily basal insulin analogs in adults with type 2 diabetes mellitus (T2DM) and included 14 randomized controlled trials (RCTs), comprising 8,487 subjects. RECENT FINDINGS: Evidence supports that once-weekly basal insulin analogs achieve comparable glycemic control to daily basal insulin analogs in adults with T2DM, offering greater reductions in HbA1c and improvements in time in range, with a safety profile similar to that of daily insulin regimens. In our analysis, once-weekly basal insulin resulted in a greater reduction in HbA1c compared with daily basal insulin (mean difference [MD] -0.09%, 95% CI -0.15 to -0.03), greater improvements in time in range (TIR) (MD 1.86%, 95% CI 0.73 to 2.98) and higher odds of attaining an HbA1c < 7.0% (OR 1.32, 95% CI 1.07 to 1.63, I2 64.9%). Rates of level 2 or 3 hypoglycemia did not differ significantly. Once-weekly basal insulin provides glycemic control comparable to daily basal insulin, with modest improvements in glycemic outcomes and similar hypoglycemia risk. Its primary advantage lies in treatment simplification and reduced injection burden, supporting its role as a convenient alternative to daily basal insulin in adults with T2DM.
PURPOSE OF REVIEW: To address the clinical dilemma of how best to counsel women with type 2 diabetes (T2D) using glucagon-like peptide-1 receptor agonists (GLP-1RA) regarding pregnancy. RECENT FINDINGS: Animal studies ra...PURPOSE OF REVIEW: To address the clinical dilemma of how best to counsel women with type 2 diabetes (T2D) using glucagon-like peptide-1 receptor agonists (GLP-1RA) regarding pregnancy. RECENT FINDINGS: Animal studies raise concern for fetal loss, malformations and adverse fetal growth after GLP-1RA exposure. Nonetheless, three cohort studies and one prospective study including 2,994 women with T2D exposed to GLP-1RA in early pregnancy indicate no increased risk of malformations compared with unexposed pregnancies, and observational data in 168 GLP-1RA exposed pregnancies are reassuring regarding miscarriage and fetal growth. Women with T2D are advised to use contraception and to discontinue GLP-1RAs two months before planned pregnancy. Despite concerns in animal studies, GLP-1RA exposure in early T2D pregnancy has not been associated with increased risk of malformations. If a woman with T2D inadvertently becomes pregnant while using GLP-1RA, the existing human evidence does not support a recommendation of terminating pregnancy.
Enlow PT, Garcia JF, Price J
… +2 more, Torres KA, Wagner DV
Curr Diab Rep
· 2026 May · PMID 42215751
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PURPOSE OF REVIEW: Synthesize data on whether existing behavioral interventions can improve health equity among youth with type 1 diabetes. RECENT FINDINGS: While existing behavioral interventions demonstrated efficacy i...PURPOSE OF REVIEW: Synthesize data on whether existing behavioral interventions can improve health equity among youth with type 1 diabetes. RECENT FINDINGS: While existing behavioral interventions demonstrated efficacy in improving health and/or psychosocial outcomes, evidence that these same interventions may improve health equity were lacking. Most interventions were evaluated using predominantly White and affluent samples and some studies did not report on racial, ethnic, or sociodemographic characteristics of their sample. Only a few interventions have been adapted for youth from minoritized backgrounds. Recent multisystemic and technology/mHealth interventions recruited samples that were sociodemographically representative of youth experiencing disparities, suggesting that these interventions could improve health and/or psychosocial outcomes for these sociodemographic groups. However, no studies conducted subgroup analyses to examine whether the effect of the intervention might vary as a function of sociodemographic characteristics. The prevalence and persistence of disparities in psychosocial and glycemic outcomes among youth with T1D underscore the urgent need for effective, evidence-based behavioral interventions for populations in most need of this care. There is a critical need for research that prioritizes recruitment of samples that represent youth most impacted by health disparities. Additionally, existing interventions can be adapted for youth from minoritized backgrounds. Future research would benefit from leveraging existing intervention development/adaptation frameworks and engaging community partners through the research process.
PURPOSE OF REVIEW: The purpose of this review is to synthesize literature investigating the relationship between type 2 diabetes (T2D) and obstructive airway diseases and to identify implications for clinical care. RECEN...PURPOSE OF REVIEW: The purpose of this review is to synthesize literature investigating the relationship between type 2 diabetes (T2D) and obstructive airway diseases and to identify implications for clinical care. RECENT FINDINGS: Type 2 diabetes is a common and challenging comorbidity in patients with asthma and chronic obstructive pulmonary disease (COPD). Basic, translational and clinical studies support a bidirectional association between T2D and the lung. In animal models and human studies, insulin resistance and hyperglycemia are associated with pulmonary inflammation, respiratory exacerbation risk and disease severity. Corticosteroids are a mainstay for respiratory disease control and exacerbation treatment but promote ongoing metabolic dysregulation. Randomized, placebo-controlled trials of glucose-lowering medications for asthma are actively ongoing. Additional studies addressing clinical pathways to co-manage respiratory and metabolic risk are needed. Patients with comorbid T2D and asthma or COPD are at risk for worse outcomes. There are opportunities to improve cross-disciplinary care, potentially reducing risk and multimorbidity associated with both conditions.
PURPOSE OF REVIEW: To examine the role of pharmacologic obesity treatment in people with type 2 diabetes (T2D), with a focus on efficacy, safety, and clinical positioning in the context of T2D-specific metabolic and ther...PURPOSE OF REVIEW: To examine the role of pharmacologic obesity treatment in people with type 2 diabetes (T2D), with a focus on efficacy, safety, and clinical positioning in the context of T2D-specific metabolic and therapeutic challenges. RECENT FINDINGS: Contemporary incretin receptor agonists enable clinically meaningful weight loss in people with T2D while improving glycemic control and cardio-renal, hepatic, and functional outcomes, including improvements in physical performance and symptoms in heart failure with preserved ejection fraction (HFpEF). However, weight loss is consistently attenuated compared with obesity without diabetes, reflecting reduced metabolic flexibility (impaired ability to appropriately adjust fuel utilization), background therapies, and social determinants of health rather than treatment failure. Obesity pharmacotherapy should be considered a disease-modifying component of T2D care. Treatment success should be defined by improvements in adiposity-related complications, organ protection, and patient-centered outcomes, not by fixed weight-loss thresholds. A complication-focused, individualized approach is essential to optimize long-term benefit in T2D.
Longo S, Rinaldi TG, Fernández-Real JM
… +1 more, Federici M
Curr Diab Rep
· 2026 Apr · PMID 41964817
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PURPOSE OF REVIEW: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a hepatic manifestation of metabolic syndrome, frequently occurring alongside type 2 diabetes (T2D), and it can present in varied phe...PURPOSE OF REVIEW: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a hepatic manifestation of metabolic syndrome, frequently occurring alongside type 2 diabetes (T2D), and it can present in varied phenotypes. This review provides a critical analysis of gut-adipose tissue-liver axis (GALA) dysregulation in MASLD pathogenesis, contextualizing the discussion within both established and emerging paradigms. The review elucidates how GALA dysregulation shapes the interplay between MASLD and T2D, emphasizing inter-organ crosstalk among the gut, liver, and adipose tissue, and highlighting the role of microbial metabolites, notably bile acids. The review further summarizes recent advances in stratifying MASLD into distinct clusters, examining intricate associations with cardiometabolic comorbidities, and critically evaluates novel therapeutic approaches targeting GALA modulation. RECENT FINDINGS: MASLD can show heterogeneous phenotypes. It significantly increases the risk of developing new-onset T2D, and both conditions often coexist due to their shared pathophysiological basis in insulin resistance. The gut microbiota influences immune function and modulates host metabolism by regulating glucose tolerance and insulin sensitivity through a specific crosstalk between the gut, liver, and adipose tissue. The dysregulation of the GALA may be a mechanism underlying the interplay between MASLD and T2D, influencing IR and metabolic syndrome. A thorough investigation of GALA's role in the physiopathogenesis of MASLD and T2D highlights its potential to distinguish specific MASLD clusters and to identify personalized therapeutic strategies.
de Lucena LA, Cavalcante DVS, Montenegro MV
… +7 more, Hespanhol LC, de Oliveira WS, Muniz JQ, Prathivadhi-Bhayankaram S, Kaplinsky E, Barbagelata A, Giorgi J
Curr Diab Rep
· 2026 Apr · PMID 41961206
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PURPOSE OF REVIEW: Lipolysis regulates lipid distribution, energy availability, and metabolic homeostasis in organisms that store triacylglycerols. In multicellular organisms, adipose tissue evolved as a specialized orga...PURPOSE OF REVIEW: Lipolysis regulates lipid distribution, energy availability, and metabolic homeostasis in organisms that store triacylglycerols. In multicellular organisms, adipose tissue evolved as a specialized organ that centralizes lipid storage and release, buffers nutrient fluctuations, and protects non-adipose tissues from lipid overload. Dysregulated adipocyte lipolysis occurs across diverse metabolic conditions, including obesity, diabetes, lipodystrophy, and inflammatory states. This review synthesizes evidence that defective suppression of basal lipolysis and impaired responsiveness to physiological stimuli disrupt lipid partitioning, promote insulin resistance, and drive ectopic lipid accumulation. RECENT FINDINGS: Research shows that metabolic dysfunction arises in both obese and non-obese settings and correlates more closely with impaired control of fatty acid flux than with adiposity itself. Higher expression of lipolytic receptors, including those targeted by weight-loss medications, together with genes that regulate lipolysis through insulin signaling, is associated with greater weight loss and improved systemic metabolic health. In this review, we highlight canonical and noncanonical mechanisms governing lipolytic regulation and contrast pathological lipolysis with the tightly controlled lipolysis observed during weight loss. Together, these findings reframe lipolysis as a central determinant of metabolic health and a therapeutic target when precisely regulated.
Driscoll KA, Trojanowski PJ, Shaffer ER
… +6 more, Manis H, Pardon A, Reynolds CM, Wetter-Wren SE, O'Donnell HK, Patton SR
Curr Diab Rep
· 2026 Mar · PMID 41870691
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PURPOSE OF REVIEW: To provide an updated review of the fear of hypoglycemia (FOH) literature published from 2016 to 2025, in youth with type 1 diabetes (T1D) and their caregivers. RECENT FINDINGS: The Hypoglycemia Fear S...PURPOSE OF REVIEW: To provide an updated review of the fear of hypoglycemia (FOH) literature published from 2016 to 2025, in youth with type 1 diabetes (T1D) and their caregivers. RECENT FINDINGS: The Hypoglycemia Fear Surveys (HFS) are the most used questionnaires to assess FOH in studies conducted in the United States and internationally. The factor structure of the Parent and Child versions of the HFS have been updated to better reflect only maladaptive aspects of managing FOH. Diabetes technology studies routinely include the HFS to assess FOH as a secondary outcome. Only two randomized clinical trials (RCT) to reduce FOH have been conducted with youth with T1D and their caregivers. FOH is a common psychological complication occurring in youth with T1D and their caregivers. More research is needed to update the HFS to reflect modern T1D self-management and test interventions that aim to reduce FOH in RCTs.
Malandris K, Charalampidis K, Loomba R
… +1 more, Sinakos E
Curr Diab Rep
· 2026 Mar · PMID 41831086
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PURPOSE OF REVIEW: Metabolic dysfunction–associated steatotic liver disease (MASLD) is highly prevalent among individuals with type 2 diabetes (T2D). This review summarizes current evidence on the pharmacologic treatment...PURPOSE OF REVIEW: Metabolic dysfunction–associated steatotic liver disease (MASLD) is highly prevalent among individuals with type 2 diabetes (T2D). This review summarizes current evidence on the pharmacologic treatment of MASLD, with emphasis on agents currently approved for the management of T2D. RECENT FINDINGS: Among glucose-lowering therapies, GLP-1 RAs, dual GIP/GLP-1 RAs, pioglitazone, and SGLT2 inhibitors demonstrate meaningful benefits in steatohepatitis. Semaglutide provides the most robust evidence for fibrosis benefit, while data suggest potential antifibrotic effects of tirzepatide and dapagliflozin. Resmetirom and semaglutide are the only agents specifically approved for MASLD. An expanding pipeline of dual glucagon/GLP-1 and triple GIP/GLP-1/glucagon agonists such as retatrutide has shown marked reductions in liver fat and signals of MASH benefit. Additional therapies, including pan-PPAR agonists, and FGF21 analogues are advancing through phase 3 development. The therapeutic landscape is rapidly evolving toward integrated metabolic, hepatic, and cardiovascular risk reduction in T2D and MASLD.
Ehrmann D, Hermanns N, Schmitt A
… +2 more, Klinker LY, Kulzer B
Curr Diab Rep
· 2026 Mar · PMID 41806225
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PURPOSE OF REVIEW: Diabetes self-management is accompanied by time-varying emotional and motivational challenges that impact mental health. These day-to-day fluctuations can be assessed via ecological momentary assessmen...PURPOSE OF REVIEW: Diabetes self-management is accompanied by time-varying emotional and motivational challenges that impact mental health. These day-to-day fluctuations can be assessed via ecological momentary assessment (EMA), that allows the repeated sampling of psychosocial variables in everyday life. The benefits of EMA over questionnaires mirror the benefits of continuous glucose monitoring (CGM) over HbA1c. We describe the insights generated by combining EMA and CGM and highlight its potential. RECENT FINDINGS: Research shows that glucose levels can influence subsequent mood, stress, cognitive functioning, and symptom reporting, with nocturnal hypoglycemia and overnight glucose being particularly relevant. Studies demonstrated the importance of differentiating between subjective person-interpreted and objectively sensor-assessed glucose levels. N-of-1 analyses revealed relevant intraindividual differences in the association between glycemic and psychosocial parameters. Combining EMA and CGM can enhance our understanding of the dynamic relationship between glycemic and psychosocial variables, supporting precision medicine approaches for mental health in diabetes.
PURPOSE OF REVIEW: Peripheral artery disease (PAD) is a serious complication in type 2 diabetes, increasing vascular morbidity and mortality. While glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic pol...PURPOSE OF REVIEW: Peripheral artery disease (PAD) is a serious complication in type 2 diabetes, increasing vascular morbidity and mortality. While glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists show cardiovascular benefits in diabetes, their effects on PAD-related outcomes are unclear. This meta-analysis assessed the impact of these therapies on vascular outcomes in type 2 diabetes with PAD. RECENT FINDINGS: A systematic review and meta-analysis were conducted per PRISMA guidelines (PROSPERO CRD420251083622). PubMed, Embase, and Cochrane Central were searched. A random-effects model pooled data. Primary outcomes were major adverse limb events, peripheral revascularization, and amputation. Secondary outcomes included major adverse cardiovascular events (MACE), all-cause mortality, myocardial infarction, stroke, HbA1c, and weight changes. Six studies (four RCTs, two propensity score-matched cohorts) with 25,866 patients were included. Incretin-based therapies significantly reduced all-cause mortality (RR 0.52 [0.28–0.95], p = 0.032) and HbA1c (MD − 0.73% [–1.32 to − 0.15], p = 0.013) compared to placebo or standard care. No significant differences were found for major adverse limb events, revascularization, amputation, MACE, myocardial infarction, or stroke. Heterogeneity and low evidence certainty were noted.
Talebloo J, Gadde KM, Mittal RK
… +1 more, Nguyen NT
Curr Diab Rep
· 2026 Jan · PMID 41606240
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PURPOSE OF REVIEW: Bariatric surgery is a highly effective treatment for obesity that yields durable weight loss with significant improvement or resolution of T2D and other weight-related chronic cardiometabolic diseases...PURPOSE OF REVIEW: Bariatric surgery is a highly effective treatment for obesity that yields durable weight loss with significant improvement or resolution of T2D and other weight-related chronic cardiometabolic diseases. While the advantages of laparoscopic sleeve gastrectomy (LSG), the most performed bariatric surgery procedure, include procedural simplicity, short operating time, lower complication rate, durable weight loss, and significant improvement including remission of type 2 diabetes, a major drawback is gastroesophageal reflux disease (GERD). The purpose of this review is to summarize the prevalence of and predictors of GERD after LSG, physiological mechanisms that explain the risk, and novel surgical management and strategy. RECENT FINDINGS: Studies note high rates of de novo GERD and worsening of pre-existing GERD following LSG; however, estimates vary due to inconsistent definitions and length of follow-ups across the cohorts. Physiological studies demonstrate that LSG increases intragastric pressure and esophageal acid exposure in conjunction with specific anatomic alterations, which together can explain the rise in reflux seen postoperatively. Preoperative reflux, including undiagnosed preoperative GERD, is the strongest predictor of postoperative GERD. For patients with persistent GERD symptoms, conversion to gastric bypass is a common treatment, and experimental work suggests that adaptations of principles from fundoplication to sleeve anatomy can offer a pathway to minimize LSG-induced reflux. Future studies should be aimed at determining which elements of the antireflux barrier that must be preserved or reconstructed to reduce reflux after LSG. Additionally, there is a need to fully understand how the mechanics of fundoplication can be adapted and applied to sleeve anatomy to create a reliable antireflux barrier.
Curr Diab Rep
· 2026 Jan · PMID 41563611
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PURPOSE OF REVIEW: Most youth with type 1 diabetes (T1D) do not meet the guidelines for physical activity engagement, thereby diminishing potential benefits to physical and mental health. This review synthesizes the rece...PURPOSE OF REVIEW: Most youth with type 1 diabetes (T1D) do not meet the guidelines for physical activity engagement, thereby diminishing potential benefits to physical and mental health. This review synthesizes the recent literature on physical activity among youth with T1D and offers recommendations for future research. RECENT FINDINGS: Studies highlight challenges related to the use of inconsistent measurement tools, which prevent definitive conclusions about the mechanistic factors underlying low physical activity in youth. There has been limited research examining young children and youth newly diagnosed with T1D. Additionally, most interventions to promote physical activity in youth with T1D have involved structured and supervised exercise sessions, leaving a gap in knowledge regarding the potential impact of unstructured and unsupervised exercise interventions. To address these gaps, rigorous studies employing validated measures of physical activity in youth are needed. Interventions should incorporate developmentally appropriate behavioral science theories and emerging technologies in their design. Additional priorities include integrating diabetes technologies into clinical care, more real-world data to improve the accuracy of machine learning models for predicting dysglycemia, and advancing personalized mHealth interventions to promote physical activity in youth. While physical activity is an important area of pediatric diabetes research, gaps remain in our knowledge and intervention development. Physical activity consultations should be a part of routine diabetes care for youth. Research can inform these consultations by providing strategies to promote physical activity uptake and maintenance and by exploring ways to leverage new technologies to help youth with T1D exercise safely.
Liakos A, Karagiannis T, Avgerinos I
… +1 more, Bekiari E
Curr Diab Rep
· 2026 Jan · PMID 41528550
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PURPOSE OF REVIEW: The pharmacologic management of type 2 diabetes prioritises sodium-glucose cotransporter 2 (SGLT-2) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists for their demonstrated cardiovascular...PURPOSE OF REVIEW: The pharmacologic management of type 2 diabetes prioritises sodium-glucose cotransporter 2 (SGLT-2) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists for their demonstrated cardiovascular benefits in individuals with atherosclerotic cardiovascular disease or multiple cardiovascular risk factors, chronic kidney disease, and heart failure. However, while current guidelines recommend these drug classes alone, combination therapy is not explicitly advocated. Herein we summarise the rationale and available evidence in support for combination therapy. RECENT FINDINGS: Evidence suggests that combining SGLT-2 inhibitors and GLP-1 receptor agonists improves metabolic outcomes, including HbA, body weight, and blood pressure. More importantly, combination therapy can offer potential advantages for addressing residual cardiovascular risk, particularly in high-risk populations. Data from cardiovascular outcomes trials and real-world studies demonstrate consistent benefits of combination therapy across diverse subpopulations, including those with established atherosclerotic cardiovascular disease or chronic kidney disease. However, robust evidence remains limited for individuals at low cardiovascular risk, where therapy should primarily focus on metabolic goals. Of note, combination therapy faces significant barriers, including safety concerns in older or frail individuals, underutilisation in disadvantaged populations, while economic challenges may further hinder the accessibility of these therapies. Upfront combination therapy with both SGLT-2 inhibitors and GLP-1 receptor agonists could further reduce cardiovascular risk in people with type 2 diabetes, although it is crucial to pare down cost and disparities to access to maximise widespread benefits at population level.
PURPOSE OF REVIEW: To synthesize the components of diabetes prevention programs (DPPs) after gestational diabetes mellitus (GDM) and how they relate to factors that influence implementation. We conducted a scoping review...PURPOSE OF REVIEW: To synthesize the components of diabetes prevention programs (DPPs) after gestational diabetes mellitus (GDM) and how they relate to factors that influence implementation. We conducted a scoping review of the literature using MEDLINE, Embase, PsychINFO, and Emcare. We provided a narrative description of intervention components based on the Template for Intervention Description and Replication (TIDieR) and the study results based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. RECENT FINDINGS: Seventeen included studies described DPPs after GDM. Recruitment typically began during pregnancy, while interventions started postpartum, with higher reach and participation rates for studies that recruited during pregnancy. The included DPPs used face-to-face delivery, virtual delivery, or a combination. Many programs were individual, but a few had a group component. Program duration varied from one month to three years. The available data highlighted the need to increase engagement, particularly for minority groups, and utilize flexibility and tailoring of program components and delivery to optimize retention, impact and sustainability. Significant barriers to the successful implementation of DPPs after GDM exist; the reporting of intervention components and implementation outcomes in the existing studies is variable. Validated frameworks, including RE-AIM, should be integrated into intervention development, implementation and evaluation.