Half the weight comes back within eight months of stopping a GLP-1

The edition in brief

The most useful number today is a rate. A Bayesian re-analysis of six discontinuation studies, covering 1,776 people who stopped semaglutide or tirzepatide, puts weight regain at 1.04 kg a month. Half the weight lost is back by seven and a half months, and all of it by fifteen. Those longer figures are extrapolations from a linear model rather than observed data, and should be read as a direction rather than a date. The practical consequence is that stopping needs a plan made in advance, not a conversation held afterwards. From Bangladesh and Tanzania, a trial that matters well beyond those two countries. HumAn-1 randomised 400 children and young adults with type 1 diabetes to insulin glargine or to continue human isophane insulin. At six months there was no difference in time below 3.0 mmol/L or in time in range. Where budgets are finite, that is an argument for spending elsewhere. Two findings that lower the burden of care. Weekly capillary ketone testing on well days predicted near-term ketoacidosis as accurately as twice weekly, halving the testing without losing the signal. And once-weekly efsitora produced hypoglycaemic episodes no longer or more troublesome than daily basal insulin across three phase 3 trials, which is the question a weekly insulin has to answer. A meta-analysis of 29 trials and 67,873 patients found no overall association between DPP-4 inhibitors and heart failure, with saxagliptin the exception in subgroup analysis. Nothing new from the regulators today; the most recent diabetes decisions remain the extended-release combination approvals of 11 August.