Nothing new today. The sweep found no fresh approvals, safety communications or guideline releases relevant to diabetes and endocrinology. The most recent regulatory activity remains a batch of supplemental application approvals dated 11 August for existing fixed-dose combinations — linagliptin-metformin, sitagliptin-metformin, empagliflozin-metformin and the empagliflozin-linagliptin-metformin combination — along with a supplement for sotagliflozin. These are supplements to products already marketed, not new indications, and none changes prescribing.
The most useful recent guidance for this desk is not a regulator's document at all. The EASO, EFAD and ECPO consensus statement on incretin-based therapy fills the gap that drug labels leave: what to do about nutrition, muscle and mind while a patient is losing weight rapidly. It sets out protein targets during weight loss, argues for progressive resistance exercise to protect fat-free mass and physical function, and recommends psychological screening, on the grounds that shifts in food reward, coping and social eating are genuine clinical problems and not side notes.
It also treats starting, up-titrating, pausing, down-titrating and stopping as one shared decision rather than five separate ones — which is the right frame given how often these drugs are interrupted for reasons that have nothing to do with efficacy. Read alongside today's regain data, it is the practical companion to a prescription rather than an alternative to one.
- No new approvals or safety communications for this desk today.
- August's FDA activity was supplemental approvals for existing metformin combinations; no prescribing change.
- Set a protein target and add progressive resistance exercise for every patient on incretin therapy.
- Screen for psychological difficulty during rapid weight loss rather than waiting for it to be volunteered.
- Frame dose changes and pauses as shared decisions, and monitor diet quality and micronutrient risk alongside weight.
The statistics, in plain English
This is a consensus statement, which sits below trial evidence in the hierarchy: it reflects what an expert panel agrees is sensible where trials have not been done. The panel is explicit that the long-term data on micronutrient status, macronutrient requirements and musculoskeletal outcomes during incretin therapy do not yet exist. Treat its recommendations as reasonable practice to adopt now, not as findings that have been tested.
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