Muscle and fat together predict diabetes better than either alone

The edition in brief

Among 479,607 diabetes-free UK Biobank participants followed for a median 14.2 years, 32,948 developed type 2 diabetes. Sarcopenic obesity, defined by handgrip strength, skeletal muscle mass-to-weight ratio and fat mass percentage, carried a hazard ratio of 3.54 (95% CI 3.34-3.74), higher than obesity or sarcopenia alone, and a landmark analysis found that moving into the phenotype carried nearly as much risk as staying in it. The FDA has classified as Class II an ongoing recall by Apollo Care of multiple strengths of compounded semaglutide multi-dose vials after nylon, polyamide and silk-type particulate matter was found in them. In the French FLUO trial, 206 adults with a body mass index of 35 or above were randomised to recombinant or egg-based standard-dose influenza vaccine; antibody titres at day 28 favoured the recombinant vaccine for three of four strains but the difference had gone by day 180. A meta-analysis of 26 studies found people with both depression and diabetes had a 30% higher rate of all-cause mortality and a 28% higher rate of complications than people with diabetes alone, with metabolic complications most raised and retinopathy, unexpectedly, less common. A Scottish registry cohort of 140 adults with Charcot neuro-osteoarthropathy found 88% had an emergency admission, 31% an amputation and 38% died over a median 4.6 years, with five-year amputation-free survival of 44%. All but the vaccine trial are observational.