One in five patients with pulmonary fibrosis has diabetes, and a recall that is about the vial rather than the drug

The edition in brief

A thin day on the diabetes desk, reported as such. The largest item is a systematic review of 251 observational studies covering 606,398 patients with idiopathic pulmonary fibrosis, which found diabetes in 21% (95% CI 19-23), overweight or obesity in 22%, dyslipidaemia in 30% and hypertension in 39% - all higher than the rates reported in IPF trial populations, which matters for anyone asked to co-manage glycaemia in a patient on corticosteroids and antifibrotics. Only lung cancer was consistently associated with mortality; the review could not establish that any metabolic comorbidity drives IPF progression. The FDA has classified as Class II an ongoing recall of compounded semaglutide vials from a single US compounder, for particulate matter identified as nylon or polyamide and a proteinaceous material. The concentrations involved match no licensed pen, which is the point: this is a failure of the compounding route rather than a signal about semaglutide, and it is a reason to ask GLP-1 users what their drug comes in. A Nature Reviews Endocrinology review of stem cell-derived beta cells argues that the gap between these cells and primary human islets is not simply immaturity - cells matured in vivo still differ substantially - and calls for harmonised comparison before the ongoing trials can be interpreted. This is research-stage and changes nothing in clinic today. The practice-changer is a JAMA Insights piece on sleep and obesity, which is a prompt rather than a dataset: ask about sleep quality and quantity in every patient being treated for obesity. Plus a clinic pearl on palpating injection sites before titrating insulin.