Semaglutide cut hsCRP by about 38% in SELECT, weeks before the weight came off

The edition in brief

In a prespecified secondary analysis of SELECT (17,604 adults with atherosclerotic cardiovascular disease and overweight or obesity, without diabetes), semaglutide lowered hsCRP by 37.8% at 104 weeks. The fall began by weeks 4 to 8, before most weight loss, and occurred even in people who did not lose weight. Baseline hsCRP predicted MACE, and semaglutide reduced MACE across hsCRP strata; modelling suggests lower inflammation explains part, not all, of the benefit. In the TrialNet Pathway to Prevention cohort, relatives with a single islet autoantibody varied widely in beta-cell function; OGTT measures combining stimulated glucose and C-peptide were the most consistent predictors of progression, identifying small groups with more than 50% two-year progression and large groups under 10% at five years. An expert perspective in Diabetes Care argues that SGLT inhibitors should be developed for heart and kidney protection in type 1 diabetes using surrogate end points, with diabetic ketoacidosis mitigation as the central safety issue. A meta-analysis of six small trials (n = 472) found curcumin associated with hsCRP about 1 mg/L lower in type 2 diabetes, on a thin evidence base. The practice-changer: in the PROMPT cluster-randomised trial, an electronic health record prompt raised diabetes self-management education referrals from 1.2% to 12.9% at 12 months, and standing orders for nurses kept the gain at 18 months.