The remission score that misses heavier children, and empagliflozin's benefit held in over-75s

The edition in brief

In 422 young people from the SEARCH for Diabetes in Youth study, an insulin dose-adjusted HbA1c (IDAA1c) of 9 or less identified C-peptide-defined partial remission with 61% sensitivity and 79% specificity overall, and only 45% sensitivity in those with overweight or obesity, whose higher insulin needs push the score up despite better beta-cell function. A Swedish register study of 34,155 adults with type 1 diabetes found that each year later at diagnosis was associated with lower mortality, and excess risk was highest when diabetes began before age 10. In Medicare claims, adults 65 and over starting empagliflozin had lower rates of cardiovascular events, heart failure admission and death than matched DPP-4 inhibitor users, with no difference in relative effect by age, sex, race or socioeconomic group; this is observational. A network meta-analysis of 27 small trials found both orders of combined aerobic and resistance training improved glycaemia and lipids, with no reliable winner. The FDA recorded a supplement to the teprotumumab licence on 23 September; the record does not say what changed. The pearl covers sick-day advice for older adults on SGLT2 inhibitors.