An amylin analogue reaches double-digit weight loss without the vomiting

The edition in brief

Today's diabetology edition leads with ZUPREME 1, a phase 2 trial of the long-acting amylin analogue petrelintide in 485 adults with obesity and without type 2 diabetes. Weight fell 9.8% at 28 weeks on the 5.0 mg dose against 1.7% on placebo, a treatment difference of -8.1% (95% CI -9.7 to -6.5), with losses still continuing at week 42. Nausea was commoner than placebo (20% versus 6%) but vomiting was not (3% versus 6%), which is the finding that separates this mechanism from the incretins. It remains phase 2, funded by the manufacturer, and 86% of participants were White. A DCCT/EDIC analysis of 963 adults with type 1 diabetes of about 43 years' duration found 64% at intermediate or high risk of obstructive sleep apnoea on STOP-Bang and 43% with poor sleep quality, with each 1% higher HbA1c associated with 15-20% higher odds of a sleep problem. The direction of that association is untested. An Indian meta-analysis of seven cross-sectional studies put confirmed sarcopenia at 27.4% in adults with type 2 diabetes, but with I2 of 91.7% and a prediction interval from 6.9% to 65.6%; the authors decline to recommend screening on it. The FDA approved BLA761497 for an insulin aspart product on 15 September. The edition closes with the first international position statement on continuous glucose monitoring, insulin pumps and automated insulin delivery in non-critically ill hospital inpatients, which covers selection, alarm settings, perioperative care, imaging and discharge.