Retatrutide reaches a quarter of body weight, and a lean liver is not a safe liver

The edition in brief

In TRIUMPH-1, 2339 adults with obesity but no diabetes took weekly retatrutide or placebo for 80 weeks. Mean weight fell 23.7% on 9 mg and 25.0% on 12 mg against 3.9% on placebo, with gains in knee osteoarthritis pain and sleep apnoea severity; gastrointestinal effects were commonest. The drug remains investigational. A Diabetes Care analysis of 1129 insulin-treated people referred for MODY testing estimated that about one in five had type 1 diabetes; adding a type 1 genetic risk score to the gene panel flagged 16% of genetically unsolved cases as probable type 1, and in children under 10 could have avoided over half of tests. An updated meta-analysis of 46 trials found behavioural programmes still improve HbA1c in youth with type 1 diabetes only modestly, with family-focused, multicomponent designs doing best. The FDA lists a Class II recall of Baxter's premixed intravenous insulin (Myxredlin) for manufacturing-practice deviations. The practice changer comes from a JAMA biopsy cohort of 18 326 people with MASLD: lean patients had milder histology but similar mortality and liver events after adjustment, fibrosis stage drove prognosis, and liver stiffness measurement outperformed FIB-4 in the lean group. Normal weight should not end the fibrosis assessment.