Semaglutide delivers at lower Asian BMI cut-offs, and a hard look at the diabetic foot

The edition in brief

Today's diabetology edition leads with STEP 12, a phase 3b trial in Chinese adults showing once-weekly semaglutide 2.4 mg cut weight by 12.1% versus 2.2% with placebo over 44 weeks, with entry at BMI thresholds (from 24 with a comorbidity) that better match Asian cardiometabolic risk than the usual BMI 30 cut-off. A real-world analysis of 86,779 CGM users finds time in range dips at weekends and on Mondays, small but reproducible rhythms worth discussing before changing doses. A population registry links very early, prepubertal type 1 diabetes onset to lower 20-year complication risk, useful information for family counselling. A clinic pearl covers annual diabetic foot risk stratification. The edition closes on an England study of 25,176 people showing one-year mortality of 23.5% after below-knee amputation, rising to 82.3% at ten years and unchanged since 2012: a reason to treat amputation as a marker of systemic disease and to push cardiovascular risk management and limb protection upstream.