Updated ADA/EASD type 1 consensus, a weekly insulin-GLP-1 combination, and pooled kidney data for semaglutide

The edition in brief

The updated 2026 ADA/EASD consensus report on adult type 1 diabetes puts technology at the centre and extends its scope to complication screening, obesity and cardiovascular risk. In COMBINE 4, once-weekly IcoSema lowered HbA1c more than daily glargine in insulin-naive adults with type 2 diabetes on oral agents (difference -0.88 percentage points), with weight loss rather than gain and fewer clinically significant hypoglycaemic episodes, though the trial was open-label. In the TRIUMPH-1 phase 3 trial in adults with obesity without diabetes, retatrutide cut body weight by about 24-25% at 80 weeks against 3.9% with placebo, with gastrointestinal adverse events most common. A meta-analysis of 17 trials of SGLT2 inhibitors in diabetic kidney disease found neutral effects on eGFR and albuminuria over the short to medium term, a reminder that surrogate markers do not capture the outcome-trial benefit; volume depletion events were more frequent. A prespecified pooled analysis of SELECT, FLOW and SOUL (30,787 participants) found semaglutide lowered a kidney composite by 16% (HR 0.84, 0.77-0.91). The pearl covers sick-day guidance for people on SGLT2 inhibitors.