After a below-knee amputation in diabetes, one in four die within a year

The edition in brief

An England population study of 25,176 people with diabetes who had a below-knee amputation found mortality of 23.5% at one year, 60.0% at five years and 82.3% at ten, with no improvement since 2012. Older age, female sex and comorbidity burden were associated with higher mortality, and one in five were readmitted within 90 days. A prespecified SELECT analysis of 7,594 people on semaglutide found median peak weight loss of 12.5%, reached at a median of 19 months, but baseline characteristics explained under 10% of the variation in response; women and those reaching the full 2.4 mg dose lost most. A multicentre Korean CGM study of 1,028 adults with type 1 diabetes found older adults and those with chronic kidney disease improved time in range over three years without more hypoglycaemia, while severe beta-cell failure blunted gains. A 12-week trial in 102 men with obesity and hyperuricaemia found DASH, carbohydrate-restricted and low-purine diets lowered urate similarly, with a transient urate rise and gout flare peak in week one. A meta-analysis of ten trials found cognitive behavioural therapy for sleep was associated with better sleep quality and an HbA1c about 0.35 percentage points lower, though heterogeneity was very high.