One in three adults with lab-proven diabetes was left without a code, a drug or both

The edition in brief

Today's diabetes and endocrinology edition closes on a gap in ordinary care. In a US claims cohort of 27,650 adults whose laboratory results met the threshold for diabetes, only 66.6% had both a diagnosis code and a prescription within a year; 9.6% had neither. Higher HbA1c made action more likely, while heavier comorbidity made it less likely. The ISPAD, EASD and ADA joint working group reached consensus on 31 statements covering the move from paediatric to adult diabetes care, split into pre-transfer, transfer and post-transfer stages. In 1,356 Framingham participants without diabetes, more time above 140 mg/dL on blinded CGM was associated with higher estimated 10-year cardiovascular risk and higher odds of hypertension and dyslipidaemia, even after adjusting for fasting glucose; this is cross-sectional and does not support CGM screening. A randomised trial of an ovine forestomach matrix with hyaluronic acid healed 46% of diabetic foot wounds by 12 weeks against 24% with standard care alone, though post-randomisation exclusions and differential withdrawal weaken the result. A meta-analysis of 11 trials suggests education and behavioural programmes may reduce fear of hypoglycaemia in type 2 diabetes, but the certainty is very low and heterogeneity extreme. The pearl is a reminder of how to confirm a diagnosis in someone without symptoms.