This Week in Diabetes & Endocrinology: Acupuncture, GLP-1s, and Exercise

From the New England Journal of Medicine, a trial reported that a phase 3 randomized controlled trial involving 1698 adults with type 2 diabetes inadequately controlled on metformin found that once-daily oral orforglipron produced significantly greater reductions in HbA1c at 52 weeks than oral semaglutide ^[3].

While the authors describe superior glycemic control with orforglipron, they also note that gastrointestinal adverse events and discontinuations were more frequent with this agent, suggesting its safety profile requires careful consideration alongside its efficacy ^[3].

Meanwhile, attention turned to complementary therapies in Research in nursing & health, where a network meta-analysis examined acupuncture interventions for type 2 diabetes ^[2].

The analysis compared various acupuncture therapies to conventional treatment in 12,231 patients and suggested associations with reductions in fasting blood glucose, HbA1c, and postprandial glucose ^[2].

However, the researchers emphasize that these findings are based on low-quality studies, requiring cautious interpretation and verification regarding safety and comparative efficacy ^[2].

Elsewhere this week, a systematic review and meta-analysis in PloS one highlighted disparities in maternal outcomes ^[1].

A review of 9,742 women with hyperglycaemia in pregnancy in Africa revealed high prevalence rates of caesarean section, preterm delivery, and neonatal intensive care unit admission ^[1].

The authors describe significant heterogeneity across outcomes and note that the analysis was limited by data from few studies, underscoring the need for more high-quality research to improve maternal and child health in this population ^[1].

Finally, we also saw research in Frontiers in Medicine evaluating exercise interventions for mitochondrial myopathy ^[5].

A meta-analysis and systematic review evaluated moderate-intensity aerobic and resistance exercise in 157 patients, indicating consistent improvements in exercise capacity and muscle function without consistent increases in creatine kinase levels ^[5].

Given the heterogeneous nature of exercise effects and the observational nature of the pooled data, clinicians should interpret these findings cautiously while awaiting larger controlled trials to confirm long-term efficacy and clarify risk profiles ^[5].