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Objective To evaluate the efficacy and safety of the domestic liraglutide injection (RD12014) in patients with type 2 diabetes mellitus (T2DM) using the imported liraglutide injection (Victoza®) as a control. Methods A multicenter, randomized, open-label, parallel, positive-controlled phase III clinical trial was conducted. From August 20, 2020 to July 18, 2022, a total of 468 T2DM patients with poor glycemic control after using metformin hydrochloride were enrolled from 41 centers nationwide. They were then randomly assigned to the RD12014 group or Victoza® group in a 1:1 ratio for 29 weeks using a stratified block randomization method. Glycated hemoglobin A1c (HbA1c), fasting plasma glucose, 2-hour postprandial glucose, fasting lipid profile body weight, HbA1c compliance rate, the incidence of adverse events (including gastrointestinal reactions and hypoglycemic events) were compared between the two groups before and after treatment. The primary efficacy endpoint was the change from baseline in HbA1c after 29 weeks of treatment; the secondary efficacy endpoints were the change from baseline in fasting plasma glucose, 2-hour postprandial plasma glucose, fasting lipid profile, and body weight after 29 weeks of treatment, the proportion of subjects with HbA1c<7%, HbA1c≤6.5%, and the proportions of subjects with HbA1c<7%, HbA1c≤6.5% without hypoglycemic events after 29 weeks of treatment. The mixed effects model for repeated measures was used to evaluate quantitative efficacy endpoints, and the HbA1c compliance rate between groups was analyzed using logistic regression models; descriptive statistical analysis was used for safety evaluation. Results A total of 468 T2DM patients (RD12014 group: 233 cases, Victoza® group: 235 cases) were enrolled. After 29 weeks of treatment, the least-squares mean (95%CI) in the changes from baseline in HbA1c for the RD12014 group and the Victoza® group were -1.42% (-1.54%-1.29%) and -1.41% (-1.54%-1.29%), respectively. The least squares mean difference (95%CI) in the change from baseline between the two groups was -0.01% (-0.18%-0.17%), with the 95%CI within the equivalence margin of -0.4%-0.4%, indicating that the efficacy of RD12014 was similar to Victoza®. Changes from baseline in fasting blood glucose, 2-hour postprandial blood glucose, and body weight, and the rate of HbA1c compliance were similar in both groups (P>0.05). The incidence of adverse events [81.4% (188/231) vs. 80.0% (188/235), respectively] and gastrointestinal reactions [45.5% (105/231) vs. 39.1% (92/235)] were similar in the RD12014 group and the Victoza® group, while the incidence of hypoglycemic events in the RD12014 group [4.3% (10/231)] was slightly lower than those in the Victoza® group [8.9% (21/235)]. Conclusion Domestic liraglutide injection RD12014 is as effective and safe as Victoza® in the treatment of T2DM and has value in clinical use. [ABSTRACT FROM AUTHOR]

Both hypertension and type 2 diabetes are attributable to premature death, cardiovascular and kidney diseases with largely overlapping population. Followed the GRADE approach, this expert consensus aimed to reduce the cardiovascular and kidney death and disability due to hypertension and minimize the treatment burden in adults with type 2 diabetes. Through online survey and discussion, a multidisciplinary team comprehensively prioritized seven key guideline questions. Informed by the evidence synthesis and online discussion, the team developed 12 recommendations under the GRADE Evidence-to-decision (EtD) framework. The recommendations covered the screening of hypertension in adults diagnosed with type 2 diabetes but not hypertension and the monitoring, lifestyle interventions, and medications in those diagnosed with type 2 diabetes and hypertension., (© 2024 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.)

Insulin resistance is the primary contributor to the disruption in glucose homeostasis in the body, playing a significant causative role in many metabolic diseases. Insulin resistance is characterized by compensatory insulin secretion and reduced insulin responsiveness in target organs. Dysregulation of the interaction between insulin-secreting cells and insulin-responsive target organs is an important factor driving the progression of insulin resistance. Circulating endocrine hormones are important mediators mediating the interaction between insulin-secreting cells and insulin-responsive target organs. In addition to the classical hormones secreted by endocrine glands and organ-specific hormones secreted by metabolism-related organs (adipose tissue, muscle, liver, etc.), extracellular vesicles have been recognized as a novel class of endocrine hormones with a complex composition. Extracellular vesicles can transport signaling molecules, such as miRNAs and LncRNAs, to vital organs related to insulin resistance, in a manner akin to conventional hormones. The significant role in regulating the development of insulin resistance underscores the increasing interest in extracellular vesicles as essential contributors to this process. In this review, we summarize the three types of hormones (classical hormones, organokines and extracellular vesicles) that play a regulatory role in insulin resistance, and focus on the novel endocrine hormones, extracellular vesicles, to elaborate the mechanism of extracellular vesicles' regulation of insulin resistance progress from two aspects: the impact on insulin-secreting cells and the influence on insulin-responsive target organs. In addition, this paper outlines the clinical applications of extracellular vesicles in insulin resistance. A comprehensive understanding of the regulatory mechanisms and diagnostic status of the inter-organ network in insulin resistance has great potential to advance targeted therapeutic interventions and diagnostic markers, thereby benefiting both the prevention and treatment of insulin resistance., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Objective: To analyze the impact of atorvastatin on blood lipids and arterial media thickness (IMT) in new-onset type 2 diabetes patients., Methods: 333 patients, 30-70 years old and diagnosed within one year as type 2 diabetes, were selected from the Chinese Diabetes Complication Prevention Study (CDCPS) to take part in this study. Changes of blood lipids and IMT of carotid, femoral and iliac artery pre and post the administration of atorvastatin were tested and followed for 24 months., Results: Total cholesterol, triglycerides and low-density lipoprotein decreased significantly (P = 0.000) and maintained at a low level. The carotid artery IMT decreased significantly (P = 0.022) at the end of this study, but the femoral and iliac artery IMT did not show any obvious change. There were no serious adverse events noticed, during the study period., Conclusion: Long-term use of atorvastatin seemed to be safe and effective in reducing blood lipids in patients with type 2 diabetes thus could delay the development of atherosclerosis.