Core Viewpoint - The article highlights the release of the "International Guidelines for Clinical Management of Diabetes in Pregnancy," which sets new standards for the management of diabetic patients during pregnancy, emphasizing a comprehensive approach from preconception to postpartum care [4][31]. Group 1: Overview of Guidelines - The guidelines are structured around "ten scenarios corresponding to ten solutions," providing evidence-based recommendations for the entire pregnancy cycle [4]. - This is the first cross-continental joint guideline released in five years, recognized for its authority by experts at the ENDO2025 conference [4]. Group 2: Key Recommendations for Preconception Diabetes Management - Preconception diabetes (PDM) refers to diabetes diagnosed before pregnancy, with a doubling of prevalence over the past 20 years, leading to increased risks during pregnancy [6]. - All women of childbearing age with diabetes should be asked about their pregnancy plans during medical visits [8][10]. - Effective screening should include promoting the necessity of preconception health management and assessing contraceptive needs [10]. Group 3: Medication Management - Type 2 diabetes patients should discontinue GLP-1 receptor agonists (GLP-1RA) before conception to avoid risks associated with sudden discontinuation [15][16]. - The routine combination of metformin with insulin therapy in pregnant women with type 2 diabetes is not recommended due to insufficient evidence [18][19]. Group 4: Dietary Recommendations - Daily carbohydrate intake should be individualized, with recommendations ranging from less than 175 grams to regular intake, balancing the need for blood sugar control and fetal development [20][22]. - Monitoring blood sugar levels is crucial, with specific targets set for fasting and postprandial glucose levels during pregnancy [26][27]. Group 5: Monitoring and Management During Pregnancy - Both continuous glucose monitoring (CGM) and traditional fingerstick monitoring are acceptable methods for blood sugar monitoring [24]. - The guidelines suggest that insulin pump therapy should be prioritized for type 1 diabetes patients, with a focus on using smart closed-loop systems [28]. Group 6: Postpartum Management - Professional diabetes management is essential postpartum, including for patients who have experienced pregnancy termination or miscarriage [30][31].

整理 | GLP1减重宝典内容团队 ▍ 司美格鲁肽是否对所有人的减肥效果相同 这个问题的答案是否定的。您对司美格鲁肽等GLP-1药物的反应可能更多地取决于您的遗传因素。 2024 年消化病周会议上发表的一项研究调查了 84 名患有肥胖症或其他体重管理问题的人，以调查遗传因素如何影响减肥药的有效性。 在这项研究中，研究人员开发了一种机器学习基因风险评分来预测遗传表型。 "饥饿肠阳性" 的人被认为拥有一系列基因，这些基因会 导致他们在 饭后胃排空得更快 ，所以他们比其他人 更早感到饥饿 。 研究人员报告称，同时给药相同剂量的司美格鲁肽，"饥饿肠阳性"的人在 9 个月时体重减轻了 14% ，而"饥饿肠阴性"的人体重减轻了 10% 。12 个月后，饥饿肠阳性的人体重减轻了 19% ，而饥饿肠阴性的人体重减轻仍然在 10% 左右。这意味着， "饥饿肠阳性"的人 可以更早看到体重的变化。 ▍ 对司美格鲁肽有反应的患者，是否意味着可以"躺瘦" 答案亦是否定的！在《华盛顿邮报》的副刊杂志——《Parade》里，Kudsi 博士强调，如果服用 Ozempic 或 Wegovy 等减肥药， 保持 健康饮食和定期锻炼仍然很重要。 ...

以下文章来源于内分泌早知道 ，作者关注内分泌的 内分泌早知道 . 当我们在忙碌生活中寻找健康密码时，一项来自英国生物样本库的突破性研究给出了令人振奋的答案：简单的快走运动竟能有效突破寿 命极限。这项涵盖数万人的长期追踪研究揭示，运动效益不仅取决于持续时间，更与运动强度存在决定性关联。 数据显示，保持每日10分钟快走习惯的男性群体平均寿命延长1.4年，女性群体同样获得0.9年的生命馈赠。这一发现彻底颠覆了传统认 知——原来不需要马拉松式的长时间锻炼，只要掌握正确的运动强度，短短十分钟的日常快走就能激活长寿基因。研究人员特别强调， 相较于散步的温和节奏，达到"微喘但能交谈"的快走强度才是触发健康效益的黄金标准，这种强度下的运动能有效改善心肺功能、调节 代谢水平并降低慢性病风险。值得注意的是，这种运动收益在不同年龄层和体质人群中均呈现显著一致性，证明快走是适合绝大多数人 的理想运动方案。 深度分享内分泌用药经验、病例剖析、指南专业解读并紧跟国内外内分泌领域前沿进展，「每医健」旗下内容平台。 ▍每日10分钟快走可延长寿命：大规模研究揭示运动强度与寿命的量化关系 更令人振奋的是，该研究通过预期寿命绝对差值直观呈现健康收 ...

Core Viewpoint - The article discusses the revolutionary impact of GLP-1 receptor agonists in obesity treatment, highlighting recent advancements in combining these drugs with NMDA receptor antagonists to enhance weight loss effects [6][8][14]. Summary by Sections GLP-1 Receptor Agonists - In 2021, the FDA approved semaglutide, a GLP-1 receptor agonist, for long-term weight management in obese and overweight adults, showing an average weight reduction of 15% with weekly injections [6]. - GLP-1 receptor agonists were initially approved for type 2 diabetes treatment, with their weight loss effects discovered during early clinical trials [8]. Innovative Combination Therapy - Researchers from Copenhagen University proposed a novel approach by combining GLP-1 receptor agonists with NMDA receptor-targeting drugs to achieve a dual weight loss effect [8]. - NMDA receptors play a significant role in appetite regulation, and previous studies have shown that NMDA receptor antagonists can induce anorexia and weight loss in mice [11]. Experimental Findings - In experiments with diet-induced obese mice, the new GLP-1–MK-801 compound resulted in a remarkable weight reduction of 23.2%, outperforming traditional calorie restriction methods [13]. - The compound maintained metabolic rates comparable to obese mice, addressing the common issue of metabolic compensation during weight loss [13]. Safety and Future Research - The safety evaluation of GLP-1–MK-801 indicated no severe adverse reactions in mice, supporting further development of this innovative drug [14]. - Future studies are needed to assess the long-term effects and safety of GLP-1–MK-801, with the potential to become a more powerful treatment option than existing weight loss medications [14]. Current GLP-1 Weight Loss Drugs - A list of GLP-1 weight loss drugs currently in various clinical stages includes: - Mounjaro (Tirzepatide) - FDA approved - Wegovy (Semaglutide) - FDA approved - Saxenda (Liraglutide) - FDA approved - Several others in clinical trials [15].

Group 1 - The core point of the article is that Borui Pharmaceutical has decided to terminate its plan for a specific issuance of A-shares for 2024 due to a comprehensive assessment of the current market environment and its own operational status [4][6] - The company had previously planned to raise 500 million yuan through this issuance, which was to be fully subscribed by its actual controller, Yuan Jiandong [4] - The initial plan was approved in May 2024, but there was no substantial progress over the year, leading to multiple revisions of the issuance plan before the company voluntarily withdrew its application [4] Group 2 - Borui Pharmaceutical is planning to issue H-shares and list on the Hong Kong Stock Exchange in 2025 to accelerate its internationalization and enhance its capital strength [6] - The company has appointed Ernst & Young as the auditing firm for this upcoming Hong Kong listing [6] - Established for over 20 years, Borui Pharmaceutical's product portfolio includes innovative drugs across various therapeutic areas, including metabolism, antiviral, antifungal, immunosuppressive, respiratory, and oncology [6] Group 3 - As of now, Borui Pharmaceutical has a market capitalization of approximately 24.5 billion yuan and has completed three rounds of financing since its IPO in November 2019 [6] - The company received a warning letter from the China Securities Regulatory Commission in June due to improper management of raised funds [6]

Core Insights - The article discusses the dual role of Neuropeptide Y (NPY) in regulating appetite and energy expenditure, revealing its complex functions in both the brain and peripheral fat tissues [7][12][16]. Group 1: NPY's Role in Appetite Regulation - NPY is known to stimulate appetite in the brain, but its absence does not significantly affect food intake in mice [11]. - Mutations in the NPY gene are associated with higher Body Mass Index (BMI) in humans, indicating a more complex relationship between NPY and weight regulation beyond just appetite stimulation [11][17]. Group 2: NPY's Role in Energy Expenditure - In peripheral fat tissues, NPY helps maintain the thermogenic capacity of brown adipose tissue (BAT) and promotes energy expenditure [7][12]. - Research shows that when NPY is knocked out in the sympathetic nerves of mice, their brown fat turns "white," leading to reduced thermogenic ability and increased susceptibility to weight gain, even without changes in food intake or activity levels [14][16]. Group 3: Mechanisms of NPY Action - Approximately 40% of sympathetic neurons in white adipose tissue express NPY, indicating its significant presence in fat tissue regulation [12][14]. - NPY promotes the proliferation of perivascular cells, which can differentiate into thermogenic fat cells, thus playing a crucial role in fat tissue regulation [14][16].

Core Viewpoint - The article discusses the significant cardiovascular benefits of oral semaglutide for high-risk type 2 diabetes patients, highlighting its potential to reduce major adverse cardiovascular events (MACE) and improve treatment adherence compared to injectable forms [4][5][15]. Summary by Sections Global Diabetes Statistics - Over 828 million people globally have diabetes, with more than 90% being type 2 diabetes patients, who face increased cardiovascular disease risks [4]. Clinical Research Overview - The SOUL study, published in the New England Journal of Medicine, involved a large-scale, international, multi-center, randomized controlled trial focusing on high-risk type 2 diabetes patients with a history of atherosclerotic cardiovascular disease or chronic kidney disease [4][7]. Study Design and Methodology - The study recruited 9,650 participants aged 50 and older with HbA1c levels between 6.5% and 10.0%, excluding those with end-stage renal disease [8]. - Participants were randomly assigned to receive either oral semaglutide (starting at 3 mg and increasing to 14 mg daily) or a placebo, with all patients receiving standard treatment [9][10]. Key Findings - Oral semaglutide significantly reduced the incidence of MACE: 12.0% in the treatment group compared to 13.8% in the control group [13]. - The study also reported a 26% reduction in non-fatal myocardial infarction risk and a 12% reduction in stroke risk [17]. Safety and Efficacy - The incidence of serious adverse events was lower in the treatment group (47.9% vs. 50.3%), while gastrointestinal reactions were slightly higher (5.0% vs. 4.4%) [14]. - The renal protective effect did not reach statistical significance, indicating a need for further research in patients with poorer baseline kidney function [15]. Implications for Treatment - The findings suggest that oral semaglutide could reshape diabetes treatment paradigms by providing a convenient oral option that maintains efficacy comparable to injectable forms, particularly in reducing non-fatal myocardial infarction risk [15]. - The study emphasizes the importance of further research to explore the drug's effects on renal outcomes in different patient populations [15].

Core Viewpoint - The article discusses the effectiveness of GLP-1 medications, such as semaglutide, in delaying weight loss plateaus, which are common among dieters after approximately one year of weight loss efforts [4][7][8]. Group 1: Research Findings - A study indicates that semaglutide and other GLP-1 medications can extend the time before patients reach a weight loss plateau by an average of one year compared to those who only restrict calorie intake [8]. - Bariatric surgeries, like gastric bypass, show even greater effectiveness, delaying the plateau by an additional year on average [9]. - The research highlights that the body's resistance to weight loss is akin to a survival mechanism, where increased weight loss leads to heightened appetite [5][8]. Group 2: Understanding Obesity - Obesity is defined as a complex disease influenced by genetic, socioeconomic, behavioral, and environmental factors, with risks potentially starting in utero [10]. - The American Medical Association recognizes obesity as a disease, yet stigma persists, often leading to oversimplified advice like "eat less, move more," which fails to address the chronic nature of obesity [10][14]. - There is a need for compassionate and supportive approaches to tackle obesity, recognizing it as a medical condition rather than a personal failing [14][12].

Core Insights - The clinical application of Semaglutide has expanded to multiple treatment areas including diabetes, obesity, cardiovascular diseases, kidney diseases, non-alcoholic fatty liver disease, autoimmune diseases, and Alzheimer's, showcasing significant market potential [2] - The expiration of Novo Nordisk's core patent for Semaglutide on March 20, 2026, is expected to lead to strong competition from generic drugs, prompting companies to build competitive advantages [2] Market Potential - Semaglutide achieved sales of $16.6 billion in the first half of 2025, ranking first among global pharmaceuticals, followed closely by Tirzepatide at $14.734 billion [5] - Global sales of GLP-1RA drugs are projected to exceed $150 billion by 2031, driven by a large patient base, with 589 million adults expected to have diabetes by 2024 and 1.13 billion projected to be obese by 2030 [5] - In China, the overweight rate among adults has surpassed 50%, potentially rising to 70.5% by 2030 if not controlled, indicating a significant market opportunity for weight management drugs [5] Competitive Landscape - The global clinical pipeline for GLP-1RA drugs has reached 283 projects, with over 360 in Phase III trials, indicating a highly competitive environment [6] - The development of GLP-1RA drugs is evolving from single-target to dual and multi-target mechanisms, with a shift from injectable to oral formulations and extended dosing intervals [6] Domestic Market Dynamics - Over 100 companies are reportedly engaged in the development of Semaglutide generics and GLP-1RA innovative drugs in China, with 8 companies having submitted applications for market approval [7] - The competition is intensifying as nearly 30 companies have had their clinical applications accepted, indicating a rapidly growing domestic market [7]

以下文章来源于内分泌早知道 ，作者关注内分泌的 内分泌早知道 . 深度分享内分泌用药经验、病例剖析、指南专业解读并紧跟国内外内分泌领域前沿进展，「每医健」旗下内容平台。 肥胖这一看似普通却暗藏危机的健康隐患，犹如潜伏在人体内的隐形杀手，随时可能诱发多种严重慢性疾病，包括但不限于糖尿病、冠 心病、脑卒中等致命性病症。长期以来，社会大众对肥胖存在严重认知误区，简单将其归咎于"贪吃少动"的个人行为问题。然而随着社 会生产力结构的深刻变革，我国劳动形态已从传统的体力主导型全面转向脑力密集型，这一转变直接 导致中国超越其他国家，成为全球 超重与肥胖患病率增速最快的国家。 更令人担忧的是，肥胖带来的健康威胁远不止体态变化，它会系统性破坏人体代谢机能，引发多重器质性损伤和心理障碍。医学研究证 实，肥胖人群罹患2型糖尿病、原发性高血压、睡眠呼吸暂停综合征等疾病的风险显著增高，同时伴随慢性疼痛、情绪焦虑及进食障碍等 心理问题，最严峻的是可能造成人均寿命缩短6至1 4年。根据世界卫生组织标准，我国成年人维持健康的体质指数（BMI）应严格控制 在1 8 . 5- 2 3 . 9 k g /m²范围内，这一数值区间是评估体重是否健康 ...