In Endocrinology, the year 2024 has been marked by new international recommendations on the management of iatrogenic adrenal insufficiency in patients treated with glucocorticoids. Clear strategies for biological monitoring have been defined, enabling the optimization of patient follow-up and avoidance of the adrenal insufficiency risk.
Regarding diabetes complications, two major studies have opened new avenues for the prevention of diabetic kidney disease and diabetic retinopathy. The FLOW study demonstrated the nephroprotective effect of semaglutide, a GLP-1 agonist, with a 24% reduction in the risk of major renal events in diabetic patients with chronic kidney disease at high risk of progression. Furthermore, the LENS study confirmed the role of fenofibrate in preventing the progression of diabetic retinopathy, reducing the risk of visual deterioration by 27% in diabetic patients with early signs of retinal involvement.
Additionally, tirzepatide, the first dual agonist of GLP-1 and GIP receptors, is now available in Belgium for the treatment of type 2 diabetes and obesity. Superior to semaglutide in terms of weight loss and glycemic control, it has demonstrated significant metabolic benefits in the SURPASS and SURMOUNT studies. It also showed promising effects in reducing cardiovascular complications and sleep apnea.
Finally, teplizumab, an anti-CD3 antibody, represents a major advance in the preventive treatment of type 1 diabetes, which has been confirmed in 2024. By targeting T lymphocytes involved in the destruction of pancreatic beta cells, it significantly delays disease onset in at-risk patients and preserves beta-cell function in newly diagnosed patients.
Keywords
Iatrogenic adrenal insufficiency, semaglutide, tirzepatide, fenofibrate, teplizumab, diabetic kidney disease, diabetic retinopathy, diabetes mellitus