A New Probe of the Planet-Forming Region in T Tauri Disks

We present new observations of the FUV (1100-2200 Angstrom) radiation field and the near- to mid-IR (3--13.5 micron) spectral energy distribution (SED) of a sample of T Tauri stars selected on the basis of bright molecular disks (GM Aur, DM Tau, LkCa15). In each source we find evidence for Ly alpha induced H2 fluorescence and an additional source of FUV continuum emission below 1700 Angstroms. Comparison of the FUV spectra to a model of H2 excitation suggests that the strong continuum emission is due to electron impact excitation of H2. The ultimate source of this excitation is likely X-ray irradiation which creates hot photo-electrons mixed in the molecular layer. Analysis of the SED of each object finds the presence of inner disk gaps with sizes of a few AU in each of these young (~1 Myr) stellar systems. We propose that the presence of strong H2 continuum emission and inner disk clearing are related by the increased penetration power of high energy photons in gas rich regions with low grain opacity.Comment: 5 pages, 3 figures, accepted by ApJ Letter

Reduction of prevalence of patients meeting the criteria for metabolic syndrome with tirzepatide: a post hoc analysis from the SURPASS Clinical Trial Program

Background: Metabolic syndrome is characterized as the co-occurrence of interrelated cardiovascular risk factors, including insulin resistance, hyperinsulinemia, abdominal obesity, dyslipidemia and hypertension. Once weekly tirzepatide is approved in the US and EU for the treatment of type 2 diabetes (T2D) and obesity. In the SURPASS clinical trial program for T2D, tirzepatide demonstrated greater improvements in glycemic control, body weight reduction and other cardiometabolic risk factors versus placebo, subcutaneous semaglutide 1 mg, insulin degludec, and insulin glargine. This post hoc analysis assessed the effect of tirzepatide use on the prevalence of patients meeting the criteria for metabolic syndrome across SURPASS 1–5. Methods: Metabolic syndrome was defined as having ≥ 3 of 5 criteria according to the US National Cholesterol Education Program: Adult Treatment Panel III. Analyses were based on on-treatment data at the primary endpoint from patients adherent to treatment (taking ≥ 75% study drug). A logistic regression model with metabolic syndrome status as the response variable, metabolic syndrome status at the baseline visit as an adjustment, and randomized treatment as fixed explanatory effect was used. The effect of tirzepatide use on the prevalence of patients meeting the criteria for metabolic syndrome by categorical weight loss, background medication and gender were assessed. Results: In SURPASS, the prevalence of patients meeting the criteria for metabolic syndrome at baseline was 67–88% across treatment groups with reductions at the primary endpoint to 38–64% with tirzepatide versus 64–82% with comparators. Reductions in the prevalence of patients meeting the criteria for metabolic syndrome was significantly greater with all tirzepatide doses versus placebo, semaglutide 1 mg, insulin glargine, and insulin degludec (p < 0.001). Individual components of metabolic syndrome were also reduced to a greater extent with tirzepatide vs comparators. Greater reductions in body weight were associated with greater reductions in the prevalence of patients meeting the criteria for metabolic syndrome and its individual components. Background SGLT2i or sulfonylurea use or gender did not impact the change in prevalence of patients meeting the criteria for metabolic syndrome. Conclusions: In this post hoc analysis, tirzepatide at all doses studied was associated with a greater reduction in the prevalence of patients meeting the criteria for metabolic syndrome compared to placebo, semaglutide 1 mg, insulin degludec, and insulin glargine. Although more evidence is needed, these data would support greater potential improvement in cardiovascular risk factor profile with tirzepatide treatment in people across the continuum of T2D

Additional file 1 of Reduction of prevalence of patients meeting the criteria for metabolic syndrome with tirzepatide: a post hoc analysis from the SURPASS Clinical Trial Program

Additional file 1

One-year sustained glycemic control and weight reduction in type 2 diabetes after addition of liraglutide to metformin followed by insulin detemir according to HbA1c target

AbstractAimTo investigate durability of efficacy and safety over 1year of the sequence of liraglutide added to metformin followed by add-on insulin detemir if glycated hemoglobin (HbA1c) remains ≥7.0%.MethodsPatients previously uncontrolled on metformin±sulfonylurea with HbA1c ≥7.0% after 12weeks of adding liraglutide 1.8mg to metformin (run-in; sulfonylurea discontinued) were randomized 1:1 to 52weeks’ open-label add-on detemir (randomized treatment [RT] group; n=162) or continuation without detemir (randomized control [RC] group; n=161). Patients with HbA1c <7.0% continued 52weeks’ unchanged treatment (observational group; n=498).ResultsRun-in HbA1c improvement from 8.3% to 7.6% (–0.6%) was further enhanced in the RT group (–0.50%) and maintained in the RC group (+0.01%) over 52weeks; estimated treatment difference (ETD)[95%CI]: −0.51 [−0.70;−0.31]; P<0.0001. More RT (52%) than RC patients (22%) achieved HbA1c <7.0% at 52weeks (P<0.0001). Run-in weight loss (–3.5kg) was maintained in the RT (–0.05kg) and enhanced in the RC group (−1.02kg) after 52weeks; ETD [95%CI]: 0.97 [0.04;1.91]; P=0.04. No major hypoglycemia occurred; minor hypoglycemia rates were low across groups (0.034–0.228 events/patient-year).ConclusionsSupplementing metformin+liraglutide with detemir for 52weeks improved glycemic control with sustained weight loss and low hypoglycemia rate