Abstract

The landscape of diabetes and obesity management has undergone unprecedented transformation in recent years, driven by innovative pharmacological developments, landmark clinical trials, and evidence-based guideline revisions. This comprehensive review examines the therapeutic revolution initiated by novel agents including bexagliflozin, next-generation incretin-based therapies such as tirzepatide, investigational triple receptor agonists, and promising combination regimens like CagriSema. We analyse pivotal clinical evidence, particularly from the SURMOUNT trial series, which has established tirzepatide’s superiority over semaglutide in achieving substantial weight loss, durable glycaemic control, and cardiovascular protection. The integration of these findings into updated American Diabetes Association guidelines represents a paradigmatic shift toward early, aggressive intervention strategies, while the introduction of teplizumab for presymptomatic type 1 diabetes prevention marks a historic milestone in immunomodulatory therapy. Policy advances, including expanded Medicare coverage for obesity pharmacotherapy, signal progress toward equitable healthcare access. These developments collectively position obesity treatment as a cornerstone of diabetes prevention and metabolic health optimization, fundamentally altering our approach to these interconnected conditions.

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Funding