Medical Bulletin 16/May/2025

The study examined data from 6,370 adults across eight randomised controlled trials and three observational studies. On average, patients lost 8kg while on weight loss injections but regained the lost weight within 10 months after stopping. Even among those using newer, high-dose treatments like semaglutide (Wegovy) and tirzepatide (Mounjaro)—who lost an average of 16 16kg—the weight regain was significant, with patients gaining back 9.6kg within a year. At that pace, the full amount lost could be recovered in just over 20 months.

“These drugs are very effective at helping you lose weight, but when you stop them, weight regain is much faster than after stopping diets,” said Susan Jebb, the co-author of the study and professor of diet and population health at the University of Oxford.

The findings raise issues for the NHS, as NICE guidelines state people should not be on weight loss injections for more than two years. Additionally, many patients give up the treatment, whether because they are buying it privately so cannot afford it, because the side effects do not suit them or because they are not losing weight anymore.

While the study did not show causality, Jebb speculated that the difference in how fast people put weight back on could be since diets are hard. People have to practice restraint to lose weight, whereas if you are taking a drug that knocks your hunger out completely, you don’t have to make that effort. “So when the drugs are then taken away, you haven’t got those sort of behavioural strategies in place that help keep the weight off.”

Study Highlights More Than Half of Mini-Stroke Patients Battle Long-Term Fatigue

New Delhi: A new study has found that people who have a transient ischemic attack, also known as a mini-stroke, may also have prolonged fatigue lasting up to one year. The study is published in Neurology. Transient ischemic stroke is typically defined as a temporary blockage of blood flow to the brain that causes symptoms that go away within a day. The study does not prove that mini-strokes cause lasting fatigue; it only shows an association.

The study involved 354 people with an average age of 70 who had a mini-stroke. They were followed for a year. Participants completed questionnaires about their level of fatigue within the first two weeks of the mini-stroke and again at three, six, and 12 months later.

One questionnaire looked at five different types of fatigue, including overall tiredness, physical tiredness, reduced activity, reduced motivation, and mental fatigue.

Scores ranged from four to 20, with higher scores indicating more fatigue. Participants had an average score of 12.3 at the start of the study.

At three months, the average score decreased slightly to 11.9; at six months, to 11.4; and at twelve months, to 11.1. Researchers looked at how many participants experienced fatigue, as defined as a score of 12 or higher.

Of the participants, 61% experienced fatigue two weeks after the mini-stroke, and 54% experienced fatigue at each of the three other testing time periods at three, six and 12 months.

Participants also had brain scans. Researchers found that the presence of a blood clot on a scan was equal between people with long-term fatigue and those without it, so this did not explain the reason for the level of fatigue. Researchers did find that previous anxiety or depression was twice as common in those participants who reported lasting fatigue.

"Long-term fatigue was common in our group of study participants, and we found if people experience fatigue within two weeks after leaving the hospital, they will likely continue to have fatigue for up to a year," said study author Boris Modrau, MD, PhD, of Aalborg University Hospital in Denmark.

References: https://www.aan.com/PressRoom/Home/PressRelease/5259

Does Developing Type 1 Diabetes After 40 Raise Your Risk of Cardiovascular Disease?

New Delhi: A new study in the European Heart Journal shows that people who develop type 1 diabetes in adulthood have an increased risk of cardiovascular disease and death and that those diagnosed later in life do not have a better prognosis than those diagnosed earlier. The study, conducted by researchers at Karolinska Institute in Sweden, points to smoking, poor glucose control, and obesity as the main risk factors.

The researchers behind the current study wanted to investigate the risk of cardiovascular disease and death in this group, particularly for those diagnosed after the age of 40.

The registry-based study identified 10,184 people diagnosed with type 1 diabetes in adulthood between 2001 and 2020 and compared them to 509,172 matched people in the control group.

The study shows that these people with adult-onset type 1 diabetes had a higher risk of cardiovascular disease and death from all causes, including cancer and infections, compared to the control group.

"The main reasons for the poor prognosis are smoking, overweight/obesity, and poor glucose control. We found that they were less likely to use assistive devices, such as insulin pumps," says first author Yuxia Wei, postdoctoral fellow at the Institute of Environmental Medicine, Karolinska Institutet.

The results emphasise the seriousness of type 1 diabetes, even when it starts later in life, the researchers say.

"But we show that the prognosis can be significantly improved by preventing smoking and obesity and improving glucose control, not least in people diagnosed at older ages," explains senior author Sofia Carlsson, senior lecturer and associate professor at the same department.

References: https://news.ki.se/adult-onset-type-1-diabetes-increases-risk-of-cardiovascular-disease-and-death