Endocrinology Today—November 18, 2025

Weekly Endocrinology update spotilighting regulatory developments, clinical trial results, new practice guidelines, public-health initiatives, mechanistic research insights, and community-focused advocacy efforts.

In Today’s Newsletter

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🩺 Metformin fails to improve walking in PAD without diabetes [1] [US • 14 Nov 2025]

https://www.healio.com/news/cardiology/20251114/metformin-does-not-improve-walking-in-peripheral-artery-disease-without-diabetes
Context: PERMET randomized 202 PAD patients without diabetes, mean age 70, AHA Scientific Sessions, JAMA report.
Key point: No benefit for 6-minute walk distance or secondary outcomes vs placebo at 6 months, safety similar.
Implication: May influence prescriber choice and payer reviews pending full data.

💉 Teplizumab gets CHMP positive opinion to delay stage 3 T1D [2] [EU • 15 Nov 2025]

https://www.reuters.com/business/healthcare-pharmaceuticals/sanofis-type-1-diabetes-drug-recommended-eu-approval-2025-11-14/
Context: Teplizumab (Teizeild) already US-approved for stage 2; CHMP recommendation advances to EC decision.
Key point: Placebo-controlled study in ≥8 years showed longer time to stage 3 onset vs placebo.
Implication: Introduces competition that may affect pricing and formulary access.

🌍 Dexcom names 16 global diabetes advocates for WDD [3] [US • 14 Nov 2025]

https://finance.yahoo.com/news/dexcom-reveals-global-diabetes-advocates-130000872.html
Context: Business Wire release details advocates across ages, types, and regions, with campaign storytelling.
Key point: Community-sourced cohort will amplify awareness and lived experiences using Dexcom tech.
Implication: DTC/telehealth: Could streamline initiation and adherence via remote prescribing and logistics.

👁️ Sun Pharma’s #SeeBeyondSugar to scale retinopathy screening in India [4] [IN • 14 Nov 2025]

https://www.bwhealthcareworld.com/article/sun-pharma-launches-nationwide-seebeyondsugar-initiative-on-world-diabetes-day-579838
Context: Supported by VRSI, plan for about 300 camps across 28 cities using AI-enabled fundus-on-phone imaging.
Key point: National awareness and screening push to detect diabetic retinopathy earlier.
Implication: May expand screening, initiation, and follow-up at scale.

🏷️ FDA to remove black box warnings on many menopause HRT drugs [5] [US • 10 Nov 2025]

https://www.msn.com/en-us/health/other/fda-chief-says-warning-labels-deterred-menopause-care-its-an-american-tragedy/ar-AA1Q9cHz
Context: CBS News interview with FDA Commissioner Marty Makary; cites evolving evidence and recent non-hormonal options.
Key point: Agency will lift black box warnings on many hormone therapies for menopause and perimenopause.
Implication: May influence prescriber choice and payer reviews pending full data.

📘 ESE revises adult hypoparathyroidism treatment guideline [6] [EU • 13 Nov 2025]

https://medicalxpress.com/news/2025-11-clinical-guideline-treatment-chronic-hypoparathyroidism.html
Context: Multidisciplinary panel chaired by Jens Bollerslev; endorsed by surgical and Australian endocrine societies.
Key point: Chronic postsurgical hypoparathyroidism redefined to ≥12 months, with algorithm for considering PTH therapy.
Implication: Could inform practice and payer discussions; interpretation depends on study design and confounding control.

🧬 FAP–FN1–TGFβ axis implicated in thyroid cancer metastasis [7] [13 Nov 2025]

https://bioengineer.org/fap-boosts-thyroid-cancer-metastasis-via-fn1-tgf%ce%b2-axis/
Context: Mechanistic study by Udinotti et al. on tumor microenvironment, invasion, and immune evasion.
Key point: Fibroblast activation protein promotes metastasis via FN1–TGFβ signaling, suggesting targets.
Implication: Could inform practice and payer discussions; interpretation depends on study design and confounding control.

🧒 Aggressive T1D in young children linked to loss of immature beta-cell clusters [8] [UK • 14 Nov 2025]

https://news.exeter.ac.uk/faculty-of-health-and-life-sciences/landmark-research-uncovers-why-type-1-diabetes-is-more-aggressive-in-young-children/
Context: Science Advances paper, >250 pancreas samples across ages, University of Exeter.
Key point: Small, immature beta-cell clusters are largely destroyed early in childhood T1D, explaining faster progression.
Implication: Could inform practice and payer discussions; interpretation depends on study design and confounding control.

Why it matters

Negative PERMET result tempers off-label interest in metformin for PAD without diabetes.
EU movement on teplizumab could broaden access to prevention in at-risk T1D populations.
Awareness and screening campaigns may shift outcomes through earlier detection and support.
ESE guidance clarifies timing and escalation to PTH therapy in chronic hypoparathyroidism.
Mechanistic insights in thyroid cancer and pediatric T1D may steer future targeted therapies.

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FAQ

What did PERMET conclude about metformin in PAD without diabetes?

Metformin did not improve 6-minute walk distance or secondary outcomes vs placebo at 6 months in a 202-patient trial presented at AHA and reported in JAMA [1].

What exactly did CHMP recommend for teplizumab?

EMA’s CHMP recommended approval to delay progression to stage 3 type 1 diabetes, with a prior US approval for stage 2, pending EC decision for EU marketing authorization [2].

What will change about menopause HRT labels in the US?

Per the FDA Commissioner in a CBS interview, many hormone therapies will have black box warnings removed, reflecting updated benefit–risk understanding and potentially increasing appropriate use [5].

How will Sun Pharma execute #SeeBeyondSugar?

Through about 300 screening camps in 28 Indian cities using AI-enabled fundus imaging, with VRSI support, to boost annual eye exams in people with diabetes [4].

What is new in ESE’s hypoparathyroidism guideline?

Chronic postsurgical disease now defined at 12 months, with a clear algorithm for when to consider PTH replacement after conventional therapy [6].

What mechanism was highlighted in aggressive thyroid cancer?

FAP-driven FN1–TGFβ signaling was linked to metastasis and immune evasion, indicating possible therapeutic targets, though clinical impact is not yet established [7].

Entities / Keywords

Teplizumab, Teizeild; Sanofi; EMA CHMP; Stage 2–3 type 1 diabetes; PERMET; Metformin; Peripheral artery disease; AHA Scientific Sessions; Dexcom; World Diabetes Day; Sun Pharma; Vitreo Retinal Society of India; Diabetic retinopathy screening; FDA; Menopause hormone therapy; HRT; Elinzanetant, Lynkuet; Veozah; European Society of Endocrinology; Hypoparathyroidism; PTH therapy; Thyroid cancer; FAP; FN1; TGFβ; University of Exeter; Pediatric type 1 diabetes; Beta-cell clusters.