An estimated quarter of the 7 million Americans taking insulin have had difficulty paying for their medication. To cope, they have reported using insulin less frequently than prescribed and injecting expired doses, resulting in worse glycaemic control, hospitalisation for diabetic ketoacidosis, and death.

In their Correspondence in The Lancet Diabetes & Endocrinology, Roy Gerona and colleagues highlighted a substantial underestimation of levels of bisphenol A (BPA) and its metabolites in urine samples when using a widely accepted method of measurement based on indirect evaluation. Concerns about BPA and the potential effects of its widespread use in commercial everyday products, including plastic bottles

In their Correspondence in The Lancet Diabetes & Endocrinology, Roy Gerona and colleauges asserted that indirect measurement of bisphenol A (BPA) metabolites in urine underestimates exposure to BPA in human biomonitoring studies. The indirect method quantifies levels of total BPA in a two-step procedure (enzymatic deconjugation and extraction), whereas the direct method eliminates the enzymatic deconjugation

In their Correspondence in The Lancet Diabetes & Endocrinology, Roy Gerona and colleagues have shown that indirect analytical methods using enzymatic hydrolysis to determine bisphenol A (BPA) metabolites in urine do not provide the same results as direct measurement of the identified metabolites using authentic reference standards. The authors explain that direct and indirect methods allow total BPA

We appreciate that our Correspondence has raised considerable concern. Like Kerri Palmer and Valerie Speirs, we are troubled by the findings, which challenge the validity of previous bisphenol A (BPA) risk assessment decisions. Accordingly, we welcome the opportunity to respond to issues and amplify concerns raised in the three Correspondences.

Metabolic surgery refers to abdominal operations initially developed for weight loss, but with the main goal of treating type 2 diabetes. Such interventions are effective, especially in the early stages of disease, but are underused., 

We thank Bengt Novik for his interest in our randomised controlled Oseberg trial and for the opportunity to respond and present our results stratified according to the Individualized Metabolic Surgery Score (IMSS). The IMSS classifies patients with diabetes according to their chances of partial remission of diabetes (HbA1c <6·5% off antidiabetes medication). The preoperative characteristics of Oseberg

Type 1 diabetes is one of the most challenging long-term medical conditions to manage. Over the past five years, technologically skilled people with type 1 diabetes have developed communication systems and algorithms that allow insulin delivery from insulin pumps to be automatically controlled. These systems combine glucose data from a continuous glucose monitor with an original algorithm that communicates

For more than 70 years, thionamide compounds have been used in the treatment of hyperthyroidism and helped to reduce the burden of comorbidities and mortality in these patients. Three thionamide antithyroid drugs are available; methimazole, its prodrug carbimazole (hereafter methimazole refers to both drugs) and propylthiouracil. Methimazole and propylthiouracil are generally well tolerated but serious

Kristensen SL, Rørth R, Jhund PS, et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol 2019; 7: 776–85—In this Article, event number data in figure 2 were corrected to present event numbers for fatal and non-fatal myocardial infarction and

As the prevalence of type 1 and type 2 diabetes increases and population-level patterns of alcohol and illicit drug use evolve, clinicians will continue to encounter people with diabetes whose substance use is affecting health outcomes. Substance use contributes substantially to the population-level prevalence of cardiovascular events, cerebrovascular events, cancers, mental health conditions, road

In the Lancet Diabetes & Endocrinology, Hertzel Gerstein and colleagues report stroke outcomes from the researching cardiovascular events with a weekly incretin in diabetes (REWIND) trial, a cardiovascular outcomes study that investigated the effect of the glucagon-like peptide 1 (GLP-1) receptor agonist dulaglutide (1·5 mg subcutaneous weekly) compared with placebo in 9901 participants with type 2

Mr A is a 89 year old patient with type 2 diabetes, congestive heart failure, end-stage kidney disease, and anaemia. His diabetes regimen consists of four insulin injections daily. He cannot take oral medications because of his kidney and heart diseases. His glucose concentrations range between 70 mg/dL and 150 mg/dL before breakfast, and between 80 mg/dL and 160 mg/dL before meals and at bedtime.

Forced migration due to armed conflicts, natural disasters, and disease outbreaks often involves walking on terrain that is treacherous. The focus of The Lancet Diabetes & Endocrinology Series on diabetes in humanitarian crises is on health-care needs in catastrophic times,,  ,  but the Series barely touches on the topic of foot care. We believe that foot care should be of primary concern for people

We thank Arsene Hobabagabo and Anne Sumner for highlighting the urgent issue of foot care in people living with diabetes in humanitarian settings. We agree that this is an often neglected and underappreciated component of diabetes care in populations undergoing forced migration, including in Africa. Unfortunately, data on this topic are scarce. This limitation was evident in the first Series paper

Fioretto P, Vettor R, Pontremoli R. SGLT2 inhibitors to prevent diabetic kidney disease. Lancet Diabetes Endocrinol 2020; 8: 4–5—In this Comment, reference 10 had not been cited in the text. This correction has been made to the online version as of Jan 21, 2020.