Roux-en-Y gastric bypass (RYGB) is an effective treatment for type 2 diabetes (T2D), but the physiological mechanisms underlying sustained improvements in glycemic control remain incompletely understood. To descriptively compare short- and long-term changes in glycemic control and insulin secretion dynamics following RYGB or best medical care (BMC) using an intravenous glucagon stimulation test (GST) in patients with non-severe obesity (BMI <35 kg/m2) and insulin-treated T2D. Thirty-five patients with long-standing insulin-dependent T2D were enrolled from two prospective studies and received either BMC or RYGB. GST was performed at baseline and repeated after 3, 6, 12 and 24 months. Changes in glucose, insulin, and C-peptide responses were analyzed. Exploratory indices derived from the GST were used to assess longitudinal within-subject changes. Diabetes remission occurred in 10
Objective The objective of this revised official guideline, published by the German Society for Gynecology and Obstetrics (DGGG) and coordinated in the joint guidelines program of the DGGG, the Austrian Society for Gynecology and Obstetrics (OEGGG), and the Swiss Society for Gynecology and Obstetrics (SGGG), is to provide evidence-based and consensus-based recommendations for the diagnosis, treatment, care, and support of girls and women with confirmed or suspected endometriosis. Methods This S2k guideline was developed through a structured consensus process involving representative members of various professions (37 professional associations, organizations, and self-help groups) and includes 25 statements and 73 recommendations which are based on a systematic literature review (2019 - 2023) and expert consensus. Recommendations For the first time, the revised guideline has placed a greater focus on individualized, symptom-oriented diagnosis and treatment that combines hormonal, surgical, and multimodal approaches. A significant innovation is the use of transvaginal ultrasound as the central diagnostic procedure for detecting endometriosis. Therapeutically, primary hormone treatment is now recommended as the first choice approach, with surgical interventions and multimodal approaches supplemented on an individual and symptom-oriented basis.
Endocrine therapy is the backbone of hormone receptor-positive, HER2-negative (HRpos/HER2neg) early breast cancer (eBC) treatment, yet early discontinuation rates are high, compromising long-term outcomes. With ribociclib plus a non-steroidal aromatase inhibitor (NSAI) now approved by the FDA and EMA for eBC at risk of recurrence, it is expected to be widely used in the adjuvant setting. Adjuvant CDK4/6 inhibitor trials show discontinuation in 30-35% of patients. Thus, adherence and persistence are crucial for an effective management of adjuvant ribociclib therapy. Recent studies have highlighted the positive impact of supportive care programs provided by qualified nurses for patients with cancer. Patient-focused motivation techniques and education performed by nurses could strengthen patients’ understanding of the risks and benefits of anticancer treatments. Personalized coaching and structured tools like the “Multinational Association of Supportive Care in Cancer (MASCC) Oral Agent Teaching Tool” (MOATT) may strengthen patient engagement and optimize therapy management. TYPER (EU Clinical Trials Number: 2024-520290-12-00) is a prospective, multicenter, randomized, controlled, phase IV study with the objective of investigating the effect of personalized patient coaching on therapy persistence in patients with HRpos/HER2neg eBC receiving adjuvant ribociclib plus NSAI according to the summary of product characteristics (SmPC). In total, 548 patients will be enrolled across 50 study sites in Germany and randomized 1:1 to receive either local routine (control arm) or continuous personalized coaching utilizing the MOATT tool (study arm) during the first 12 months of adjuvant ribociclib therapy. A patient classification model organizes individuals into four distinct groups based on responses to a typology questionnaire. It is based on the idea that personal acceptance of and perceived control over the illness determine the type of support that is most helpful for each individual. The different patient groups therefore call for varied approaches to patient support. Personalized patient coaching will be tailored to individual patient profiles based on patient typology and use the MOATT tool and must be performed by trained (TYPER) coaches. As part of the study, healthcare professionals will be trained to become TYPER coaches. The primary objective is to evaluate the effect of patient education and patient typology-based coaching on persistence, with the primary endpoint being time to permanent ribociclib discontinuation. Secondary endpoints include persistence rates at month 6, 12 and 36, side effect management, and unplanned therapy interruptions. A biomarker program will explore correlations with clinical outcomes. Participants will remain in the study until completion or death, with a maximum individual participation period of 60 months, comprising a 24-month enrollment phase and 36-month follow-up phase. Patient recruitment is planned between Q2/2025 and Q2/2027, with overall study completion expected by Q2/2030. M. Welslau, C. Zeder-Goess, R. Haidinger, B. Welter, B. Aktas, P. Wimberger, P. A. Fasching, H. Kolberg, J. C. Radosa, C. Rudlowski, A. Hein, S. Seitz, D. Fischer, C. Iuliano, C. Mann, M. Braun, V. Mueller, E. Stickeler, M. Thill, N. Ditsch. Typer—A randomized controlled trial evaluating the effect of typology-based coaching on therapy management for patients with hr+/her2- early breast cancer under adjuvant ribociclib treatment [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS3-08-14.
