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Intensive blood pressure target fails to cut events in type 2 diabetes; CMS finalizes 2027 fee schedule; hormone therapy shows no cardiovascular harm
A systolic target below 120 mm Hg did not significantly reduce cardiovascular events in 9,476 adults with type 2 diabetes in OPTIMAL-DIABETES, reported Nov. 7 at the American Heart Association (AHA) Scientific Sessions. The Centers for Medicare & Medicaid Services (CMS) finalized the 2027 physician fee schedule with new remote monitoring rules, and an AHA abstract found no rise in cardiovascular events with hormone therapy started at ages 45 to 59.
Read this week's roundup and its sources: https://physicianintheloop.org/specialties/endocrinology/2026-11-01/
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The voices on this episode are generated by AI, and so is the script, from the week's specialty roundup at Physician in the Loop. Every fact in the roundup links to its source.
The week's innovation news in endocrinology for endocrinologists, every Sunday in a few minutes: new technology, AI tools, devices, FDA decisions and new ways of delivering care. From the Specialties pages of Physician in the Loop, where every story links to its sources: physicianintheloop.org/specialties/endocrinology/. Read by AI voices.
Voice 1: This is Physician in the Loop, the weekly endocrinology briefing, for November 1st to November 7th, 2026.
Voice 1: A blood pressure target under 120 did not reduce cardiovascular events in 9,476 adults with type 2 diabetes, in a trial called OPTIMAL-DIABETES, presented November 7 at the American Heart Association Scientific Sessions.
Voice 2: Where was it run, and how were the two groups treated?
Voice 1: It enrolled adults 50 and older with elevated systolic pressure at 33 sites in Brazil. One group was treated to a systolic target below 120 millimeters of mercury, the other to below 140. Major cardiovascular events occurred in about 6% of the intensive group versus about 7% of the standard group, and the American Heart Association said the difference was not statistically significant. The trial was published in the New England Journal of Medicine.
Voice 2: Was there any difference in kidney outcomes?
Voice 1: Kidney events, mainly declines in function, occurred in about 6% of the intensive group versus about 4% of the standard group. Rates of end-stage renal disease were similar between the two groups.
Voice 2: The Centers for Medicare and Medicaid Services finalized its 2027 physician fee schedule this week, lowering the conversion factor.
Voice 1: By how much, and what changed for remote monitoring?
Voice 2: CMS set the nonqualifying alternative payment model conversion factor at about $33, a projected decrease of about 2%. Practitioners billing for remote physiologic or remote therapeutic monitoring now must furnish a separately reportable initiating visit. CMS also delayed until January 1, 2029, a rule limiting who can perform those services to practice-employed clinical staff, and the rule now recognizes diabetes self-management training and medical nutrition therapy as stand-alone visits under the rural health clinic benefit.
Voice 1: A meta-analysis in the journal Thyroid found that 37% of patients remained euthyroid after stopping thyroid hormone.
Voice 2: Did that depend on why they’d started it?
Voice 1: Yes. Among patients who began with subclinical hypothyroidism, 41% stayed euthyroid after stopping, compared with 11% of those who’d had overt hypothyroidism. The review pooled 21 studies with 2,020 participants, and in 11 of those studies, 60% of patients who stopped eventually restarted therapy. The authors said the findings support considering deprescribing in selected patients without clear indications for starting treatment, with close biochemical monitoring.
Voice 2: An AHA abstract this week found no rise in cardiovascular events among women who started hormone therapy between ages 45 and 59.
Voice 1: How did the rates compare with women who didn’t take it?
Voice 2: In a retrospective matched cohort of about 52,000 women followed for a mean of 12 years, atherosclerotic cardiovascular disease occurred at a rate of about 8 per 1,000 person-years in both the hormone therapy group and the control group, an adjusted hazard ratio of 0.98. Venous thromboembolism occurred at the same rate in both groups. Healio reported that the abstract has not been peer reviewed, and the investigator said the observational study cannot prove causation and that hormone therapy should treat menopausal symptoms, not serve as cardiovascular prevention.
Voice 1: Sources and corrections are at physicianintheloop.org, where you can sign up for the free email briefing. This briefing was read by AI voices.