Top Medical Papers to Read – February 2026 | The Doctor’s Daily

– Tea, anti-hepatic steatosis (1)

Nonalcoholic fatty liver disease (NAFLD) represents a major public health challenge, with few specific therapeutic options. Tea consumption appears to be a promising preventive and therapeutic strategy; a systematic and integrated understanding of its mechanisms is still lacking. A fundamental mechanism highlighted in this review concerns the intestine-liver axis. We emphasize that, despite their low systemic bioavailability, tea polyphenols exert powerful prebiotic effects. In addition, the polyphenols, polysaccharides, caffeine and theanine of tea collectively and favorably modulate the structure of the microbiota, all of which also highlights the significant potential for the development of nutraceuticals and targeted pharmaceutical products based on tea. Read for details of the potential mechanisms involved.

– Reduced risk of hemorrhagic (and ischemic) strokes under iSGLT2 in T2DM nephropathy (2)

The effect of SGLT2 inhibitors on reducing the risk of ischemic and hemorrhagic stroke in subjects with T2DM and renal impairment remains unclear. The Credence study and a meta-analysis confirmed that these inhibitors did not significantly reduce the risk of ischemic stroke, but had a benefit in preventing hemorrhagic stroke. A meta-analysis of the Empa-Reg-Outcome, Canvas, Declare-Timi 58, Vertis CV and Credence trials demonstrated a significant benefit of iSGLT2 treatment, with a reduction of 51% [0,30-0,82] hemorrhagic stroke, but not ischemic stroke. This is therefore the first study to examine the two causes of stroke in these patients, i.e. 107,819 users of SGLT2 inhibitors and 107,819 non-users. iSGLT2 treatment was associated with a significant reduction in the incidence of ischemic stroke (HR 0.86 [0,81-0,90]) and also hemorrhagic: HR = 0.80 [0,74-0,87]. Excellent news!

– The response to oral insulin to prevent T1D: a question of genetics (3)

Oral insulin, administered in very small doses, aims to induce immune tolerance to β-cell antigens, in the hope of reducing autoimmune progression of T1D. This study evaluated whether genetic variations in individuals at risk for T1D influence the preemptive response to oral insulin administration to prevent or delay the onset of T1D. The TrialNet Oral Insulin Prevention trial tested oral insulin to prevent stage 3 T1D in 560 stage 1 T1D subjects. The Teddy-T1DExomeChip was used to genotype 552 participants with available DNA.

Conclusion, genetics significantly influences the response to oral insulin for the prevention of T1D. Certain variants are associated with better protection against disease progression. These results encourage genetic screening in preventive strategies for T1D.

Oral insulin is not equally effective in all at-risk individuals, a specific genetic profile could predict benefit. This type of approach is a step towards personalized medicine in the prevention of T1D, which could optimize future clinical trials, identify individuals most likely to benefit from oral insulin, reduce unnecessary exposure to treatments for non-responders.

– Obesity in Prader-Willy Syndrome: caution in prescribing GLP1 agonists (4)

Prader-Willi syndrome (PWS) is a rare genetic disease characterized in particular by hyperphagia (excessive hunger without feeling full), leading to severe obesity. The pharmacological treatment available to reduce appetite and weight remains very limited. Semaglutide or tirzepatide, with recognized effects in obesity and T2DM in the general population, are increasingly prescribed to subjects with PWS. Their effectiveness is quite limited, and above all poorly established, and their undesirable effects, particularly digestive, are sometimes very serious given the diagnostic delays specific to these subjects. The Prader and Willy foundation is issuing an alert and undertaking in-depth work so that serious tests are carried out in order to answer the question of the effectiveness and usefulness of treating these subjects with this class, the data being almost non-existent and contradictory. Especially since other therapeutic classes are being developed, with more benefits expected in these particular indications.

– The use of androgens for anabolic purposes does not increase the risk of type diabetes (5)

This retrospective population study in Denmark shows no increase in diabetes under androgens with regular use. These certainly reassuring data are, however, based on insufficiently precise data: no precision on the androgens received, nor the route of administration nor the age (probably young athletes), nor the legitimacy of these treatments. These are not subjects with hypogonadism, nor elderly subjects and any generalization of these conclusions would be excessive. But these data remain reassuring and useful, since the use of unregulated anabolic androgens for sporting purposes (muscle mass, performance) is, even if we can be concerned, more and more frequent.

(1) Ren J, Jiang T, Wei X, Bian T, Xu M, Zhao Y, Zheng Y, Li X. Unravelling the Mechanisms of Tea Against NAFLD: An Integration of Bibliometrics, Network Pharmacology, and the Gut-Liver Axis. Diabetes Metab Res Rev. 2026 Jan;42(1):e70118
(2) Lin YH, Lin TK, Liao PL, Yang TY, Jong GP. Risk of New-Onset Ischaemic and Haemorrhagic Stroke in Patients With Type 2 Diabetes With Chronic Kidney Disease on SGLT-2 Inhibitor Users: A Population-Based Cohort Study. Diabetes Metab Res Rev. 2026 Jan;42(1):e70122
(3) You L, Parikh HM, Triolo TM, Ferrat LA, Templeman EL, Oram RA, Gottlieb PA, Rich SS, Onengut-Gumuscu S, Steck AK, Krischer J, Redondo MJ. Genetic Predictors of Response to Oral Insulin for Type 1 Diabetes Prevention. Diabetes Care. 2026 Feb 1;49(2):344-351
(4) Finer N, Strong T, Vrana-Diaz C, Stafford DEJ. Recommendations for real-world evidence of efficacy and safety of GLP1 agonists in Prader-Willi syndrome: Report of a workshop held by the Foundation for Prader-Willi Research and International Prader Willi Syndrome Organisation. Diabetes Obes Metab. 2026 Feb;28(2):799-802
(5) Esmann FVL, Heerfordt IM, Windfeld-Mathiasen J, Horwitz A, Dalhoff KP, Andersen JT, Middelboe M, Horwitz H. Anabolic androgenic steroid use and risk of diabetes mellitus in males. Diabetes Obese Metab. 2026 Feb;28(2):1076-1080