Diabetes and metabolic care expanded with both repurposing and new mechanism work. A clinical study linked SGLT2 inhibitor therapy with lower circulating activin A levels and improved right-heart function, while modulating BMP/activin signaling in ischemic heart failure patients at high risk of pulmonary hypertension. A separate metabolic repurposing signal came from blocking fructose metabolism: a trial reported improved hepatic and whole-body insulin sensitivity in people with MASLD (metabolic dysfunction–associated steatotic liver disease) and prediabetes, without weight loss driving the effect. On the drug class front, a meta-analysis suggested higher maintenance dosing of the oral GLP-1 agonist orforglipron improves weight and metabolic outcomes compared with a lower dose, keeping safety broadly comparable. The overall message for developers is that metabolic benefits are being pursued through multiple levers—cardiopulmonary signaling, diet-derived metabolism pathways, and oral incretin optimization.