Background: SGLT2 inhibitors (SGLT-2i) and GLP1 receptor agonists (GLP-1 RA) are recommended as the first line therapy for the management of type 2 diabetes mellitus (T2DM), particularly in patients with chronic kidney disease (CKD), cardiovascular disease (CVD), and heart failure (HF). Despite their established efficacy, there is limited evidence available to predict which subset of patients will respond favorably to them. We conducted this study to identify baseline characteristics to predict the response to therapy with SGLT-2i and GLP-1 RA. Methods: A retrospective analysis of the medical records was conducted at the Veteran Affairs Medical Center (VAMC) in Omaha, Nebraska, USA. Veterans who had completed 6–12 months of treatment with SGLT-2i or GLP-1 RA were included. Favorable treatment outcomes were a ≥0.5% reduction in glycosylated hemoglobin (HbA1c) or a ≥5% reduction in body weight; and those who achieved both outcomes were classified as adequate responders. Results: Patients in the GLP-1 RA group had 2.11 (95% CI: 1.45, 3.07) times the odds of achieving an adequate response as compared to patients in the SGLT-2i group in the unadjusted analysis, p < 0.001. HbA1c > 8% and older age was significantly associated with achieving an adequate response. Conclusions: Treatment with GLP-1 RA should be considered in Veterans with these characteristics.

Background: Primary hyperparathyroidism (PHPT) is commonly caused by a parathyroid adenoma and typically presents with hypercalcemia and elevated parathyroid hormone (PTH) levels. Spontaneous infarction of parathyroid adenoma is a rare phenomenon that can lead to spontaneous resolution of hypercalcemia. Case Presentation: We report the case of a 48‐year‐old male with a history of PHPT diagnosed 7 years prior and was lost to follow up, who presented with left‐sided facial and finger paresthesia. Initial labs revealed low ionized calcium with a normal PTH level. Imaging identified a heterogeneous mass adjacent to the left thyroid lobe. Biopsy confirmed infarcted parathyroid adenoma. The patient’s prior PHPT had spontaneously resolved, but he now presented with symptomatic hypocalcemia likely due to adenoma infarction. Discussion: Spontaneous infarction of a parathyroid adenoma is an uncommon cause of remission in PHPT. While transient remission of hypercalcemia has been documented, long‐term outcomes remain variable. Our case is unusual as the patient presented with symptomatic hypocalcemia years after initial diagnosis. Conclusion: Autoinfarction of parathyroid adenomas can result in spontaneous remission of PHPT but may also lead to unexpected complications such as hypocalcemia. Ongoing follow‐up is essential to monitor both recurrence of hypercalcemia and the development of hypocalcemia.