[New developments in endocrinology/diabetology]

Advances in our understanding of hormone action and disease pathophysiology are enabling increasingly personalised therapeutic strategies and expanding treatment options for common endocrine and metabolic disorders, which are major contributors to the global burden of chronic disease.This Review highlights three topics of particular relevance to clinical practice in internal medicine and summarises key developments over the past year.The most rapid progress has been made in the field of obesity, where incretin-based therapies are fundamentally reshaping clinical management. Beyond achieving substantial and sustained weight loss, these agents offer new opportunities to prevent and treat a broad range of obesity-related complications. At the same time, emerging diagnostic frameworks that move beyond the traditional body mass index (BMI)-based classification are prompting a reassessment of how obesity is defined and clinically stratified, with the aim of improving risk assessment and guiding treatment decisions.Recent evidence has also refined the diagnostic evaluation and management of adrenal incidentalomas and endocrine causes of hypertension. In parallel, the development of selective aldosterone synthase inhibitors introduces a potential new treatment option for primary aldosteronism, the most common cause of secondary hypertension.A similar paradigm shift is occurring in the management of thyroid nodules and thyroid cancer. Contemporary strategies increasingly emphasise risk-adapted diagnostic and therapeutic approaches that enable accurate identification of clinically significant disease while reducing overdiagnosis and unnecessary intervention. In patients with low-risk thyroid cancer, organ-preserving surgery, more selective use of radioiodine therapy, and, in carefully selected cases, active surveillance are increasingly incorporated into clinical practice. Collectively, these developments aim to reduce treatment-related morbidity while maintaining excellent oncological outcomes and preserving long-term quality of life.