Searches run (live PubMed, esearch/esummary/efetch + MCP PubMed tools): IDF Diabetes Atlas 2021 estimates; GBD 2021 diabetes burden; EMPA-REG OUTCOME; LEADER (+renal analysis); SUSTAIN-6; PIONEER 6; CREDENCE; FLOW; SELECT (+SELECT weight/HbA1c analyses); SURPASS-2; SURMOUNT-1/-2; tirzepatide-vs-semaglutide obesity head-to-head; BMJ network meta-analysis and living guideline; DiRECT 1-/2-/5-year; remission consensus definition; twin-cycle/calorie-restriction model; STAMPEDE 5-year; UKPDS 33/34/80/91; GRADE; DPP and DPPOS 15-year; Look AHEAD long-term mortality; TODAY youth-onset complications; ADA/EASD 2022 consensus; ADA Standards of Care 2026 sections; precision diabetes medicine consensus; diabetes stigma consensus.
Verification: all cited PMIDs retrieved from live PubMed this session; abstracts fetched for all quantitative claims (prevalence, hazard ratios, remission rates, weight-loss percentages). Volume/page details included only where returned live.
Next: full build queued per CONDITIONS-ROADMAP.md — 15 remaining wiki pages, literature layer, ClinicalTrials.gov verification (obesity-diabetes convergence pipeline), patient-voice layer.
Built all 16 canonical pages: expanded overview.md; added epidemiology/burden, pathophysiology/subtypes, prevention, remission/weight, incretins, SGLT2/kidney/heart, glycaemic legacy trials, metabolic surgery, complications, youth onset, guidelines, biomarkers, clinical-trials landscape, patient experience/advocacy, and red flags/safety. All remain draft pending the required separate audit.
Density: every wiki page is 154–206 lines and carries 25–39 unique verified PMIDs; tables are used for thresholds, trial comparisons, complication surveillance, treatment trade-offs, pipeline status, cross-domain evidence and safety controls.
Literature layer: generated BIBLIOGRAPHY.md with 106 unique cited PMIDs and cited-by mapping; wrote six landmark notes (UKPDS, DPP, EMPA-REG, DiRECT, CREDENCE, FLOW); built guideline registry, statistics tables and four-file patient-voice layer.
Open questions: replaced seed list with 18 stable tiered questions (OQ-1 to OQ-18) and 14 “Dots not yet connected” junctions.
PubMed searches run: global IDF/GBD prevalence and projection; undiagnosed disease; global/LMIC economic burden; mortality and incidence trends; young-adult onset; sex differences; urban/rural and slum prevalence; DALYs and attributable diet/PM2.5; insulin resistance/β-cell failure/ominous octet; twin-cycle and ectopic fat; Ahlqvist clusters and precision diabetes; DPP/DPPOS and Da Qing prevention; DiRECT/remission durability; bariatric remission and long-term RCTs; GLP-1 CVOTs; tirzepatide/SURPASS; withdrawal/weight regain; SGLT2 cardiovascular/kidney trials and DKA; UKPDS/ACCORD/ADVANCE/VADT/GRADE; complications; TODAY/youth β-cell failure; HbA1c/C-peptide/genetic/multi-omic biomarkers; diabetes distress, stigma, treatment burden and indigenous care; current guideline and safety searches.
ClinicalTrials.gov: queried the v2 condition endpoint (11,859 broad records returned) and exact study endpoints. Twelve NCT identifiers written in the condition were re-resolved live; tracked records include EMPA-REG, LEADER, SUSTAIN-6, CREDENCE, FLOW, SELECT, SURPASS-CVOT, SOUL, retatrutide, CagriSema and tirzepatide CKD programmes.
Patient-voice web verification: fetched official IDF, ADA, Diabetes UK and Diabetes Australia pages; public sources only, no private-person identifiers or private forums.
Validation: batch PubMed EFetch resolved all 106/106 PMIDs written anywhere under the condition; ClinicalTrials.gov v2 resolved 12/12 NCT IDs; all 16 pages passed frontmatter/status, required-heading, 150–400-line and local-link checks.
Conflicts preserved: IDF vs GBD prevalence models; remission denominators and definitions; UKPDS legacy vs ACCORD-era intensive-control harm; class versus molecule outcome inference; WHO resource-sensitive older sequencing vs modern organ-protection guidance; surgery versus incretin evidence horizons.
Not verified/omitted: no global single undiagnosed fraction was asserted; no prevalence was inferred from patient-organization campaigns; no claim that data-driven clusters improve treatment outcomes; no unpublished SURPASS-CVOT numeric result was added. Exact guideline wording may change after this date and requires live re-fetch at audit/update.
Next: run the playbook’s separate audit session: re-fetch every claim→PMID pair, verify author/year/numbers and only then promote passing pages to curated and roadmap status to audited.
Deepened all 16 canonical wiki pages in place: preserved the prior verified text and added page-specific sections rather than restarting pages. New material covers Steno-2 multifactorial outcomes; NCD-RisC prevalence and treatment coverage; global diagnosis-to-control cascades; Whitehall II pre-diagnostic trajectories; β-cell failure mechanisms; Finnish DPS, IDPP-1, Da Qing and DPPOS prevention; Look AHEAD/SOS remission outcomes; ELIXA, AMPLITUDE-O, SOUL and SURPASS-CVOT; HFpEF/CKD SGLT2 evidence; VADT/ACCORD Eye legacy conflicts; long-term surgical outcomes and harms; MASLD/foot burden; RISE, Ellipse and DINAMO youth evidence; ACP/AACE/ESC guideline disagreements; diagnostic/C-peptide/genomic biomarkers; patient-reported outcomes, cost and distress; and DKA–HHS/hypoglycaemia safety.
Density after deepening: pages are 185–248 lines and contain 32–49 distinct PMIDs each. All remain draft; this was a build/deepening session, not the playbook's independent audit session.
Literature searches: ran more than 90 targeted live PubMed ESearch queries across the 16 page domains, followed by ESummary and EFetch for selected records and abstracts. Searches included exact landmark trial/programme names plus systematic-review, cohort, mechanism, diagnostic-accuracy, implementation, equity, safety and guideline queries.
Bibliography: increased from 106 to 240 unique PubMed records. Every new wiki PMID has a house-format bibliography line with tags and cited-by page mapping.
ClinicalTrials.gov: re-fetched all 12 NCT registrations through the v2 study API on 2026-08-30. Eight landmark trials and the retatrutide obesity/CVD study returned COMPLETED; tirzepatide CKD/obesity, REDEFINE 3 and TRIUMPH-Outcomes returned ACTIVE_NOT_RECRUITING. Added published SOUL and SURPASS-CVOT outcomes to the trials page.
Statistics and guidelines: expanded STATISTICS.md with care-cascade, prevention, remission, surgery, organ-protection, monitoring, youth and crisis tables. Added ACP 2024, AACE 2022/2023 and ESC 2023 to REGISTRY.md, retained resource-sensitive disagreement, and made metformin prerequisite, HbA1c target and DPP-4 positions explicit.
Open questions: sharpened existing combination, youth and retinopathy questions; expanded from 18 to 26 stable questions and from 14 to 22 cross-domain junctions, including cascade repair, youth disease modification, remission causality, target-strategy trials, MASLD screening, CGM outcomes, active-comparator sequencing and actionable patient-reported outcomes.
Verification: performed a final live PubMed EFetch over every PMID present anywhere under the condition; 240/240 resolved. Re-resolved 12/12 NCT IDs live. All 16 pages passed frontmatter, required-heading, 150–400-line, local-link and inline-PMID-to-reference checks. No excluded condition, convention, tool or frontend path was changed.
Conflicts preserved: global totals by IDF/GBD/NCD-RisC; treatment percentage versus absolute untreated count; cluster labels versus continuous traits; prediabetes intervention versus overmedicalisation in older adults; remission association versus causality; active- versus placebo-comparator CVOTs; kidney composite definitions; ACP versus ADA/AACE targets; surgery durability versus contemporary pharmacotherapy; and conflicting rare pancreatitis/biliary signals.
Next: a separate audit session should compare each newly added quantitative claim to the full paper (not only abstract), check updated guideline wording at source websites, and promote pages to curated only after claim-level review.
Scope checked: all 16 canonical wiki pages and all 13 literature artifacts (master bibliography, guideline registry, statistics register, six landmark notes and four patient-voice files), plus INDEX.md and OPEN-QUESTIONS.md for consistency.
Citation counts checked: 246 unique current PMIDs across 1,797 pre-log citation occurrences; all 246/246 were re-resolved through live PubMed E-utilities after the final repair pass. The wiki contains 770 inline PMID occurrences and 587 reference-list occurrences; every inline PMID is present in its page reference list, every reference is used, and all 246 bibliography cited-by mappings match the pages exactly.
Trial counts checked: 12 unique NCT identifiers across 27 occurrences; all 12/12 were re-resolved by exact identifier through the live ClinicalTrials.gov v2 study API. Nine records were COMPLETED and three were ACTIVE_NOT_RECRUITING on 2026-08-30. The broad condition endpoint still returned 11,859 records and remains labelled as a broad, non-drug-development count.
Web/guideline checks: re-checked 15 official public-source records/URLs. NICE's February 2026 NG28 wording was updated in the synthesis; KDIGO 2022 remains the current guideline while a 2026 update is a public-review draft and is not presented as final. Patient-organisation access dates were refreshed to 2026-08-30.
Wrong citation/report pairs fixed (2): HARMONY Outcomes used an unrelated lung-cancer PMID (30280657) and now uses the live-matched report (PMID 30291013); GRADE glycaemic durability now uses the glycaemic-outcomes report (PMID 36129996), while the companion microvascular/cardiovascular report remains correctly separated (PMID 36129997).
Metadata and framing defects fixed: EMPA-KIDNEY was normalised from online-release year 2022 to its PubMed journal citation, 2023; three abbreviated bibliography titles were restored to their live titles; a renal-glucose-reabsorption mechanism claim was moved from an outcome trial to the mechanism review (PMID 20206731); four orphaned reference records were removed; and cited-by sections in all six landmark notes were reconciled to the current wiki.
Stale absences repaired: live dated searches were rerun for GLP-1RA+SGLT2 combination outcomes, surgery versus GLP-1RA, anti-stigma interventions, pharmacological remission terminology/trials, incretin pancreatitis/biliary safety, biomarker-guided care, cluster-guided care, C-peptide remission thresholds, post-remission surveillance, MASLD screening strategies, CGM complication outcomes, retinopathy titration, SGLT2 sick-day implementation, youth β-cell preservation and modern HbA1c-target strategies.
New evidence incorporated: a target-trial emulation of layered RAASi+SGLT2i+GLP-1RA therapy (PMID 42658186); observational surgery-versus-GLP-1RA synthesis (PMID 42660781); a 21-clinician stigma-training pilot (PMID 42579884); 2025–2026 pancreatitis/biliary meta-analyses (PMID 39569606; PMID 40988099; PMID 41927408); and emerging pharmacological-remission mapping, observational definitions and terminology (PMID 40419497; PMID 41142657; PMID 41852334). Each is labelled by design and limitations; observational evidence is not presented as randomised proof.
Evidence-gap wording: genuine gaps are now positively and explicitly dated—what the search found is stated before the missing strategy/outcome evidence. No claim of absence relies solely on the prior build search.
Final validation: all 16 pages are 186–253 lines, contain 32–50 unique PMIDs, and pass required-frontmatter, TL;DR, open-question, related-page, reference-use and local-link checks. Remaining unverified flags: 0. Remaining substantive issues: 0. All 16 pages were promoted to status: curated; INDEX.md and CONDITIONS-ROADMAP.md were advanced to audited.