bims-glumda Biomed News
on CGM data in management of diabetes
Issue of 2026–02–01
sixteen papers selected by
Mott Given
  1. Continuous glucose monitoring versus self-monitoring of blood glucose in gestational diabetes: an updated systematic review and meta-analysis of randomized controlled trials.
  2. Correction to "Minimum expectations for market authorization of continuous glucose monitoring devices in Europe-'eCGM' compliance status".
  3. Use of continuous glucose monitoring in non-intensively managed type 2 diabetes: a Saudi Arabian consensus.
  4. Beyond scalar metrics: functional data analysis of postprandial continuous glucose monitoring in the AEGIS study.
  5. Relationship between continuous glucose monitoring and corneal neuropathy in type 2 diabetes.
  6. Continuous Glucose Monitoring and Diabetic Foot Ulcers: Is it Time to Walk in Range? A Brief Narrative Review.
  7. Evolution and Future of Glucose Monitoring: From Blood Glucose Meters to Continuous Systems and Their Projected Impact in the Middle East and North Africa (MENA) Region.
  8. International clinical opinion on transparency, standardisation, and calibration alignment in the performance evaluation of systems for continuous glucose monitoring.
  9. Efficacy of telemedicine on glycaemic control in nursing home residents with type 2 diabetes on basal-bolus insulin therapy: A randomised controlled trial.
  10. Emotional Well-Being and Glycemic Control in People with Diabetes After a Multidisciplinary Hybrid Education.
  11. Adults with type 1 diabetes who sleep 7-9 hours per night present lower glycemic variability: a cross-sectional study.
  12. Impact of continuous glucose monitoring on fear of hypoglycemia and quality of life in children and adolescents with type 1 diabetes.
  13. Hypoglycaemia and Cardiac Arrhythmias in Type 1 Diabetes Mellitus: A Mechanistic Review.
  14. Integrating Self-Determination Theory and Continuous Glucose Monitoring: Promoting Youth Development Among Campers with Type 1 Diabetes.
  15. The beneficial impact of a low-carbohydrate diet on glycemic variability in insulin-deficient diabetes.
  16. Diabetes technology use in the Middle East and Southeast Asia: penetrance, challenges, and unmet needs.
  1. Acta Diabetol. 2026 Jan 27.
    Continuous glucose monitoring versus self-monitoring of blood glucose in gestational diabetes: an updated systematic review and meta-analysis of randomized controlled trials.
    Naveen Gautam, Bruno Lins de Souza, Jessica Abramowitz, Denise Machado Mourão, Sasan Mirfakhraee, Marconi Abreu.
       AIMS: Continuous glucose monitoring (CGM) benefits pregnant women with type 1 or type 2 diabetes, but its role in gestational diabetes (GDM) remains uncertain. We aimed to compare the effects of CGM with self-monitoring of blood glucose (SMBG) on glycemic, maternal, and neonatal outcomes in women with GDM.
    METHODS: We compared CGM with SMBG in women with GDM through a systematic search across randomized controlled trials (RCTs) in PubMed, Cochrane Library, Embase, and Scopus. We evaluated glycemic, maternal and neonatal outcomes using a random-effects model.
    RESULTS: Eleven RCTs (n = 1225) met inclusion criteria. The use of CGM increased the likelihood of achieving appropriate maternal weight gain (RR 1.37, 95% CI 1.02 to 1.82; I2 = 0%) and reduced mean neonatal birth weight (MD - 122.79 g, 95% CI - 189.78 to - 55.79; I2 = 0%). CGM use did not change maternal time in range (TIR), time above range (TAR), time below range (TBR), glycated hemoglobin, gestational hypertension, cesarean delivery, macrosomia, preterm delivery, neonatal hypoglycemia, or neonatal intensive care unit admissions.
    CONCLUSIONS: In women with GDM, the use of CGM improved the likelihood of appropriate maternal weight gain and lowered neonatal birth weight compared with SMBG, but it did not improve overall glycemic control or other maternal and fetal outcomes.
    TRIAL REGISTRATION: PROSPERO CRD420251044960 (registered 2025).
    Keywords:  Continuous glucose monitoring; Gestational diabetes mellitus; Meta-analysis; Pregnancy; Self-monitoring of blood glucose; Time in range
    DOI:  https://doi.org/10.1007/s00592-026-02644-1
  2. Diabetes Obes Metab. 2026 Jan 28.
    Correction to "Minimum expectations for market authorization of continuous glucose monitoring devices in Europe-'eCGM' compliance status".
      
    DOI:  https://doi.org/10.1111/dom.70521
  3. Front Endocrinol (Lausanne). 2025 ;16 1738398
    Use of continuous glucose monitoring in non-intensively managed type 2 diabetes: a Saudi Arabian consensus.
    Mohammed Almehthel, Abdulghani Al-Saeed, Fahad Al-Sabaan, Faisal Al-Malky, Hawazen Zarif, Lamya Al-Zubaidi, Mohammed E Al-Sofiani, Omar Abdulaal, Reem Al Argan, Saud Al Sifri, Turki Al-Harbi, Raed Aldahash.
       Background: Saudi Arabia has one of the highest prevalences of diabetes globally, with 16.4% of the population living with type 2 diabetes (T2D). While continuous glucose monitoring (CGM) is widely used for patients with type 1 diabetes, evidence suggests its benefits can extend to patients with T2D. The aim of this Delphi consensus was to provide a framework for the use of CGM in patients with T2D who are non-intensively managed in Saudi Arabia.
    Methods: An expert panel of ten adult endocrinology physicians, one internal medicine and diabetology specialist, and one family medicine physician was formed. Consensus generation was undertaken using Delphi methodology; a face-to-face expert meeting and literature review formed the basis of preliminary statements, which were further refined by the panel. Two rounds of voting were used to confirm the level of agreement to each statement.
    Results: Consensus was reached on 27 statements relating to the use of CGM in non-intensively managed T2D. Recommended patient profiles for continuous and intermittent use of CGM are provided, alongside general principles of CGM use and background statements.
    Conclusions: This consensus provides recommendations and summarizes local and international evidence as well as expert opinion regarding CGM use in patients with T2D. To expand the use of CGM into the wider population of T2D in Saudi Arabia and enable these individuals to benefit from the technology, a shift in healthcare services, education, and attitudes across the country is necessary.
    Keywords:  Saudi Arabia; continuous glucose monitoring; non-intensive; oral antidiabetics; type 2 diabetes
    DOI:  https://doi.org/10.3389/fendo.2025.1738398
  4. BMC Med Res Methodol. 2026 Jan 24.
    Beyond scalar metrics: functional data analysis of postprandial continuous glucose monitoring in the AEGIS study.
    Marcos Matabuena, Joseph Sartini, Francisco Gude.
      
    Keywords:  Continuous glucose monitoring; Functional data analysis; Glucose metabolism; Hierarchical modeling; Postprandial glucose
    DOI:  https://doi.org/10.1186/s12874-025-02748-2
  5. J Clin Endocrinol Metab. 2026 Jan 28. pii: dgag030. [Epub ahead of print]
    Relationship between continuous glucose monitoring and corneal neuropathy in type 2 diabetes.
    Suresh Rama Chandran, Jasmine Koh Shimin, Chang Liu, Isabelle Xin Yu Lee, May Zin Oo, Mingyi Yu, Rheia Tay Jia Hui, Su Yen Goh, Phong Ching Lee, Emily Ho, Daphne Gardner, Chun Fan Lee, Hong Chang Tan, Yu-Chi Liu.
       OBJECTIVE: The relationship between corneal neuropathy measured by in vivo confocal microscopy (IVCM) and continuous glucose monitoring (CGM) remains unclear. We describe the associations between corneal neuropathy and CGM metrics.
    METHODS: A single center cross sectional study recruited people with type 2 diabetes. All participants wore a 14-day blinded Freestyle Libre Pro CGM and underwent corneal IVCM. Multiple generalized estimating equation models were created to study the association of independent variables (HbA1c and CGM metrics) on dependent variables (corneal nerve fiber and cellular metrics) adjusted for age, sex, ethnicity, hypertension, hyperlipidemia, BMI, diabetes duration. Benjamini-Hochberg procedure controlled for multiplicity.
    RESULTS: 307 people were recruited, 277 were included in the analysis. Median Age 58y, 49.5% female, 60.6% Chinese, BMI 26.6 kg/m², diabetes duration 12y, HbA1c 8.1%. HbA1c associated negatively (β= -0.609, pseudoR²= 0.068, p=0.013) with Corneal Nerve Fiber Density and positively (β= 0.003, pseudoR² = 0.066, p=0.027) with Corneal Nerve Fiber Width (CNFW). Time-in-Range and Time-in-Tight-Range negatively (β for both = -0.006, pseudoR²= 0.075 and 0.066, respectively, both p<0.03), and Time-Above-Range (β=0.006, pseudoR²=0.073, p=0.021) positively, associated with CNFW. Among Corneal Cellular metrics, Time-Above-Range (β=0.088, pseudoR² = 0.055, p=0.004), mean glucose (β=0.049, pseudoR²=0.055, p=0.004) and glucose variability (SD, MAGE and MODD; β= 0.13, 0.046, 0.164; pseudoR²= 0.053, 0.044, 0.060, respectively, all p<0.03) associated positively with average epithelial size, while Time-in-Range and Time-in-Tight-Range had a negative association (β= -0.084 and -0.104; pseudoR²= 0.052 and 0.057, respectively, both p<0.01).
    CONCLUSION: CGM measures, including mean glycemia, TIR, TITR and glucose variability, were significantly associated with corneal neuropathy, supporting the role of CGM metrics in optimising glycemia.
    Keywords:  continuous glucose monitoring; corneal neuropathy; in vivo confocal microscopy; type 2 diabetes
    DOI:  https://doi.org/10.1210/clinem/dgag030
  6. Int J Low Extrem Wounds. 2026 Jan 27. 15347346261415723
    Continuous Glucose Monitoring and Diabetic Foot Ulcers: Is it Time to Walk in Range? A Brief Narrative Review.
    Dimitrios Pantazopoulos, Evanthia Gouveri, Djordje S Popovic, Nikolaos Papanas.
      Diabetic foot ulcers (DFUs) are a serious and common complication of diabetes mellitus (DM), contributing substantially to patient morbidity, reduced quality of life, and healthcare costs. Accumulating evidence suggests that both low and high blood glucose may delay wound healing and increase mortality. Continuous glucose monitoring (CGM) in people with DM is known to improve glycaemic control compared with self-monitoring of blood glucose. This narrative review summarises current evidence on the role of CGM and CGM-derived metrics, such as time in range (TIR), in DFU management. Emerging evidence suggests that optimising glycaemic control with CGM sensors in patients with DFUs may be essential to promote wound healing and, ultimately, reduce the risk of amputations. Accordingly, CGM emerges as a promising tool to improve DFUs outcomes. Well-designed clinical trials are now needed to confirm these findings and to provide guidelines for everyday clinicians.
    Keywords:  CGM; DFU; continuous glucose monitoring; diabetes mellitus; diabetic foot ulcer; time in range
    DOI:  https://doi.org/10.1177/15347346261415723
  7. Cureus. 2025 Dec;17(12): e100272
    Evolution and Future of Glucose Monitoring: From Blood Glucose Meters to Continuous Systems and Their Projected Impact in the Middle East and North Africa (MENA) Region.
    Omar Darkhabani, Abdalla Ahmed.
      The management of diabetes mellitus is fundamentally reliant on the accurate measurement of glycemic levels. For decades, self-monitoring of blood glucose (SMBG) via finger-stick blood glucose meters (BGMs) has been the cornerstone of daily diabetes care. However, the advent of continuous glucose monitoring (CGM) systems represents a paradigm shift, offering real-time interstitial fluid glucose readings, trend data, and hypoglycemic alerts. This review delineates the fundamental principles, developmental history, and comparative advantages and disadvantages of BGM and CGM technologies. We explore the technical evolution from first-generation reflectance meters to modern, connected BGMs and from retrospective professional CGMs to minimally invasive, real-time personal and factory-calibrated systems. Furthermore, we project the future trajectory of these technologies, including non-invasive methods and algorithmic integration. A specific focus is placed on the Middle East and North Africa (MENA) region, which bears one of the world's highest diabetes prevalence rates. We analyze the current market dynamics and project a significant growth in CGM adoption from 2025 to 2035, driven by increasing awareness, competitive pricing, and crucial expansions in healthcare reimbursement, even as BGM remains a vital tool for large segments of the population.
    Keywords:  continuous glucose monitoring; diabetes; flash glucose monitoring; mena region; self-monitoring of blood glucose; technology adoption
    DOI:  https://doi.org/10.7759/cureus.100272
  8. Diabetes Obes Metab. 2026 Jan 26.
    International clinical opinion on transparency, standardisation, and calibration alignment in the performance evaluation of systems for continuous glucose monitoring.
    John S Pemberton, Robert C Andrews, Katharine Barnard-Kelly, Tadej Battelino, Thomas Danne, Lutz Heinemann, Partha Kar, Alistair Lumb, David M Maahs, Julia K Mader, Chantal Mathieu, Viswanathan Mohan, Helen R Murphy, Eleanor M Scott, Jennifer L Sherr, Carmel E Smart, Martin Tauschmann, Amanda Williams, Emma G Wilmot, Dessi P Zaharieva, Othmar Moser.
      Continuous glucose monitoring (CGM) is now central to diabetes management, yet variation in how respective medical products are evaluated limits meaningful comparison between CGM systems. Three barriers currently constrain reliable interpretation of glucose-derived measures. The first is limited transparency: in several regulatory settings, particularly those using Conformité Européenne marking, clinical-study reports, reference-method information and analytical documentation required for market authorisation are not publicly accessible. The second barrier is heterogeneity in study procedures. Existing evaluations use different reference-glucose methods, sampling strategies, glucose-manipulation protocols and participant characteristics, leading to accuracy estimates that cannot be interpreted consistently across systems. The third barrier is calibration alignment. Even with full transparency and aligned procedures, CGM systems may differ because their calibration algorithms are trained on distinct reference-glucose datasets, influencing reported glucose ranges, automated insulin-delivery behaviour and interpretation during device transitions. A modified Delphi process involving clinicians, laboratory scientists, and researchers identified these issues as the principal determinants of comparability. During this process, the International Federation of Clinical Chemistry and Laboratory Medicine released a validated framework for performance evaluation of CGM systems, providing a unified approach to reference-method selection, dynamic in-clinic testing, and structured reporting. Adoption would reduce procedural variability but does not resolve calibration-alignment differences. This international clinical opinion proposes a pathway towards internationally interpretable CGM evaluation: immediate transparency of clinical evidence, routine declaration of calibration alignment, and progressive adoption of validated standardised procedures. These steps provide a foundation for reliable interpretation and globally comparable assessment of CGM technologies.
    DOI:  https://doi.org/10.1111/dom.70460
  9. Diabetes Obes Metab. 2026 Jan 26.
    Efficacy of telemedicine on glycaemic control in nursing home residents with type 2 diabetes on basal-bolus insulin therapy: A randomised controlled trial.
    Ilaria Dicembrini, Chiara D Poggi, Gloria G Del Vescovo, Christian Marinelli, Daniele Scoccimarro, Valentina Vitale, Giovanni A Silverii, Luca Drigani, Francesca Pancani, Roberto Norgiolini, Graziano Di Cianni, Edoardo Mannucci.
       AIMS: Management of insulin therapy in elderly individuals with type 2 diabetes (T2D) residing in nursing homes is often challenging due to comorbidities, cognitive impairment and limited access to specialist care. Continuous glucose monitoring (CGM) and telemedicine may help optimise glycaemic control in this vulnerable population.
    MATERIALS AND METHODS: In order to assess the efficacy and safety of a CGM and telemedicine-based management of insulin therapy in nursing home residents with T2D, a 12-week, randomised, controlled and open-label trial has been designed. Eighty-five patients on stable basal-bolus insulin therapy were assigned to either telemedicine-assisted insulin titration based on CGM data (intervention group) or standard care with capillary blood glucose monitoring (control group). The primary endpoint was the change in time in range (TIR, 70-180 mg/dL), with secondary outcomes including time below range (TBR), time above range (TAR), haemoglobin A1c (HbA1c), insulin dose and safety endpoints.
    RESULTS: TIR increased significantly in the intervention, but not in the control group, with a significant difference between study groups (p = 0.010). TBR showed a reduction in the intervention arm and an increase in the control arm with a significant difference between groups (p = 0.007). HbA1c and mean insulin daily units significantly also decreased in the intervention group, with significant differences between groups (p = 0.028 and p = 0.002, respectively). No safety issues potentially related to the intervention were identified during the study.
    CONCLUSION: In conclusion, remote insulin dose adjustment based on interstitial glucose monitoring ameliorates glucose control in nursing home residents with T2D on basal-bolus insulin therapy.
    Keywords:  continuous glucose monitoring (CGM); glycaemic control; hypoglycaemia; insulin treatment; telemedicine
    DOI:  https://doi.org/10.1111/dom.70511
  10. Healthcare (Basel). 2026 Jan 13. pii: 198. [Epub ahead of print]14(2):
    Emotional Well-Being and Glycemic Control in People with Diabetes After a Multidisciplinary Hybrid Education.
    Carmen Amelia Ruiz-Trillo, Ana Pérez-Morales, Ana Cortés-Lerena, Pilar Santa Cruz-Álvarez, Mónica Enríquez-Macias, Manuel Pabón-Carrasco, Miguel Garrido-Bueno, Rocío Romero-Castillo, Virginia Bellido.
       BACKGROUND/OBJECTIVES: Multidisciplinary hybrid educational programs combined with continuous glucose monitoring may contribute to improved self-management in adults with type 1 diabetes mellitus (T1DM); however, real-world evidence remains limited. This study assessed the effects of an educational intervention integrated with continuous glucose monitoring on glycemic control and patient-reported outcomes in adults with T1DM.
    METHODS: We conducted a single-group quasi-experimental study including 210 adults with T1DM from a public hospital. The nurse-led hybrid intervention consisted of a 2-h in-person group educational session followed by an individual telematic follow-up session. All participants used continuous glucose monitoring. The primary outcome was the change in HbA1c at 9 months. Secondary outcomes included continuous glucose monitoring metrics, diabetes-related quality of life, treatment satisfaction, and hypoglycemia awareness.
    RESULTS: HbA1c showed a statistically significant but modest reduction from 7.70 ± 1.10% to 7.45 ± 0.91% following the intervention (p = 0.003). No statistically significant changes were observed in continuous glucose monitoring metrics, including time in range, time below and above range, mean glucose, glycemic variability, or sensor wear time. In terms of emotional well-being, treatment satisfaction increased significantly (8.17 ± 7.86 vs. 12.73 ± 5.49; p < 0.001), and the Clarke score showed a statistically significant but modest decrease (2.49 ± 1.90 vs. 2.12 ± 1.88; p = 0.017). Although the overall quality of life score did not change significantly, statistically significant differences were observed in several subscales, including satisfaction, impact, and diabetes-related concern.
    CONCLUSIONS: A multidisciplinary hybrid educational intervention integrated with continuous glucose monitoring was associated with modest improvements in HbA1c and statistically significant, though limited, enhancements in quality of life, treatment satisfaction, and hypoglycemia awareness in adults with T1DM. These findings suggest that similar educational models may have a supportive role in routine care.
    Keywords:  nurses; patient education; remote consultation; type 1 diabetes mellitus
    DOI:  https://doi.org/10.3390/healthcare14020198
  11. Front Endocrinol (Lausanne). 2025 ;16 1745272
    Adults with type 1 diabetes who sleep 7-9 hours per night present lower glycemic variability: a cross-sectional study.
    Anna Duda-Sobczak, Michal Kulecki, Stanislaw Pilacinski, Dariusz Naskret, Dorota Zozulinska-Ziolkiewicz.
       Introduction: The National Sleep Foundation (NSF) recommends 7-9 hours of sleep per night for adults. Inadequate sleep may negatively impact the outcomes of diabetes treatment.
    Objectives: This study aimed to investigate the associations between sleep duration and quality and glycemic variability in adults with type 1 diabetes.
    Patients and methods: 155 participants with type 1 diabetes (73 men, 47%), mean (SD) age 33 (9) years, median (IQR) diabetes duration 12 (8-20) years, completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Continuous glucose monitoring (CGM) data were analyzed using Glyculator 3.0. The ANOVA/Kruskal-Wallis test with post-hoc Bonferroni correction analysis, logistic regression, and multivariable linear regression models were used.
    Results: 78 participants (50.3%) met the NSF criteria of recommended sleep duration, 56 (36.1%) declared sleeping less than 7h, and 21 (13.6%) sleeping more than 9h. Compared with participants sleeping 7-9h per night, each other group had significantly higher: mean glucose, coefficient of glycemic variability (CV), glycemia risk index (GRI), high blood glucose index (HBGI), mean amplitude of glucose excursions (MAGE), glycemic risk assessment in diabetes equation (GRADE), mean of daily differences (MODD) and lower time-in-range (TIR). No differences in sleep quality, low blood glucose index (LBGI), HbA1c, or diabetes duration were shown among groups. In multivariable logistic regression analysis sleeping 7-9h per night was associated with lower CV, MAGE and MODD after adjustment for age, sex and HbA1c.
    Conclusions: Adults with type 1 diabetes who sleep 7-9 hours per night present lower glycemic variability compared with those sleeping less or more.
    Keywords:  continuous glucose monitoring; glycemic variability; sleep duration; sleep quality; type 1 diabetes
    DOI:  https://doi.org/10.3389/fendo.2025.1745272
  12. J Pediatr Endocrinol Metab. 2026 Jan 26.
    Impact of continuous glucose monitoring on fear of hypoglycemia and quality of life in children and adolescents with type 1 diabetes.
    Özge Köprülü, Murat Çağlar Karataş, Sevgi Akbel, Fatma Yavuzyılmaz Şimşek, İbrahim Mert Erbaş, Özlem Nalbantoğlu, Hüseyin Anıl Korkmaz, Behzat Özkan.
       OBJECTIVES: This study aimed to evaluate changes in fear of hypoglycemia (FOH) and quality of life (QoL) following at least six months of continuous glucose monitoring (CGM) use in the same cohort with type 1 diabetes mellitus (T1DM).
    METHODS: This was a prospective, observational study including first-time CGM users. Auxologic, laboratory, and CGM data was collected. All participants were asked to complete the validated Turkish versions of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Diabetes Module for both children and parents; the quality of life for youth scale for adolescents; children's hypoglycemia index (CHI).
    RESULTS: When pre- and post-CGM scores were compared, the mean total CHI score significantly decreased (p=0.018). Among the subscales, significant reductions were also observed in the "specific situations" (p=0.044) and "behavior scales" (p=0.025) subscales, whereas the "general fears" did not show a significant change (p=0.396). In PedsQL forms, there were no statistically significant differences between pre- and post-CGM total or subscale scores. CGM metrics were also compared between participants who showed improvement in FOH and/or QoL and those who did not. Participants with improvement in FOH had significantly higher sensor active use percentages compared to those without improvement (98.95 vs. 93.0 %, p=0.039).
    CONCLUSIONS: This study's ability to assess pre- and post-CGM outcomes in the same patients highlights its clinical significance. Our findings suggest that using CGM in children and adolescents with T1DM is associated with a reduction in FOH.
    Keywords:  continuous glucose monitoring; fear of hypoglycemia; quality of life; type 1 diabetes
    DOI:  https://doi.org/10.1515/jpem-2025-0733
  13. J Pers Med. 2026 Jan 09. pii: 45. [Epub ahead of print]16(1):
    Hypoglycaemia and Cardiac Arrhythmias in Type 1 Diabetes Mellitus: A Mechanistic Review.
    Kyriaki Mavromoustakou, Christos Fragoulis, Kyriaki Cholidou, Zoi Sotiropoulou, Nektarios Anagnostopoulos, Ioannis Gastouniotis, Stavroula-Panagiota Lontou, Kyriakos Dimitriadis, Anastasia Thanopoulou, Christina Chrysohoou, Konstantinos Tsioufis.
      Hypoglycaemia in patients with type 1 diabetes mellitus (T1DM) remains a major clinical burden and, beyond its metabolic complications, can cause serious cardiac arrhythmias. Multiple mechanisms lead to different types of arrhythmias during hypoglycaemia. However, existing studies often involve mixed diabetes populations, small cohorts, or limited monitoring during nocturnal periods, leaving a critical gap in understanding the links between glucose fluctuations and arrhythmic events. This review provides an updated combination of experimental and clinical evidence describing how autonomic dysfunction and ionic imbalances lead to electrophysiological instability and structural remodelling of the myocardium during hypoglycaemia. Continuous glucose monitoring (CGM) combined with electrocardiographic or wearable rhythm tracking may enable early detection of glycemic and cardiac disturbances and help identify high-risk individuals. Future prospective studies using combined CGM-ECG monitoring, particularly during sleep, are essential to clarify the relationship between hypoglycaemia and arrhythmic events.
    Keywords:  QTc prolongation; atrial fibrillation; autonomic dysfunction; cardiac arrhythmia; continuous glucose monitoring; dead-in-bed syndrome; hypoglycaemia; impaired awareness of hypoglycaemia; type 1 diabetes mellitus
    DOI:  https://doi.org/10.3390/jpm16010045
  14. Behav Sci (Basel). 2025 Dec 22. pii: 24. [Epub ahead of print]16(1):
    Integrating Self-Determination Theory and Continuous Glucose Monitoring: Promoting Youth Development Among Campers with Type 1 Diabetes.
    Eddie Hill, Bethany Arrington, Taylor Harvey, Alexis Barmoh, Rowan Williams, Laura Hill.
      The purpose of this cohort study was to evaluate participants' general self-management and experiences of autonomy while attending diabetes camp using quantitative and qualitative data collection. Through a partnership, an outdoor diabetes camp was designed to assist youth with type 1 diabetes (T1D) in their management. The REACH Teen program conducted a week-long summer camp for youth with T1D. The study was designed through Outcome-Focused Programming grounded in Self-Determination Theory (SDT) to meet campers' needs of autonomy, competence, and relatedness. Campers participated in outdoor activities and diabetes education designed to increase healthy behaviors. Twenty-three campers completed a 24-item pre- and post-camp questionnaire measuring participants' perceived levels of satisfaction or frustration of their three basic psychological needs. At the conclusion of camp, 21 youth participated in 35-min focus group interviews. Through a paired-sample t-test, all three measures were trending in a positive direction, with relatedness (R) being the closest to significance. Cloud-based biometric data was used to compute the percentage of TIR for the week, during camp hours. The results from the focus group interviews revealed three themes: lack of outside understanding, varying levels of autonomy, and experiences at REACH. Not reporting TIR data outside of camp was a limitation of this study. Diabetes medical specialty camps grounded in SDT can provide an opportunity for campers to internalize healthy behaviors needed to manage their diabetes.
    Keywords:  blood glucose levels; diabetes camp; multi-methods; self-determination theory; time in range; type 1 diabetes
    DOI:  https://doi.org/10.3390/bs16010024
  15. Front Nutr. 2025 ;12 1733037
    The beneficial impact of a low-carbohydrate diet on glycemic variability in insulin-deficient diabetes.
    Jing Song, Jingjie Wang, Jing Wan, Ye Lu, Wenjie Wang, Li Li, Jun Wang, Li Wei, Jun Yin.
       Aims: To evaluate the short-term metabolic effects of a low-carbohydrate diet (LCD) compared with a control diet (CON) in hospitalized patients with insulin-deficient diabetes, with particular focus on glycemic variability (GV).
    Methods: This non-randomized clinical trial included 359 inpatients with fasting C-peptide levels ≤1.0 ng/mL. Participants chose either an LCD or CON during hospitalization. GV was assessed using capillary and continuous glucose monitoring, with coefficient of variation (CV) as primary outcome. Secondary measures included other GV metrics, antidiabetic medication use, ketone levels, and adverse events. Subgroup analysis was conducted based on baseline C-peptide levels.
    Results: LCD led to a greater reduction in CV (diet-by-time interaction, p = 0.03), as well as improvements in MAGE, SD, TIR, and iAUC compared with CON. LCD patients also showed reduced requirements for oral agents and insulin injection at discharge. Benefits were more pronounced in individuals with lower C-peptide levels (P for interaction = 0.002). No increase in adverse events was observed. Ketone levels increased in the LCD group and negatively correlated with discharge blood glucose and CV.
    Conclusion: Short-term LCD intervention improved GV in insulin-deficient diabetes, especially in patients with more significant β-cell dysfunction, with blood ketones negatively correlated with blood glucose and GV.
    Clinical trial registration: ChiCTR2000038006, https://www.chictr.org.cn/showproj.html?proj=60712.
    Keywords:  C-peptide; continuous glucose monitoring; glycemic variability; ketone body; low-carbohydrate diet
    DOI:  https://doi.org/10.3389/fnut.2025.1733037
  16. Diabetes Res Clin Pract. 2026 Jan 24. pii: S0168-8227(26)00036-7. [Epub ahead of print] 113117
    Diabetes technology use in the Middle East and Southeast Asia: penetrance, challenges, and unmet needs.
    Asma Deeb, Hussain Al Saffar, Nadha Yaqoob, Andrea E Scaramuzza.
       AIMS: Little data exist on the extent of diabetes technology use in the treatment of diabetes in young people outside high-income, Western countries. Here we explored uptake of diabetes technology in the Middle East, Southeast Asia, and beyond METHODS: A multinational, cross-sectional survey was distributed via major pediatric endocrine societies to healthcare professionals (HCPs) managing children and adolescents with diabetes. The survey assessed CGM and insulin pump penetrance, challenges to adoption, and perceived solutions.
    RESULTS: Based on 196 responses from 27 countries, a profound technology gap was confirmed. Nearly half of HCPs (49.2%) reported CGM use in fewer than 5% of their patients, while insulin pump use was even lower, with 74.1% reporting use in under 5% of their pediatric population. While lack of financial resources was the principal barrier (>95%), HCPs also highlighted critical non-financial needs, including simpler technology (53.3%), maintaining patient motivation (52.3%), and deficits in provider training (47.2%) and structured patient education (46.7%).
    CONCLUSION: The adoption of modern diabetes technology is critically low in these regions, reinforcing the existence of an interregional "technology gap". Improving outcomes for children and adolescents with type 1 diabetes not only relies on funding to promote equitable access but also support through culturally-adapted education for providers, patients, and their families.
    Keywords:  Adolescents; Children; Continuous glucose monitoring; Insulin pump; Technology
    DOI:  https://doi.org/10.1016/j.diabres.2026.113117
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