bims-glumda Biomed News
on CGM data in management of diabetes
Issue of 2026–04–05
twenty papers selected by
Mott Given
  1. Continuous Glucose Monitoring for Pregnant Patients With Gestational Diabetes and Type 2 Diabetes.
  2. Continuous glucose monitoring, diabetes distress, and well-being in adults with type 1 diabetes: findings from a National Survey in Lithuania.
  3. Impact of Missing Data and Monitoring Duration on Downstream Analyses in Continuous Glucose Monitoring.
  4. A Pilot Study Evaluating Associations between Continuous Glucose Monitoring Metrics in Pregnancy and Postpartum A1c and Blood Pressure.
  5. Cost-effectiveness analysis comparing real-time continuous glucose monitoring with self-monitoring of blood glucose for patients with type 2 diabetes treated with insulin in Japan.
  6. Clinical accuracy of Dexcom G6 and G7 continuous glucose monitors in hospitalized pediatric patients with type 1 diabetes: a real-world study.
  7. Accuracy of Continuous Glucose Monitoring in Adults With Postbariatric Hypoglycemia After Roux-en-Y Gastric Bypass Surgery Under Stable and Dynamic Glucose Conditions.
  8. Comparison of the Continuous Glucose Monitoring Profiles of Four Glucose-Lowering Medications in the GRADE Randomized Trial.
  9. Healthcare professionals' experiences with the use of continuous glucose monitoring in nursing homes and home healthcare services: a qualitative study.
  10. Acceptability of and Barriers to Continuous Glucose Monitoring in Individuals with Type 2 Diabetes Mellitus Receiving Chronic Hemodialysis: Research Letter.
  11. Commentary on 'Diabetes and Technology - An Update for the General Physician'.
  12. Exploring the gap between sensor-detected (SDH) and person-reported hypoglycaemia (PRH): The voice of people living with diabetes.
  13. The Association Between Ambient Temperature and Hypoglycemia in People Living With Type 1 Diabetes: A Case Time Series Analysis Using Real-Time Continuous Glucose Monitoring.
  14. Transition from Continuous Subcutaneous Insulin Infusion to IDeg-Based Regimens in Hospitalized T2DM Patients: A Single-Center Retrospective Analysis.
  15. The Dawn Phenomenon Exacerbates Post-Breakfast Hyperglycemia in Type 2 Diabetes Mellitus: A Cross-Sectional Continuous Glucose Monitoring Study.
  16. Burden and Risk Factors of CGM-Detected Hypoglycemia in Older Adults With Type 2 Diabetes.
  17. The dt-Report: A Novel Real-World Data Approach to Understanding the Use and Impact of Diabetes Technology in European Countries.
  18. Meeting time in range and time below range targets is not associated with psychological outcomes in type 1 or insulin-treated type 2 diabetes in the Hypo-METRICS study.
  19. A novel way to represent weekly blood sugar data to increase user understanding and control.
  20. Insulin Glulisine Versus Regular Human Insulin for Prednisolone-Associated Hyperglycemia Assessed by Continuous Glucose Monitoring: An Open-Label Crossover Study.
  1. Clin Obstet Gynecol. 2026 Mar 31.
    Continuous Glucose Monitoring for Pregnant Patients With Gestational Diabetes and Type 2 Diabetes.
    Ashley N Battarbee.
      Glucose monitoring is arguably one of the most important components of diabetes management in pregnancy. In this review, the application of continuous glucose monitoring (CGM) in managing diabetes during pregnancy is explored with a focus on gestational diabetes mellitus (GDM) and type 2 diabetes (T2D). It highlights the expanding applications of CGM technology, starting with evidence from the landmark CONCEPTT trial. The review examines normative CGM data in uncomplicated pregnancies and emphasizes the emerging evidence for CGM in GDM management. Finally, it addresses the limited but growing data on CGM in T2D pregnancies. Although CGM offers promising new opportunities to overcome the limitations of traditional SMBG testing, knowledge gaps persist. Further research is needed to determine how to effectively use this novel technology in pregnant patients with GDM and T2D to maximize maternal glycemic control and optimize pregnancy outcomes.
    Keywords:  CGM; continuous; diabetes; glucose; monitoring; pregnancy
    DOI:  https://doi.org/10.1097/GRF.0000000000001010
  2. Front Clin Diabetes Healthc. 2026 ;7 1708124
    Continuous glucose monitoring, diabetes distress, and well-being in adults with type 1 diabetes: findings from a National Survey in Lithuania.
    Jurga Šuminienė, Rimantas Stukas, Virginija Gaigalaite, Dovilė Kriaučiūnienė, Natalja Istomina.
       Background: Continuous glucose monitoring (CGM) has transformed glycemic management in type 1 diabetes (T1D), yet its associations with general well-being remain heterogeneous.
    Objective: To examine associations between glucose monitoring modality and general well-being among adults with T1D in Lithuania and to explore relationships between diabetes distress, hypoglycemia confidence, and well-being, including within predefined higher-risk subgroups.
    Methods: A cross-sectional national online survey was conducted between December 2023 and May 2024 among 368 adults with T1D (171 using flash glucose monitoring [FGM] and 197 using continuous glucose monitoring [CGM]). Participants completed the WHO-5 Well-Being Index, Diabetes Distress Scale (DDS-17), and Hypoglycemia Confidence Scale. Multivariable logistic regression models were used to identify predictors of good well-being (WHO-5 ≥50) and high hypoglycemia confidence (≥3), adjusting for sociodemographic and clinical factors. Median duration of CGM use was 24 months (IQR 12-36).
    Results: Compared with FGM users, CGM users reported lower diabetes distress, higher hypoglycemia confidence, and higher median WHO-5 scores. After adjustment, CGM use was independently associated with high hypoglycemia confidence but not with good general well-being. Better glycemic stability (time in range >70%) and absence of recent acute events were independently associated with higher odds of good well-being. In selected higher-risk subgroups (unemployment, frequent non-severe hypoglycemia, and time in range <70%), CGM users more frequently reported good well-being; these findings represent cross-sectional associations.
    Conclusion: CGM use was associated with improved diabetes-specific emotional outcomes, particularly hypoglycemia confidence. Associations with general well-being appear to operate indirectly through glycemic stability and hypoglycemia-related factors. These findings support integrating CGM into comprehensive, patient-centered diabetes care models, particularly for individuals with elevated psychosocial vulnerability.
    Keywords:  continuous glucose monitoring; diabetes distress; hypoglycemia confidence; type 1 diabetes; well-being
    DOI:  https://doi.org/10.3389/fcdhc.2026.1708124
  3. Diabetes Care. 2026 Mar 30. pii: dc252935. [Epub ahead of print]
    Impact of Missing Data and Monitoring Duration on Downstream Analyses in Continuous Glucose Monitoring.
    Neo Kok, Walter T Williamson, Joyce M Lee, Irina Gaynanova.
       OBJECTIVE: Consensus guidelines recommend at least 14 consecutive days of continuous glucose monitoring (CGM) monitoring with 70% completeness to represent 90-day glycemic exposure. This study quantifies bias and uncertainty introduced into downstream analyses by using CGM metrics from incomplete or reduced monitoring, relative to a 90-day complete profile.
    RESEARCH DESIGN AND METHODS: Using a type 1 diabetes cohort with 1,010 complete 90-day CGM profiles, we simulated incomplete profiles by varying monitoring duration and data completeness. Consensus CGM metrics were computed on incomplete and complete profiles to quantify measurement error, which was propagated into two downstream regression models: 1) CGM metric is an outcome for a binary treatment (clinical trial setting); 2) CGM metric is an explanatory variable (covariate) for another continuous outcome. Bias was quantified using observed-to-true effect size ratios and uncertainty by the sample size increase required to maintain precision.
    RESULTS: In the clinical trial setting, treatment effects remain unbiased but lose precision; for time in range (TIR), 14 days required ≥16% more participants versus 90 days; 30 days required ≥6.5%. When the CGM metric is a covariate, associations with outcomes are attenuated (biased toward zero up to 14% at 14 days and 6% at 30 days for TIR) and less precise.
    CONCLUSIONS: Representing 90 days of glycemic exposure with 14 days can lead to bias and loss of precision in downstream analyses. We recommend study protocols require at least 30 days of CGM monitoring with 70% completeness. If 30 days is not feasible, studies should plan for increased sample sizes.
    DOI:  https://doi.org/10.2337/dc25-2935
  4. AJP Rep. 2026 Jan;16(1): e72-e76
    A Pilot Study Evaluating Associations between Continuous Glucose Monitoring Metrics in Pregnancy and Postpartum A1c and Blood Pressure.
    Chloe F Michalopoulos, Diana C Soria-Contreras, Sarah Hsu, Robin Azevedo, Arantxa Medina Baez, Emily A Rosenberg, Camille E Powe.
       Objective: This study aimed to examine the relationship between continuous glucose monitoring (CGM) metrics during gestational diabetes mellitus (GDM)-affected pregnancy and postpartum cardiometabolic measures in a pilot study.
    Study Design: We enrolled participants >6 months postpartum from a previous GDM trial where they wore a CGM during the third trimester. At the postpartum visit, we assessed hemoglobin A1c (HbA1c) and blood pressure (BP). We used linear regression models adjusted for age and body mass index (BMI) at the time of CGM wear to test for a relationship between pregnancy CGM metrics (mean glucose, coefficient of variation, time in pregnancy range 63-140 mg/dL [pTIR], time >120 and >140 mg/dL) and postpartum outcomes (HbA1c and BP).
    Results: Of 14 eligible participants with pregnancy CGM data, 11 (79%) returned at a mean of 20.3 months postpartum (range 11-33). Age and BMI during pregnancy CGM wear were 36.0 (2.7) years and 28.7 (5.5) kg/m 2 ; gestational age was 32.0 (2.0) weeks. Higher pTIR was associated with lower postpartum HbA1c ( n  = 8, β = -0.06, p  = 0.007). Other CGM metrics were not associated with HbA1c. There were no associations between CGM metrics and BP.
    Conclusion: Third-trimester CGM pTIR should be tested as a predictor of postpartum glycemia in a larger study.
    Keywords:  continuous glucose monitoring; diabetes risk assessment; gestational diabetes; pilot and feasibility study; pregnancy
    DOI:  https://doi.org/10.1055/a-2837-6898
  5. J Diabetes Investig. 2026 Apr 01.
    Cost-effectiveness analysis comparing real-time continuous glucose monitoring with self-monitoring of blood glucose for patients with type 2 diabetes treated with insulin in Japan.
    Hirotaka Watada, Shiro Tanaka, Jessica Y Matuoka, Hamza Alshannaq, Richard F Pollock, Martin Field, Gregory J Norman.
       INTRODUCTION: Real-time continuous glucose monitoring (rt-CGM) systems are associated with reductions in glycated hemoglobin (HbA1c) and hypoglycemic events compared with self-monitoring of blood glucose (SMBG). This analysis aimed to assess the cost-effectiveness of rt-CGM compared with SMBG in the management of people with T2D who require insulin treatment in Japan.
    MATERIALS AND METHODS: A lifetime economic evaluation was conducted using the IQVIA Core Diabetes Model, version 10. Effectiveness data were obtained from a randomized controlled trial that showed rt-CGM reduced HbA1c by 0.9% compared to SMBG. Cohort characteristics and cost data were primarily sourced from Japanese studies. Costs were inflated to 2023 Japanese Yen (JPY) and discounted at 2.0% per annum. The robustness of the base case results was subsequently assessed through sensitivity analyses.
    RESULTS: In the base case, there was an incremental gain of 1.501 quality-adjusted life years (QALYs) favoring rt-CGM at an incremental cost of JPY 500,192, resulting in an incremental cost-effectiveness ratio (ICER) of JPY 333,150/QALY gained. This was far below the assumed willingness-to-pay (WTP) threshold of JPY 5,000,000/QALY gained. The result was robust in sensitivity analyses, with all scenarios tested also returning ICERs below the WTP threshold. When examining projected clinical outcomes, rt-CGM was associated with reductions in the incidence of the majority of complications considered.
    CONCLUSIONS: From a Japanese healthcare perspective, rt-CGM is highly cost-effective for the glycemic management of people with T2D who require insulin treatment.
    Keywords:  Continuous glucose monitoring; General diabetes; Health economics
    DOI:  https://doi.org/10.1111/jdi.70279
  6. Ann Pediatr Endocrinol Metab. 2026 Apr 01.
    Clinical accuracy of Dexcom G6 and G7 continuous glucose monitors in hospitalized pediatric patients with type 1 diabetes: a real-world study.
    Dong Jun Ha, Ha Kyoung Lee, Jeong Ho Han, Mi Yang, Hwa Young Kim, Jaehyun Kim.
       Purpose: Continuous glucose monitoring (CGM) is being increasingly utilized in inpatient pediatric diabetes care; however, data on its real-world accuracy remain limited.
    Methods: We retrospectively assessed the clinical accuracy of factory-calibrated Dexcom G6 and G7 CGM systems in 69 pediatric patients with type 1 diabetes at a Korean tertiary hospital between 2019 and 2025. A total of 1838 CGM readings were temporally paired with point-of-care (POC) capillary glucose measurements. Accuracy was evaluated using the mean absolute relative difference (MARD), mean absolute difference (MAD), Bland-Altman analysis, and Clarke error grid classification. Subgroup analyses were performed according to the sensor day, glucose range, care setting, and CGM type.
    Results: The overall MARD was 10.6±10.1% and MAD was 15.4±16.2 mg/dL. Accuracy improved over time, with MARD declining from 13.8% (G6) and 11.0% (G7) on Day 1 to <10% on Days 6 and 4, respectively. Bland-Altman limits narrowed from ±60 to ±39 mg/dL. During Days 6-11, 86% of CGM-POC pairs were within Clarke Zone A and 97% in Zones A+B. The MAD increased with higher glucose levels, whereas the MARD was highest during hypoglycemia (15.2%) and lowest during hyperglycemia (8.5%). ICU admission significantly increased the MAD (p=0.001) without affecting the MARD. G7 demonstrated superior accuracy to G6 (pooled MARD: 9.8% vs. 11.2%, p=0.003). Mixed-effects modeling confirmed that sensor day was an independent predictor of accuracy improvement (-0.34% MARD/d, p<0.001).
    Conclusion: The Dexcom G6 and G7 CGMs met the ISO 15197:2013 and FDA integrated-CGM criteria after a short inpatient stabilization period.
    Keywords:  Continuous glucose monitoring; Diabetes Mellitus Type 1; Hospitalization; Point-of-Care Systems; Retrospective Studies
    DOI:  https://doi.org/10.6065/apem.2550338.169
  7. Diabetes Care. 2026 Mar 31. pii: dc252724. [Epub ahead of print]
    Accuracy of Continuous Glucose Monitoring in Adults With Postbariatric Hypoglycemia After Roux-en-Y Gastric Bypass Surgery Under Stable and Dynamic Glucose Conditions.
    Aritz Lizoain, Martina Vettoretti, Antonio Ferreira, Katja A Schönenberger, Olivia Streicher, Eva Rolfes, Vincent Braunack-Mayer, Andrea Facchinetti, David Herzig, Martina Rothenbühler, Lia Bally.
       OBJECTIVE: Although continuous glucose monitors (CGMs) are increasingly used to detect and manage postbariatric hypoglycemia (PBH) and associated glucose variability, data on their accuracy in this population remain scarce.
    RESEARCH DESIGN AND METHODS: We retrospectively assessed the accuracy of the Dexcom G6 CGM system in adults with PBH after Roux-en-Y gastric bypass (RYGB) surgery (n = 70). Glucose excursions were induced using a standardized solid mixed-meal test, and reference blood glucose (BG) values were obtained through repeated venous whole-blood sampling. CGM accuracy was analyzed separately during stable and dynamic postmeal glucose periods, with dynamic phases stratified according to magnitude and direction of the rate of change (RoC). We further estimated the lag time for each sensor and examined predictive factors affecting CGM accuracy.
    RESULTS: A total of 1,822 CGM-BG pairs obtained with 70 individuals were included in the analysis. Mean absolute relative differences at stable and dynamic levels were 9.6% and 16.4%, respectively. After the meal test, 67.6% of pairs had CGM values within 15%, or 15 mg/dL of the reference BG; 78.0% within 20%, or 20 mg/dL; and 90.8% within 30%, or 30 mg/dL. Performance was worse at rapid plasma glucose decline (>1.5 mg/dL/min), and CGM values at the time of plasma glucose nadir were systematically higher (bias, 8.2 mg/dL). Plasma-interstitium time delay was estimated at 9.8 min. No participant or sensor characteristic had a significant impact on CGM accuracy.
    CONCLUSIONS: Meal-induced glucose dynamics, particularly rapid declines, challenge CGM accuracy in people with PBH and must be carefully considered when diagnosing or managing the condition.
    DOI:  https://doi.org/10.2337/dc25-2724
  8. Diabetes Care. 2026 Apr 02. pii: dc253055. [Epub ahead of print]
    Comparison of the Continuous Glucose Monitoring Profiles of Four Glucose-Lowering Medications in the GRADE Randomized Trial.
    GRADE Research Group*
       OBJECTIVE: Glycemic management metrics derived from continuous glucose monitoring (CGM) are increasingly recognized as important therapeutic targets. We performed one of the first comparisons of CGM metrics and achievement of CGM targets among four classes of glucose-lowering medications in combination with metformin.
    RESEARCH DESIGN AND METHODS: The Glycemia Reduction Approaches in Diabetes (GRADE) study randomly assigned participants with type 2 diabetes and taking metformin to add one of four glucose-lowering medications (insulin glargine, glimepiride, liraglutide, or sitagliptin) and followed them for glycemic outcomes for 5 ± 1.3 years. A 2-week masked CGM analysis was conducted midstudy in 1,080 participants to evaluate CGM metrics, 24-h ambulatory glucose profile, and achievement of consensus goals. Treatment effects among the four groups were compared.
    RESULTS: The sitagliptin and liraglutide groups had the highest time in range 70-180 mg/dL (TIR70-180) and the lowest time below range <70 mg/dL (TBR<70) and percentage coefficient of variation (%CV). The glimepiride group had the lowest TIR70-180, and the highest %CV, TBR<70, and number of CGM-derived hypoglycemic events (P < 0.001), and was the only drug showing daytime hypoglycemia. Sitagliptin and liraglutide were best for achieving consensus goals of very low TBR<54 <1% and the combined metric of TIR70-180 >70% and TBR<70 <4% (P < 0.001). When stratified by HbA1c, mean glucose did not differ among treatments, but %CV and TBR<70 were higher with glargine and glimepiride within each HbA1c stratum.
    CONCLUSIONS: Incretin class drugs had the lowest %CV, the least hypoglycemia, and best achievement of CGM-based glycemic targets. CGM metrics and profiles provide clinical insights, beyond HbA1c, to guide diabetes management.
    DOI:  https://doi.org/10.2337/dc25-3055
  9. BMC Geriatr. 2026 Mar 31.
    Healthcare professionals' experiences with the use of continuous glucose monitoring in nursing homes and home healthcare services: a qualitative study.
    Anne Merete Vik Aslestad, Anne Haugstvedt, Monica Hermann.
      
    Keywords:  CGM; Continuous glucose monitoring; Diabetes; Glucose monitoring; Healthcare worker; Insulin; Nursing home; Qualitative study
    DOI:  https://doi.org/10.1186/s12877-026-07414-w
  10. Can J Kidney Health Dis. 2026 ;13 20543581251414602
    Acceptability of and Barriers to Continuous Glucose Monitoring in Individuals with Type 2 Diabetes Mellitus Receiving Chronic Hemodialysis: Research Letter.
    Brigitte H Baragar, Ashley K Seitz, Carmen A Hurd, Clara J Bohm.
      Continuous glucose monitoring (CGM) in individuals receiving hemodialysis is more accurate than hemoglobin A1c (HbA1c) and may improve diabetes management in this population, but little is known regarding patient perspectives on CGM technology and its use in clinical outpatient hemodialysis care. We aimed to explore the real-world acceptability of CGM use in nonhospitalized individuals receiving hemodialysis. This pragmatic prospective observational study was nested within a qualitative improvement initiative that embedded an endocrinologist providing care for people with type 2 diabetes mellitus and HbA1c greater than 8% within the hemodialysis unit. As part of this initiative, some people seen by the endocrinologist were prescribed CGMs. These individuals were approached to participate in the study and followed for 2 weeks during CGM wear. Reasons for CGM decline were collected and collated inductively using content analysis. Of 47 consults, only 22 (47%) people were prescribed CGM. Of these, six (27%) declined CGM use and only six (27%) consented to the study, but ultimately only three participants (13.6%) completed the study. Reasons for CGM decline included lack of comfort with technology, cost and poor cellphone, internet and data availability. Our findings suggest that further exploration of barriers to CGM use and solutions to these barriers is required prior to broad use of CGM in real-world outpatient hemodialysis settings.
    Keywords:  continuous glucose monitoring; diabetes mellitus; feasibility; hemodialysis
    DOI:  https://doi.org/10.1177/20543581251414602
  11. Clin Med (Lond). 2026 Mar 27. pii: S1470-2118(26)00027-8. [Epub ahead of print] 100578
    Commentary on 'Diabetes and Technology - An Update for the General Physician'.
    Prajakta Udmale, Vaishali Khobragade, Aparna Dixit.
      
    Keywords:  Continuous Glucose Monitoring (CGM); Diabetes Technology; Glycemic Control; Hybrid Closed-Loop Systems (HCL); Primary Care Practice
    DOI:  https://doi.org/10.1016/j.clinme.2026.100578
  12. Diabet Med. 2026 Mar 29. e70301
    Exploring the gap between sensor-detected (SDH) and person-reported hypoglycaemia (PRH): The voice of people living with diabetes.
    Hypo‐RESOLVE consortium
       BACKGROUND AND AIMS: In people with insulin-treated diabetes experiencing hypoglycaemia, the multicentre Hypo-METRICS study found that 60% of sensor-detected hypoglycaemic episodes (SDH) were asymptomatic, and over 40% of person-reported hypoglycaemia (PRH) occurred at glucose levels ≥70 mg/dL (3.9 mmol/L). This subanalysis explored participants' experiences of these episodes to identify possible clinical implications.
    METHODS: Fifty-eight Austrian participants received a 15-item questionnaire on their experience of asymptomatic hypoglycaemia and symptoms at glucose levels ≥70 mg/dL (3.9 mmol/L).
    RESULTS: The response rate was 86% (n = 50). Among all participants, 56% (n = 28) reported experiencing hypoglycaemic symptoms at glucose levels ≥70 mg/dL (3.9 mmol/L) "sometimes" or "often." They attributed this to a combination of a threshold shift due to chronic hyperglycaemia, rapid glucose decline and fear of hypoglycaemia. 68% of all SDH < 70 mg/dL and 59% of those below the clinically critical level of 54 mg/dL were asymptomatic.
    CONCLUSION: These results demonstrate that SDH and PRH each capture different, yet equally important, dimensions of the hypoglycaemia experience. Relying on only one source of information inevitably provides an incomplete picture. By integrating the patient's voice, diabetes professionals can provide appropriate support and tailor continuous glucose monitoring (CGM) alarm settings and treatment plans to truly meet individual needs.
    Keywords:  continuous blood glucose monitoring; diabetes; patient experience; type 1 diabetes; type 2 diabetes
    DOI:  https://doi.org/10.1111/dme.70301
  13. Diabetes Care. 2026 Mar 31. pii: dc252383. [Epub ahead of print]
    The Association Between Ambient Temperature and Hypoglycemia in People Living With Type 1 Diabetes: A Case Time Series Analysis Using Real-Time Continuous Glucose Monitoring.
    Harriet E Daultrey, Nick S Oliver, Ali J Chakera, Arturo de la Cruz Libardi, Collins C Iwuji, Antonio Gasparrini.
       OBJECTIVE: To investigate the short-term association between ambient temperature and risk of hypoglycemia in adults with type 1 diabetes mellitus (T1DM). We hypothesized that higher ambient temperature would increase the odds of hypoglycemia developing.
    RESEARCH DESIGN AND METHODS: We applied a case time series design to assess the longitudinal association between ambient temperature and hypoglycemia measured using routine continuous glucose monitoring data from individuals with T1DM. A quasi-binomial fixed-effect regression with distributed lag nonlinear models was used to estimate potentially nonlinear and lagged risks of nonoptimal temperature on hypoglycemic episodes, defined as ≥15 min of glucose concentration <3.9 mmol/L. The model was adjusted for long-term trends, seasonality, day of the week, and public holidays. A secondary outcome was change in daily mean glucose concentration.
    RESULTS: We analyzed 32,966,282 glucose readings from 679 adults with T1DM attending two National Health Service clinics in Sussex, England, between 2017 and 2024. Higher ambient temperatures were associated with an increased risk of hypoglycemia. The risk increased nonlinearly for temperatures above 13°C, with the odds ratio reaching 1.26 (95% CI 1.13-1.26) at 25°C. The strongest effect was observed on the same day of the exposure, and it diminished over subsequent days. In the secondary analysis, higher temperatures were associated with lower mean glucose levels.
    CONCLUSIONS: Elevated ambient temperature significantly increases the short-term risk of hypoglycemia in adults with T1DM. These findings are specific to the U.K. population and climate, which may limit generalizability. Our results support anticipatory insulin adjustments during hot weather and consideration of ambient temperature in hybrid closed-loop insulin algorithms.
    DOI:  https://doi.org/10.2337/dc25-2383
  14. Diabetes Metab Syndr Obes. 2026 ;19 557994
    Transition from Continuous Subcutaneous Insulin Infusion to IDeg-Based Regimens in Hospitalized T2DM Patients: A Single-Center Retrospective Analysis.
    Ruiqing Dong, Lifan Gu, Heping Li, Yuanna Hu, Hui Liu, Xuna Kou, Yukun Zhao, Meng Zhao, Bingyin Shi, Hui Guo, Wei Qiang.
       Background: Chinese patients with type 2 diabetes mellitus (T2DM) often initiate insulin therapy in the hospital, requiring rapid glycemic control and simplified post-discharge plans. Few clinical studies have focused on the transition protocols for continuous subcutaneous insulin infusion (CSII).
    Objective: To evaluate the efficacy, safety, and patient satisfaction of transitioning from CSII to three treatment regimens: insulin degludec (IDeg), insulin degludec/insulin aspart (IDegAsp), or insulin degludec and liraglutide (IDegLira).
    Methods: Clinical information and continuous glucose monitoring (CGM) data were retrospectively collected from 171 patients in a single center. Patient satisfaction and quality of life were assessed using standardized questionnaires in a three-month follow-up.
    Results: After transition, mean glucose (MG) and glucose management indicator (GMI) decreased, while time in range (TIR) increased significantly. Coefficient of variation (CV) and time above range (TAR) decreased. Time below range (TBR) was unchanged in IDegAsp and IDegLira groups but slightly increased in the IDeg group (0.60% [0.00%, 1.60%] vs 1.10% [0.00%, 3.40%], P = 0.003). IDegAsp and IDegLira groups showed higher TIR and lower MG, GMI, CV, TAR, and TBR. 64.3% of IDegLira patients required one or fewer additional medications. Patient satisfaction was highest in the IDegLira group, with hypoglycemia avoidance, better weight management, fatigue prevention and less anxiety.
    Conclusion: All three regimens enabled a smooth transition after CSII therapy. IDegAsp and IDegLira demonstrated superior glycemic control and reduced variability compared to IDeg. IDegLira was more convenient and associated with higher patient satisfaction.
    Keywords:  continuous glucose monitoring; insulin degludec; insulin degludec and liraglutide; insulin degludec/insulin aspart; type 2 diabetes mellitus
    DOI:  https://doi.org/10.2147/DMSO.S557994
  15. Br J Hosp Med (Lond). 2026 Mar 11. 87(3): 51727
    The Dawn Phenomenon Exacerbates Post-Breakfast Hyperglycemia in Type 2 Diabetes Mellitus: A Cross-Sectional Continuous Glucose Monitoring Study.
    Wen Tan, Jing Zhang, Cuiping Jiang, Yuxin Huang, Xiaoming Tao.
       AIMS/BACKGROUND: The dawn phenomenon (DP), characterized by spontaneous morning hyperglycemia in type 2 diabetes mellitus (T2DM), may exacerbate post-breakfast glucose excursions. This study investigated the association between DP and postprandial hyperglycemia, referred to as the "extended dawn phenomenon".
    METHODS: In this cross-sectional study, 500 T2DM patients (glycated hemoglobin A1c (HbA1c) <7.5%) were recruited from Huadong Hospital, Fudan University between 2021 and 2023. A total of 40 participants were excluded due to incomplete data, resulting in 460 patients for final analysis. All participants underwent continuous glucose monitoring (CGM) and were stratified by the magnitude of DP (δDawn, defined as the difference between fasting glucose and nocturnal nadir glucose, with a threshold of ≥1.11 mmol/L). They were then matched by fasting glucose. Glycemic profiles, including peak post-breakfast glucose and time-in-range (TIR; percentage of time within the target glucose range of 3.9-10.0 mmol/L), were compared between groups. Multivariable logistic regression was used to identify determinants of post-breakfast hyperglycemia.
    RESULTS: Despite comparable fasting glucose levels, patients with DP exhibited higher peak post-breakfast glucose (median (interquartile ranges [IQR]): 9.7 [8.2-10.7] vs 8.9 [8.0-10.0] mmol/L, p = 0.02) and reduced TIR in the overall cohort (94.1% [85.8-100.0] vs 100.0% [92.3-100.0], p < 0.001), although this difference attenuated after matching (p = 0.133). δDawn independently predicted post-breakfast hyperglycemia (odds ratio (OR) = 1.591, 95% confidence interval (CI): 1.283-1.993, p < 0.001), along with HbA1c (OR = 2.322, 95% CI: 1.530-3.566, p < 0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (OR = 1.308, 95% CI: 1.110-1.548, p = 0.001), and homeostasis model assessment of β-cell function (HOMA-β) (OR = 0.990, 95% CI: 0.983-0.997, p = 0.004).
    CONCLUSION: DP contributes to prolonged postprandial hyperglycemia, underscoring its role as a potential therapeutic target for optimizing glycemic control in T2DM.
    Keywords:  continuous glucose monitoring; postprandial hyperglycemia; type 2 diabetes mellitus
    DOI:  https://doi.org/10.31083/BJHM51727
  16. J Am Geriatr Soc. 2026 Mar 31.
    Burden and Risk Factors of CGM-Detected Hypoglycemia in Older Adults With Type 2 Diabetes.
    Michael Fang, Natalie Rula Daya, Yein Jeon, Justin B Echouffo-Tcheugui, B Gwen Windham, Scott Zeger, Elizabeth Selvin.
       BACKGROUND: Comprehensive data on the burden of biochemical hypoglycemia in older adults with type 2 diabetes are lacking. We seek to characterize the burden and risk factors for hypoglycemia detected by continuous glucose monitoring (CGM) in older adults with type 2 diabetes.
    METHODS: A cross-sectional analysis of 315 older adults with type 2 diabetes who attended visit 9 of the Atherosclerosis Risk in Communities Study (2021-2022). We examined rates of Level 1 hypoglycemia (< 70 mg/dL) and percentage meeting recommended targets for hypoglycemia (< 1% of time). We identified risk factors for CGM-detected hypoglycemia by comparing the median time spent in hypoglycemia across subgroups. All analyses were stratified by high-risk medication use (insulin/sulfonylureas vs. not).
    RESULTS: Of the 315 participants with type 2 diabetes (mean age 83 years, 55% women, 41% Black adults), 32.4% were using insulin or sulfonylureas. Among individuals using these high-risk medications, the median time spent in hypoglycemia was 3.4%, and ~66% of participants spent more than 1% of the time with CGM glucose < 70 mg/dL. Hypoglycemic episodes typically occurred overnight and lasted a median of ~1.5 h among individuals using insulin or sulfonylureas. CGM-detected hypoglycemia was low in participants not using high-risk medications (median time spent in hypoglycemia: 0.7%). In unadjusted analyses, cardiovascular disease, cognitive impairment, poor physical functioning, and chronic kidney disease were associated with increased time spent in hypoglycemia, regardless of high-risk medication use.
    CONCLUSIONS: There may be a substantial burden of unrecognized CGM-detected hypoglycemia in very old adults with type 2 diabetes using high-risk medications in the general population. Hypoglycemia may also be present among persons not on high-risk medication, but the burden is much lower. Further research is needed to clarify the clinical significance of these hypoglycemic episodes.
    Keywords:  continuous glucose monitoring; correlates/correlation; diabetes in elderly; glucose monitoring technologies; hypoglycemia
    DOI:  https://doi.org/10.1111/jgs.70412
  17. J Diabetes Sci Technol. 2026 Apr 03. 19322968261436830
    The dt-Report: A Novel Real-World Data Approach to Understanding the Use and Impact of Diabetes Technology in European Countries.
    Derek Brandt, Norbert Hermanns, Dominic Ehrmann, Bernhard Kulzer, Peter Diem, Javier Ampudia-Blasco, Julia K Mader, Gabriele Faber-Heinemann, Lutz Heinemann.
      Usage of diabetes technology by people living with diabetes does help them a lot with their daily diabetes management burden. Evidence for the efficacy of using systems for continuous glucose monitoring, automated insulin delivery, and so on has largely been derived from randomized controlled trials, which are pivotal for regulatory approvals and reimbursement decisions. However, evidence obtained from real-world usage of technology is crucial as it confirms the benefits also under such conditions. Data obtained from a detailed survey answered by health care professionals and people living with diabetes provides further insights into the reality of usage. They also help to understand the hurdles in daily life and what can be done to overcome these. In this special theme issue, a set of specific topics is addressed that are of academic and clinical importance: dropouts from automated insulin delivery systems, technology use in people living with type 2 diabetes, technology and aging, smart insulin pens, and green diabetes. The data basis for the analysis presented in these manuscripts is from Germany, Austria, and Switzerland. In the future, data from other European Countries will complement the insights gained. This will help to understand the similarities and differences between these countries, which have specific differences in their health care systems. This can lead to subsequent activities in the different countries to improve the clinical care of people living with diabetes.
    Keywords:  AID systems; CGM systems; HCPs; RCT; insulin pens; insulin pumps
    DOI:  https://doi.org/10.1177/19322968261436830
  18. Diabetes Res Clin Pract. 2026 Mar 31. pii: S0168-8227(26)00139-7. [Epub ahead of print] 113220
    Meeting time in range and time below range targets is not associated with psychological outcomes in type 1 or insulin-treated type 2 diabetes in the Hypo-METRICS study.
    Hypo-RESOLVE Consortium
      Meeting the composite target of time in range (TIR) >70% and time below range (TBR) <4% was not associated with differences in diabetes distress, fear of hypoglycaemia, depression, or anxiety in participants with type 1 (T1D) or insulin-treated type 2 diabetes (T2D) in the Hypo-METRICS study. >50% of all participants reported moderate-to-high diabetes distress, highlighting the need for routine screening.
    Keywords:  Anxiety; Continuous glucose monitoring (CGM); Depression; Diabetes distress; Fear of hypoglycaemia; Hypoglycaemia; Psychological outcomes; Time below range (TBR); Time in range (TIR)
    DOI:  https://doi.org/10.1016/j.diabres.2026.113220
  19. Comput Methods Biomech Biomed Engin. 2026 Mar 28. 1-5
    A novel way to represent weekly blood sugar data to increase user understanding and control.
    Peter J Kyberd, Alix Chadwell, Matthew Lee, Farooq Othman Farooq Al Safi.
       BACKGROUND: Tight control of blood glucose is associated with good health. This is easier to achieve with continuous glucose monitoring. However, patients need to be able to interpret the data without reference to experts. Simplifying the visual display, can simplify decisions. Appropriate display of data can lead to improved control and health.
    METHODS: A novel method to display data: Mapping time series data onto a spiral - one day is a single turn, a week is seven. The colour of the line is related to the blood sugar level.
    RESULTS: Plots which are simpler and easier to interpret.
    Keywords:  Blood glucose; diabetes mellitus; glycated haemoglobin A; self-monitoring
    DOI:  https://doi.org/10.1080/10255842.2026.2645166
  20. Cureus. 2026 Feb;18(2): e104228
    Insulin Glulisine Versus Regular Human Insulin for Prednisolone-Associated Hyperglycemia Assessed by Continuous Glucose Monitoring: An Open-Label Crossover Study.
    Hiroki Takizawa, Hirotsugu Uzawa, Masahiro Masuzawa, Osamu Ogawa.
       BACKGROUND: Steroid (glucocorticoid)-induced hyperglycemia is common in hospitalized patients treated with prednisolone and often requires prandial insulin. Evidence is limited regarding whether rapid-acting insulin analogs provide different glycemic profiles compared with regular human insulin under protocol-based titration.
    METHODS: We conducted a single-center, non-randomized, open-label, crossover study in hospitalized adults with type 2 diabetes or steroid-induced diabetes who were receiving morning oral prednisolone (≥5 mg/day) and required insulin therapy. After an insulin dose-adjustment period (with non-insulin agents withheld throughout the dose-adjustment and study periods), participants received insulin glulisine and regular human insulin on consecutive study days without a washout interval, switching unit-for-unit at identical pre-meal doses. Glucose profiles were assessed using continuous glucose monitoring (CGM). Primary endpoints were total glucose area under the curve (AUC) over 0-24 hours and time-segment AUCs (0-8, 8-12, 12-18, and 18-24 hours).
    RESULTS: Thirteen of 26 eligible patients provided informed consent; six were excluded because >25% of expected CGM readings were missing, all due to device-related recording issues, leaving seven patients for analysis. The total AUC did not differ between insulin glulisine and regular human insulin (118.02 ± 30.95 vs 117.41 ± 30.20 ×10^2 mmol/L·min; P = 0.925), and no significant differences were observed in time-segment AUCs. Mean glucose, maximum glucose, minimum glucose, mean amplitude of glycemic excursions, and time-in-range metrics were similar. Coefficient of variation was lower with insulin glulisine (28.81 ± 9.05% vs 34.55 ± 8.96%; P = 0.034). In an exploratory post hoc analysis within a 30-minute time window around 16:00, AUC, mean glucose, and maximum glucose were lower with regular human insulin than with insulin glulisine (P < 0.05).
    CONCLUSIONS: Under protocol-based titration during prednisolone treatment, insulin glulisine and regular human insulin produced comparable overall 24-hour glucose exposure. Findings on glycemic variability and post hoc time window analyses should be interpreted as exploratory and warrant confirmation in larger studies.
    Keywords:  continuous glucose monitoring; crossover study; insulin glulisine; regular human insulin; steroid-induced hyperglycemia
    DOI:  https://doi.org/10.7759/cureus.104228
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