bims-glumda Biomed News
on CGM data in management of diabetes
Issue of 2026–07–19
nineteen papers selected by
Mott Given
  1. A Prospective Multicenter Assessment of the Accuracy and Safety of the Yuwell CT3 Real-Time Continuous Glucose Monitoring System in Patients With Diabetes Over 14 Days.
  2. Wearable Blood Sugar Alert Gadget for Continuous Glucose Monitoring and Glycemic Notifications: A Futuristic Concept.
  3. Continuous glucose monitoring in spanish primary care: Current situation and Delphi consensus to inform clinical practice recommendations.
  4. Association of Variability of Monthly Continuous Glucose Monitoring-Derived Metrics With Diabetic Kidney Disease in Type 1 Diabetes.
  5. Impact of national continuous glucose monitoring reimbursement on utilization and glycemic outcomes in children and adolescents with type 1 diabetes.
  6. Continuous glucose monitoring characteristics of common MODY subtypes and their clinical applications: a review.
  7. Use of continuous glucose monitoring (CGM) in diabetes management in Africa: opportunities, challenges, and future prospects.
  8. US race/ethnic disparities in diabetes technologies: a systematic review and meta-analysis of 950 000 individuals.
  9. Real-world comparative effectiveness of analogue and human insulin on glycemic control in children and adolescents with Type 1 diabetes in Lebanon using continuous glucose monitoring data.
  10. Understanding parents' perspectives of repeated blinded continuous glucose monitoring in children with early-stage type 1 diabetes and an affected first-degree relative.
  11. Exploring the feasibility and acceptability of Continuous Glucose Monitoring among people with type 1 diabetes and healthcare providers in South Africa's public sector: A qualitative study.
  12. User satisfaction with fingerstick versus continuous glucose monitoring in surgical wards: A two-centre non-randomised clinical trial.
  13. Glycemic variability and muscle loss in elderly type 2 diabetes: insights from continuous glucose monitoring and chest CT in 303 patients.
  14. When Headache Signals Hypoglycemia: Clinical Recognition and Management.
  15. CGM access in Pakistan: Extending the LMIC diabetes technology gap beyond Brazil.
  16. Early Dysglycemia Detected by Continuous Glucose Monitoring in a 6-Year-Old Child with Cystic Fibrosis: A Case Report.
  17. The Role of Sensor-Derived Daily Glycemic Variability in Treatment-Requiring Diabetic Ocular Disease: A Retrospective Case-Control Study.
  18. Association between the glycemic risk index and peripheral atherosclerosis in hospitalized patients with type 2 diabetes: a cross-sectional study.
  19. Sleep patterns and glycemia in adults with cystic fibrosis-related diabetes: a remote pilot study.
  1. J Diabetes. 2026 Jul;18(7): e70246
    A Prospective Multicenter Assessment of the Accuracy and Safety of the Yuwell CT3 Real-Time Continuous Glucose Monitoring System in Patients With Diabetes Over 14 Days.
    Lingli Zhou, Yufeng Li, Xingguang Zhang, Hongwei Ling, Yibing Lu, Linong Ji.
      This 14-day multicenter study assessed CT3 CGM accuracy and safety in 71 adults with diabetes. Key results: overall MARD 9.1% (median 7.1%), 82.4%-98.2% met %15/15-%30/30 criteria, 99.7% values in CEG zones A/B. CT3 showed strong performance, suitable for reliable 14-day wear.
    Keywords:  CT3; MARD; accuracy; continuous glucose monitoring; error grid analysis
    DOI:  https://doi.org/10.1111/1753-0407.70246
  2. Iran J Nurs Midwifery Res. 2026 May-Jun;31(3):31(3): 544
    Wearable Blood Sugar Alert Gadget for Continuous Glucose Monitoring and Glycemic Notifications: A Futuristic Concept.
    Hardeep Kaur, Shatrughan Pareek, Yashwant Ramawat.
      
    DOI:  https://doi.org/10.4103/ijnmr.ijnmr_160_25
  3. Prim Care Diabetes. 2026 Jul 11. pii: S1751-9918(26)00124-5. [Epub ahead of print]
    Continuous glucose monitoring in spanish primary care: Current situation and Delphi consensus to inform clinical practice recommendations.
    Consensus Group
       OBJECTIVE: To assess the current situation of continuous glucose monitoring (CGM) use in Spanish primary care (PC) and to agree on CGM-related aspects that should be addressed in future clinical practice recommendations.
    METHODS: This cross-sectional study combined a 29-item survey with a Delphi consensus. The survey explored professional characteristics, regional access, use of CGM, coordination between care levels, training, barriers, and perceived impact on clinical management. The Delphi panel evaluated 131 criteria, assessing consensus via RAND/UCLA method.
    RESULTS: 58 PC healthcare professionals participated (40 physicians, 18 nurses). Participants reported low CGM prescription uptake among eligible people with type 2 diabetes, and identified barriers to broader implementation, particularly lack of CGM integration into electronic medical records (EMRs), limited consultation time, training needs, and suboptimal coordination between primary and hospital care. The main changes perceived as necessary were continuing education, integration of CGM data into EMRs, development of national protocols, and more time per consultation. The Delphi process supported the inclusion of 129 criteria in future recommendations.
    CONCLUSIONS: Spanish PC professionals perceive CGM as a useful tool, but its implementation remains limited by organizational, training, and access-related barriers. Recommendations on CGM use in Spanish PC should be based on this Delphi consensus.
    DOI:  https://doi.org/10.1016/j.pcd.2026.07.007
  4. Diabetes Obes Metab. 2026 Jul 14.
    Association of Variability of Monthly Continuous Glucose Monitoring-Derived Metrics With Diabetic Kidney Disease in Type 1 Diabetes.
    Byeongjae Kang, Rosa Oh, Taeyoung Kim, Jee Hee Yoo, Danbee Kang, Gyuri Kim, Sang-Man Jin, Myung Jin Chung, Jae Hyeon Kim.
       BACKGROUND: While HbA1c is the standard for monitoring long-term glycaemic control, it fails to capture glycaemic variability. We investigated the discriminatory capacity of longitudinal continuous glucose monitoring (CGM) metrics and identified CGM metric patterns associated with diabetic kidney disease (DKD) in individuals with type 1 diabetes (T1D) using machine learning (ML).
    METHODS: We analysed cross-sectional data from 282 T1D patients with 1-year consecutive CGM data. DKD was defined by persistent laboratory abnormalities (urine albumin-creatinine ratio ≥ 30 mg/g or estimated glomerular filtration rate < 60 mL/min/1.73 m2) confirmed by at least two measurements within the 1-year period. LightGBM, XGBoost, Random Forest, and Logistic Regression (LR) were developed. Feature importance was assessed using SHAP analysis.
    RESULTS: The LightGBM model achieved the highest performance (AUROC = 0.91 [95% CI, 0.88-0.93], F1 score = 0.65). All tree-based ML models outperformed the LR model. SHAP analysis identified the standard deviation (SD) of monthly time in range (TIR) and time in tight range (TITR) as the most influential features. In contrast, the CV of sensor glucose did not differ significantly between groups (p = 0.416). Even in the early DKD subgroup, the SD of monthly TIR and TITR remained significantly elevated.
    CONCLUSION: The SD of monthly TIR and TITR is strongly associated with DKD in T1D, whereas the CV of sensor glucose is not. ML-based integration of these longitudinal metrics offers improved discrimination of concurrent DKD status beyond conventional glycaemic markers.
    Keywords:  continuous glucose monitoring; diabetes mellitus type 1; diabetic kidney disease; machine learning
    DOI:  https://doi.org/10.1111/dom.71117
  5. Acta Diabetol. 2026 Jul 15.
    Impact of national continuous glucose monitoring reimbursement on utilization and glycemic outcomes in children and adolescents with type 1 diabetes.
    Leyla Kara.
       BACKGROUND: Continuous glucose monitoring (CGM) use is associated with improved glycaemic outcomes and reduced hypoglycaemia in type 1 diabetes; however, access remains limited due to cost and reimbursement disparities.
    METHODS: This retrospective observational study included children and adolescents with type 1 diabetes followed in a single center. Clinical outcomes before and after reimbursement were compared using paired statistical analyses.
    RESULTS: The implementation of the reimbursement policy in Türkiye was associated with improved access to diabetes technology through reduced financial barriers and with favourable changes in clinical outcomes. CGM usage increased significantly from 26% (n = 11) before reimbursement to 92% (n = 38) after reimbursement. A slight reduction in mean HbA1c levels was observed (from 9.08% to 8.99%). In children under 10 years of age, the proportion achieving target HbA1c levels (< 7%) increased from 16% to 33% (p = 0.042). In addition, a decreasing trend in hypoglycemia frequency and emergency department visits was observed following continuous glucose monitoring use.
    CONCLUSION: The introduction of a national reimbursement policy was associated with a marked increase in access to CGM in children and adolescents with type 1 diabetes. However, changes in glycaemic outcomes were limited and not statistically significant in the overall cohort. These findings suggest that the primary impact of reimbursement was improved adoption of diabetes technology rather than substantial short-term improvement in glycaemic control. Further large-scale studies are needed to evaluate long-term clinical outcomes and patient-reported benefits.
    Keywords:  Children and adolescents; Continuous glucose monitoring; Glycemic outcomes; Reimbursement policy; Type 1 diabetes
    DOI:  https://doi.org/10.1007/s00592-026-02753-x
  6. J Pediatr Endocrinol Metab. 2026 Jul 14.
    Continuous glucose monitoring characteristics of common MODY subtypes and their clinical applications: a review.
    Aibibai Rouzimaimaiti, Jiazireya Zaiyinati, Yanrong Ma, Fuhui Ma, Rui Ma, Yan Hu, Yanying Guo.
       BACKGROUND: Maturity-onset diabetes of the young (MODY) is a heterogeneous monogenic diabetes category caused by defects in genes involved in pancreatic β-cell development, glucose sensing, or insulin secretion. In children, adolescents, and young adults, its clinical presentation may overlap with type 1 diabetes (T1D) or early-onset type 2 diabetes (T2D), which can complicate etiological classification.
    CONTENT: This review examines continuous glucose monitoring (CGM) patterns in HNF1A-, GCK-, HNF4A-, HNF1B-, and KATP channel-related MODY. PubMed/MEDLINE, Embase, Web of Science Core Collection, and Scopus were searched through March 1, 2026, with supplementary citation tracking. Priority was given to genetically confirmed or clearly defined studies reporting CGM/flash glucose monitoring (FGM) metrics, glycemic variability, hypoglycemic exposure, or treatment-transition data.
    SUMMARY AND OUTLOOK: CGM can complement glycated hemoglobin (HbA1c) by showing stable mild hyperglycemia, postprandial excursions, nocturnal or asymptomatic hypoglycemia, and treatment-related fluctuations. It should not be used as a substitute for genetic diagnosis. Multicenter, genetically confirmed studies using standardized CGM metrics are needed to clarify its role in precision management.
    Keywords:  continuous glucose monitoring; maturity-onset diabetes of the young; monogenic diabetes; precision medicine
    DOI:  https://doi.org/10.1515/jpem-2026-0198
  7. Cardiovasc Diabetol Endocrinol Rep. 2026 Jul 14. pii: 41. [Epub ahead of print]12(1):
    Use of continuous glucose monitoring (CGM) in diabetes management in Africa: opportunities, challenges, and future prospects.
    M A Olamoyegun, O D Olamoyegun, A T Akinlade, O O Saliu, T A Adeyemi.
       BACKGROUND: Diabetes mellitus represents a growing public health crisis across Africa, with prevalence rates increasing due to urbanization, lifestyle transitions, and epidemiological transition. Despite numerous technological advances in diabetes management, including continuous glucose monitoring (CGM), access to these innovations remains limited across the continent.
    OBJECTIVE: This narrative review examines the current state, opportunities, challenges, and prospects of CGM technology in African diabetes care, with emphasis on the socioeconomic, infrastructural, and cultural factors influencing implementation.
    METHODS: A comprehensive review of peer-reviewed literature, clinical trials, and implementation studies from African contexts was conducted, incorporating evidence on CGM technology, diabetes epidemiology, healthcare systems, and policy frameworks across African nations.
    RESULTS: CGM technology offers substantial benefits for glycaemic control, complication reduction, and patient empowerment. However, widespread adoption in Africa faces significant barriers including prohibitive costs, limited healthcare infrastructure, supply chain challenges, inadequate healthcare workforce training, and sociocultural factors. Emerging clinical trials in South Africa, Kenya, and Malawi demonstrate feasibility and clinical benefits, though large-scale implementation remains constrained.
    CONCLUSIONS: While CGM holds important potential at transforming African diabetes care, successful integration requires multisectoral collaboration, innovative financing mechanisms, capacity building, and feasible implementation strategies. Policy frameworks that support equitable access, regulatory harmonization, and sustainable scale-up models are essential for realizing CGM's full potential across the continent.
    Keywords:  Africa; Continuous glucose monitoring; Diabetes management; Healthcare technology
    DOI:  https://doi.org/10.1186/s40842-026-00310-7
  8. J Endocr Soc. 2026 Aug;10(8): bvag150
    US race/ethnic disparities in diabetes technologies: a systematic review and meta-analysis of 950 000 individuals.
    Maria L M Rego, Maxim Barnett, Maria Helena Siqueira Tavares de Melo, Ana Rivadeneira.
       Purpose: To provide a descriptive summary and to quantitatively examine racial and ethnic disparities in the use of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) among people living with diabetes in the United States.
    Research Design and Methods: We followed the Cochrane and PRISMA guidelines (PROSPERO: CRD420251124678). Search was conducted on PubMed, Embase, and Cochrane up to August 2025. Observational studies were included if they (1) were conducted in the United States, (2) evaluated the use of CGM/CSII across different races/ethnic groups, and (3) reported odds ratios (ORs) for between-group comparisons. Three-level random-effect meta-analyses examined OR in the use of CGM/CSII across different groups: Non-Hispanic White (NHW; reference group) vs Black/African American, Hispanic, Asian, and Other. Subgroup analyses were conducted for children vs adults, and type 1 vs type 2 diabetes.
    Results: Totally, 1737 studies were screened, and 18 studies were included (N = 955 556 individuals). Most participants were NHW (70.9%). Approximately 40% of individuals had type 2 diabetes, and 98.9% were adults. Black/African Americans (OR = 0.47, 95% CI = 0.38-0.60), Hispanics (OR = 0.59, 95% CI = 0.50-0.69), and "Other" (OR = 0.69, 95% CI = 0.58-0.83) were less likely to use CGM, relative to NHW individuals, while Asians were equally likely. Black/African Americans (OR = 0.31, 95% CI = 0.23-0.42) and Hispanics (OR = 0.48, 95% CI = 0.42-0.55) were less likely to use a CSII when compared to NHW. No analysis was conducted for "Asian" or "Other." Limitations include moderate/substantial heterogeneity and reliance on electronic medical record data.
    Conclusion: Racial and ethnic disparities exist in the use of diabetes technologies. Its recognition is essential to advance solutions that promote equitable care in diabetes.
    Keywords:  continuous glucose monitoring; continuous subcutaneous insulin infusion; diabetes; insulin pump; racial/ethnic disparities
    DOI:  https://doi.org/10.1210/jendso/bvag150
  9. J Comp Eff Res. 2026 Jul 16. e260036
    Real-world comparative effectiveness of analogue and human insulin on glycemic control in children and adolescents with Type 1 diabetes in Lebanon using continuous glucose monitoring data.
    Sahar Masri, Manuel Albela, Iza Ciglenecki, Philippa Boulle, Tania Hachem, Sola Bahous, David Prieto-Merino, Pablo Perel.
      Aim: In high income settings, insulin analogues were associated with improved glycemic control among adults with diabetes, mainly measured through HbA1c and hypoglycemic episodes. In low- and middle-income countries, especially those affected by humanitarian crises, analogue insulins may be helpful as proper diabetes care for this population remains challenging; yet, supporting evidence is lacking. Materials & methods: Routinely collected continuous glucose sensor data from patients with Type 1 diabetes, aged 4 to 18 years old, between April 2019 and December 2022 was retrospectively extracted. Changes in glycemic metrics while using analogue insulins were compared with human insulin using multiple linear regression with random effects. Results: Forty-five patients included in the study used continuous glucose monitor devices for an average duration of 73 days (±53) while using human insulin and 170 days (±83) while using analogue insulins. Compared with human insulin, analogue insulins were associated with an additional 26 min (95% CI; 15, 37, p < 0.001) per day spent within the normal target range and a reduction of 11 min (95% CI; -16, -5) and 10 min (95% CI; -13, -7) in overall and nocturnal hypoglycemia, respectively. Analogue insulin was also associated with a reduction of 6 mg/dl in 24 h mean glucose. Conclusion: Insulin analogues were associated with slight improvements in time within and below range compared with human insulin, yet within patient glycemic variability remains high. Further research is needed to explore its acceptability among patients, impact on quality of life and its cost-effectiveness and sustainability in low resource contexts.
    Keywords:  Type 1 diabetes; analogue insulin; continuous glucose monitoring; hypoglycemia; low-middle income countries; real-world data; time-in-range
    DOI:  https://doi.org/10.57264/cer-2026-0036
  10. Diabet Med. 2026 Jul 14. e70424
    Understanding parents' perspectives of repeated blinded continuous glucose monitoring in children with early-stage type 1 diabetes and an affected first-degree relative.
    ENDIA Study Group
       AIM: To explore the lived experiences of parents of children at risk of type 1 diabetes (T1D) undergoing repeated blinded continuous glucose monitoring (CGM).
    METHOD: Since 2021, children with persistent islet autoimmunity in the Environmental Determinants of Islet Autoimmunity (ENDIA) study have been invited to participate in a sub-study involving blinded Dexcom G6 CGM. Parents with children undergoing repeated CGM participated in a semi-structured audio call interview. Open-ended questions captured their experiences of their child's repeated blinded CGM. Data were analysed using inductive thematic analysis.
    RESULTS: Nineteen parents (18 mothers, 1 father) of children with a mean (SD) age of 7.5 (1.3) years, who had undergone a mean 5.5 (3.2) CGM assessments, were interviewed for a mean duration of 21.3 (8.0) minutes. Three main themes were identified: Challenges of CGM wear: All parents identified at least one difficult experience (e.g. pain with sensor insertion, anxiety of data loss) during CGM assessments Content and timing of feedback of CGM assessment findings: Parents described a range of experiences related to receiving feedback from health care professionals and their child's stage of T1D. Preparation for diagnosis of clinical (Stage 3) T1D and initiation of insulin treatment: Parents described feeling empowered by knowing their child's risk, allowing them to feel more prepared for progression to Stage 3 T1D.
    CONCLUSION: Despite the challenges parents face while their child undergoes CGM assessments, they reported repeated blinded CGM as an acceptable form of monitoring that provided valuable knowledge regarding their child's risk of stage 3 type 1 diabetes.
    Keywords:  CGM; children; early‐stage type 1 diabetes; monitoring; pre‐symptomatic
    DOI:  https://doi.org/10.1111/dme.70424
  11. PLoS One. 2026 ;21(7): e0352590
    Exploring the feasibility and acceptability of Continuous Glucose Monitoring among people with type 1 diabetes and healthcare providers in South Africa's public sector: A qualitative study.
    Lorrein Muhwava, Elena Marbán-Castro, Mpho Silima, Maria Karsas, Tanja Kemp, Johane Freitas, Yvonne Kamau, Beatrice Vetter, Cathy Haldane, Paul Rheeder, Michelle Carrihill, Joel A Dave, Sonjelle Shilton.
       BACKGROUND: Continuous Glucose Monitoring (CGM) is an advancement in diabetes management, offering real-time insights into blood glucose levels and facilitating decision-making around diabetes care. However, its adoption in low- and middle-income countries (LMICs) remains low. This study explored the perceptions and experiences of CGM use among people living with type 1 diabetes (T1D), their caregivers, and healthcare providers (HCPs) in the public sector in South Africa.
    METHODS: Convenience sampling was used to recruit participants from the ACCEDE study - a pragmatic randomised controlled trial on CGM use among people living with T1D in South Africa. Between July 2024 and February 2025, we conducted focus group discussions (FGDs) with recipients of care and caregivers and semi-structured interviews (SSIs) with HCPs across study sites in Cape Town and Pretoria. All FGDs and SSIs were audio-recorded, transcribed, and analysed using MAXQDA 2022. Data analysis followed thematic content analysis, and the findings presented according to the socioecological framework.
    RESULTS: A total of 107 participants, including 75 people living with T1D, 17 caregivers, and 15 HCPs, were included in the study. CGM was generally perceived as acceptable due to convenience, reduced need for finger-prick testing, and enhanced understanding of glucose patterns. Feasibility was enhanced by ease of use, access to training, and social support. Key barriers included cost, limited awareness, and socio-economic constraints such as food insecurity and lack of access to transport.
    CONCLUSION: CGMs are both feasible and acceptable within South Africa's public healthcare context. However, integration requires a coordinated, multi-level response, strengthening provider and patient awareness, knowledge, adequately resourced multi-disciplinary diabetes care teams, and addressing affordability through supportive health policies.
    DOI:  https://doi.org/10.1371/journal.pone.0352590
  12. Diabet Med. 2026 Jul 11. e70422
    User satisfaction with fingerstick versus continuous glucose monitoring in surgical wards: A two-centre non-randomised clinical trial.
    Tine Lumbye Thomsen, Marian Christin Petersen, Line Abrahamsen, Torill Donslund Nielsen, Karoline Schousboe, Sören Möller, Helen Schultz.
       AIMS: To compare person-reported outcomes on point-of-care (POC) fingerstick glucose monitoring (FSGM) with POC continuous glucose monitoring systems (CGMS) in adults admitted to surgical wards. The primary outcome was convenience; the secondary outcome was satisfaction with diabetes-related treatment.
    METHODS: This two-centre non-randomised clinical trial consisted of an initial standard care period with FSGM, followed by a period with POC CGMS. The trial included adults at risk of hypo- or hyperglycaemia in Danish surgical wards who were initially prescribed glucose monitoring at least four times daily and expected to be hospitalised for a minimum of three days. Person-reported outcomes were assessed at discharge using the validated Danish Diabetes Treatment Satisfaction Questionnaire for Inpatients (DTSQ-IP).
    RESULTS: A total of 199 adults were included. Adjusted analyses showed significantly higher convenience (p < 0.0001) and overall satisfaction (p = 0.001) with POC CGMS than with FSGM. CGMS also produced significantly higher adjusted scores for flexibility, willingness to recommend and continue the treatment, quality of communication with staff, time spent with diabetes nurses and the discharge treatment plan. No between-group differences were found in experiences of hypoglycaemia, hyperglycaemia and glucose monitoring or satisfaction with understanding of the treatment, staff knowledge of participants' treatment or responsiveness to needs.
    CONCLUSIONS: Among adults at risk of hypo- or hyperglycaemia in surgical wards, CGMS as POC provided greater convenience and satisfaction than FSGM regardless of diabetes status, reflecting greater comfort with CGMS. No differences were found in user-reported dysglycaemia.
    Keywords:  DTSQ‐IP; continuous glucose monitoring; fingerstick glucose monitoring; questionnaire study; user satisfaction
    DOI:  https://doi.org/10.1111/dme.70422
  13. Front Endocrinol (Lausanne). 2026 ;17 1863226
    Glycemic variability and muscle loss in elderly type 2 diabetes: insights from continuous glucose monitoring and chest CT in 303 patients.
    Xiao-le Zhang, Ning Bai, Chun-Pu Mao, Chun-Yan Liu.
       Purpose: Sarcopenia is common among older adults with type 2 diabetes mellitus (T2DM). Although chronic hyperglycemia is known to contribute to muscle loss, it remains unclear whether glucose fluctuations-independent of average glucose levels-also play a role. This study aimed to investigate the association between glucose fluctuation and pectoralis muscle mass in elderly patients with T2DM.
    Methods: This retrospective cross-sectional study included 303 elderly patients with T2DM who underwent continuous glucose monitoring and chest CT between October 2022 and December 2025. Glycemic variability was assessed using several metrics: coefficient of variation (CV), standard deviation (SD), mean amplitude of glycemic excursions (MAGE), mean of daily differences, time in range, time above range, time below range (TBR), and mean blood glucose. Pectoralis muscle index (PMI) was measured from CT images at the T4 vertebra level. Multivariable linear regression, subgroup analyses, and sensitivity analyses were performed.
    Results: Four glycemic variability indicators-CV, SD, MAGE, and TBR-were independently associated with lower PMI after adjusting for confounders (all P < 0.05). Among these, CV explained the largest proportion of PMI variance (adjusted R² = 0.22), followed by TBR (0.21), SD (0.20), and MAGE (0.19). A linear dose-response relationship was observed between CV and PMI (P for trend < 0.001). The inverse association was stronger in patients with diabetes duration ≥ 10 years (β = -0.18, P < 0.001) and those with BMI < 24 kg/m² (β = -0.18, P < 0.001), with significant interactions for both subgroups (P = 0.022 and 0.027, respectively). Sensitivity analyses confirmed the robustness of these findings.
    Conclusions: Greater glycemic variability is independently associated with lower pectoralis muscle mass in elderly patients with T2DM, especially among those with longer disease duration or normal body weight. Stabilizing glucose fluctuations may be an important consideration for preserving muscle mass in this population.
    Keywords:  continuous glucose monitoring; elderly; glucose variability; sarcopenia; type 2 diabetes mellitus
    DOI:  https://doi.org/10.3389/fendo.2026.1863226
  14. Am J Med Sci. 2026 Jul 16. pii: S0002-9629(26)00273-9. [Epub ahead of print]
    When Headache Signals Hypoglycemia: Clinical Recognition and Management.
    Brian Burroughs.
      Headache is an underrecognized manifestation of hypoglycemia in individuals with diabetes. Although hypoglycemia is well known to produce autonomic and neuroglycopenic symptoms, headache is frequently overlooked as a potential indicator of low glucose, which may lead to unnecessary diagnostic evaluation and missed opportunities to prevent recurrent episodes. A landmark pre-CGM study reported hypoglycemia-related headache in 43% of insulin-treated individuals experiencing hypoglycemia, although contemporary prevalence estimates remain uncertain.. Recognition of the temporal relationship between headache episodes and glucose fluctuations is essential for accurate diagnosis. Continuous glucose monitoring can help identify symptomatic and asymptomatic hypoglycemia associated with headache and support prevention through real-time alerts and pattern recognition. This review summarizes the pathophysiology, clinical presentation, diagnostic evaluation, and management of hypoglycemia-related headache and provides a practical clinical approach, including a diagnostic algorithm, to assist clinicians in evaluating headache complaints in patients with diabetes.
    Keywords:  Continuous glucose monitoring; Diabetes mellitus; Headache; Hypoglycemia; Migraine
    DOI:  https://doi.org/10.1016/j.amjms.2026.07.005
  15. Diabet Med. 2026 Jul 11. e70428
    CGM access in Pakistan: Extending the LMIC diabetes technology gap beyond Brazil.
    Saim Jan.
      
    DOI:  https://doi.org/10.1111/dme.70428
  16. Pediatr Allergy Immunol Pulmonol. 2026 Jul 13. 2151321X261469365
    Early Dysglycemia Detected by Continuous Glucose Monitoring in a 6-Year-Old Child with Cystic Fibrosis: A Case Report.
    Busra Baspinar, Merve Nur Tekin, Ayşe Özfer Özçelik, Nazan Çobanoğlu.
      Background:Cystic fibrosis-related diabetes (CFRD) screening is typically recommended from age 10, yet glucose abnormalities may emerge earlier. Conventional screening tools may fail to detect dysglycemia in young children with cystic fibrosis (CF).Case Presentation:A 6-year-old girl with CF and severe pancreatic insufficiency underwent 14-day continuous glucose monitoring (CGM) as part of an observational study on glucose metabolism in pediatric CF patients.Results:CGM detected marked glycemic variability (38.4%), a mean glucose level of 192 mg/dL, and a time in range of 56%, despite only mildly elevated fasting glucose values. Laboratory workup confirmed CFRD (glycated hemoglobin 8.8%). After insulin initiation, pulmonary function improved substantially, with forced expiratory volume increasing from 76% to 97% of predicted within 2 months.Conclusions:CGM may identify clinically significant dysglycemia in young children with CF who would otherwise go undetected by age-based screening. In selected high-risk pediatric CF patients below the standard screening age, CGM may enable earlier diagnosis and timely intervention-a clinical question that warrants prospective investigation.
    Keywords:  case report; continuous glucose monitoring; cystic fibrosis; cystic fibrosis–related diabetes; pediatric dysglycemia
    DOI:  https://doi.org/10.1177/2151321X261469365
  17. Can J Diabetes. 2026 Jul 13. pii: S1499-2671(26)00126-7. [Epub ahead of print]
    The Role of Sensor-Derived Daily Glycemic Variability in Treatment-Requiring Diabetic Ocular Disease: A Retrospective Case-Control Study.
    Kelly Ann Hutchinson, Olivia Calancie, Patrick Wang, Sara Awad, Robert J Campbell, Manpartap Bal.
       PURPOSE: Daily glycemic variability (GV) has been proposed as a contributor to diabetic ocular complications beyond chronic glycemic control. This study evaluated whether sensor-derived GV (coefficient of variation, %CV) is associated with treatment-requiring diabetic ocular disease.
    METHODS: Retrospective case-control study of adults with diabetes followed by Endocrinology at two tertiary hospitals in Kingston, Ontario.
    INCLUSION: diabetes ≥5 years, age ≥18, CGM wear ≥70% over a continuous 90-day period (Jan 2023-May 2024), and a documented eye exam (Jan 2023-Dec 2024). Cases had diabetic ocular treatment (intravitreal injections [IVI], retinal laser, and/or pars plana vitrectomy) identified by OHIP codes (2015-2024) and confirmed by blinded ophthalmology chart review; controls had none. Device-reported 14- and 90-day CGM metrics were extracted. In cases treated between 2022-2024, IVI burden was compared by 90-day %CV (≤36 vs >36) and correlated with CGM metrics.
    RESULTS: Among 485 patients, 72 (14.8%) were cases. Cases were older and had longer diabetes duration than controls (both p<0.0001). There were no differences between cases and controls in 14- or 90-day GV (%CV), mean glucose, or time-in-range. In 57 recently treated cases (2022-2024), IVI burden was higher in the low %CV group than the high %CV group (9.9 vs 6.3; p=0.046). %CV showed a weak negative, non-significant correlation with IVI count, while time-in-range correlated positively with IVI count (r=0.351; p=0.012).
    CONCLUSIONS: Short-term CGM-derived GV was not associated with treatment-requiring diabetic ocular disease. Within recently treated patients, GV-treatment relationships likely reflect care-intensity and disease-stage confounding.
    Keywords:  Coefficient of variation; Continuous glucose monitoring; Diabetes mellitus; Diabetic macular edema; Diabetic retinopathy; Glycemic variability
    DOI:  https://doi.org/10.1016/j.jcjd.2026.06.008
  18. Diabetes Metab. 2026 Jul 11. pii: S1262-3636(26)00058-3. [Epub ahead of print] 101779
    Association between the glycemic risk index and peripheral atherosclerosis in hospitalized patients with type 2 diabetes: a cross-sectional study.
    Li Ruopu, Cheng Dihe, Chen Yan.
       OBJECTIVE: The Glycemic Risk Index (GRI) is a novel composite glycemic indicator, but its role in peripheral atherosclerotic lesions in type 2 diabetes (T2D) remains unclear. This study examined the association between GRI and the severity of peripheral atherosclerotic lesions in T2D patients and assessed its value in identifying high-risk individuals.
    METHODS: This retrospective study included 878 T2D patients hospitalized at the Second Hospital of Jilin University from October 2023 to October 2025. Patients were divided into no-lesion (n=88), single-lesion (n=287), and dual-lesion (n=503) groups by carotid plus lower extremity arterial ultrasound examinations and stratified by GRI quartiles. The performance of GRI in identifying vascular lesion risk was compared with traditional indicators, including TIR and HbA1c. Multivariate ordinal logistic regression and subgroup analyses were conducted.
    RESULTS: Higher GRI quartiles were associated with poorer glycemic control, greater variability, and higher prevalence of peripheral atherosclerosis (86%-95% from Q1 to Q4), while TIR and HbA1c showed no similar trend. After full adjustment, the highest GRI quartile conferred a 76% higher risk of more severe atherosclerosis versus Q1 (OR=1.76, 95%CI:1.15-2.70, P = 0.009; P for trend = 0.002). This association was stronger in overweight patients (BMI≥24 kg/m², P for interaction=0.03).
    CONCLUSION: GRI is independently and positively associated with the severity of peripheral atherosclerotic lesions in T2D and outperforms traditional glycemic indicators, especially in overweight individuals, supporting its clinical use for atherosclerosis risk stratification.
    Keywords:  Continuous glucose monitoring; Glycemic Risk Index; Glycemic variability; Peripheral atherosclerosis; Type 2 diabetes
    DOI:  https://doi.org/10.1016/j.diabet.2026.101779
  19. J Cyst Fibros. 2026 Jul 15. pii: S1569-1993(26)01659-0. [Epub ahead of print]
    Sleep patterns and glycemia in adults with cystic fibrosis-related diabetes: a remote pilot study.
    Anushka Sharma, Evangelos Vassilakis, Hao Deng, Jessica K Salwen-Deremer, Bethany L Bartley, Melissa S Putman, Hassan S Dashti.
       BACKGROUND: Cystic fibrosis-related diabetes (CFRD) is a common and serious complication of cystic fibrosis (CF) that leads to worse clinical outcomes. Sleep disturbance is prevalent in CF and may represent a modifiable contributor to dysglycemia in CFRD, however concurrent real-world assessments of sleep and glycemia are limited.
    METHODS: This was a fully remote, 10-day observational study to evaluate the feasibility of at-home phenotyping of sleep and glycemia in adults with CFRD. Participants were recruited nationwide and completed continuous glucose monitoring, wrist actigraphy, validated surveys, and at-home fingerstick hemoglobin A1c collection. Feasibility was assessed with study completion and enrollment rates. Descriptive analyses characterized sleep and glycemic measures, and exploratory analyses assessed their relationship.
    RESULTS: Thirty patients (43.7 ± 12.3 years; 83.3% female; 93.3% White) were enrolled, yielding 100% completion and 96.8% enrollment. Broadly, 76.7% of participants reported poor overall sleep quality; in terms of sleep disorders, 46.7% endorsed clinically significant insomnia symptoms, 30% were at high risk for obstructive sleep apnea, and 16.7% met criteria for definite restless legs syndrome. Time in range (TIR) did not differ across sleep categories. Actigraphy estimates indicated median (Q1, Q3) sleep duration of 7.5 h (6.5, 8.1) and sleep efficiency of 87.5% (83.9, 89.3). Among the actigraphy measures, longer sleep onset latency was significantly correlated with lower TIR.
    CONCLUSIONS: This study demonstrates the feasibility of fully remote physiological phenotyping in CF research and highlights sleep patterns as a potential contributor to metabolic health in CFRD.
    Keywords:  Actigraphy; Circadian rhythms; Continuous glucose monitoring; Cystic fibrosis–related diabetes; Real-world data; Remote monitoring; Sleep disturbance
    DOI:  https://doi.org/10.1016/j.jcf.2026.07.005
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