bims-glumda 2025-07-27 papers

bims-glumda

Biomed News

on CGM data in management of diabetes

Issue of 2025–07–27
eighteen papers selected by
Mott Given

Accuracy and Reliability of the Sinocare Continuous Glucose Monitoring System.
The Use of Continuous Glucose Monitoring in Comparison to Self-Monitoring of Blood Glucose in Gestational Diabetes: A Systematic Review.
Continuous glucose monitoring versus fasting blood glucose basal insulin titration: a retrospective analysis.
Continuous glucose monitoring and automated insulin delivery systems in the management of diabetes among individuals with chronic kidney disease on dialysis.
Continuous Glucose Monitors Have Acceptable Accuracy but High Discordance at High and Low Glucose Concentrations in Pediatric Hospitalized Patients.
Consensus statement on standardizing CGM evaluation metrics in Latin America: an expert approach.
Accuracy of Glucose Trends by Subcutaneous Continuous Monitoring vs Intermittent Arterial Measurements in Critically Ill Patients.
The Role of Nanomaterials in the Wearable Electrochemical Glucose Biosensors for Diabetes Management.
Flash glucose monitoring and continuous glucose monitoring among patients with coexisting diabetes and severe mental illness - a convergent mixed-methods study.
Real-time continuous glucose monitoring vs self-monitoring of blood glucose in distinct multi-ethnic cohorts of patients living with insulin-treated type 2 diabetes in the United States: A cost-utility analysis from a Medicare perspective.
Increased Glycemic Variability in Patients With Chronic Pancreatitis and Diabetes Compared to Type 2 Diabetes.
Correlation Between Blood Glucose Variability Indices Using Continuous Glucose Monitoring in Gestational Diabetes Patients and Abnormal Glucose Levels 42 Days Postpartum.
Erratum: Correction of Authors and Supplementary Tables in the Article "Quality of Life in Women With Gestational Diabetes Mellitus and Treatment Satisfaction Upon Intermittently Scanned Continuous Glucose Monitoring".
Differential effects of lifestyle interventions on continuous glucose monitoring metrics in persons with type 2 diabetes: Potential for personalised treatment.
Diabetes technology use in U.S. hospitals: A survey of user experiences.
Continuous Glycemic Monitoring Metrics of Children and Adolescents with Type 1 Diabetes During the Iron Swords War.
Assessment of Microvascular Disturbances in Children with Type 1 Diabetes-A Pilot Study.
Electrochemical glucose sensors for detection of diabetic retinopathy.

Diabetes Ther. 2025 Jul 24.

Accuracy and Reliability of the Sinocare Continuous Glucose Monitoring System.

Anuj Bhargava, Kristy S McKeating, Alvin Lin, Ting Chen.

   INTRODUCTION: The Sinocare iCan i3 Continuous Glucose Monitoring (CGM) system, manufactured by Sinocare, is available in China and certain European markets. This study aimed to evaluate the performance of this system in a free-living environment.
METHODS: Thirty-six (36) participants, with a diagnosis of either type 1 or type 2 diabetes, wore one Sinocare iCan i3 CGM system on the abdomen for up to 15 days and performed up to eight capillary fingerstick blood glucose tests per day, over the wear period, in a home setting. The CGM sensor performance was compared to the blood glucose meter (BGM) reference and evaluated in terms of analytical and clinical accuracy, as well as sensor survival.
RESULTS: For the study period, the mean absolute relative difference (MARD) was 17.2%. 69.5% of the results were within 20 mg/dL or 20% of the BGM reference, with 98.8% of the data falling within zones A and B of the consensus error grid. 77.1% of the sensors lasted up to the 15 days of sensor wear.
CONCLUSIONS: In this real-world study of the Sinocare iCan i3 CGM system, the accuracy and reliability of the sensors were assessed in comparison to a capillary fingerstick blood glucose reference. The MARD was 17.2% while 77.1% of the sensors lasted the 15-day wear duration.

Keywords:  Analytical accuracy; Clinical accuracy; Continuous glucose monitoring; Sensor reliability; Sinocare CGM system

DOI:  https://doi.org/10.1007/s13300-025-01773-0
J Diabetes Sci Technol. 2025 Jul 23. 19322968251357873

The Use of Continuous Glucose Monitoring in Comparison to Self-Monitoring of Blood Glucose in Gestational Diabetes: A Systematic Review.

Bhavadharini Balaji, Wesley Hannah, Polina V Popova, Uma Ram, Mohan Deepa, Janeline Lunghar, Kumaran Uthra, Haritha Sagili, Sadishkumar Kamalanathan, Ranjit Mohan Anjana, Viswanathan Mohan.

   BACKGROUND: Continuous glucose monitoring (CGM) has emerged as an important tool for managing gestational diabetes mellitus (GDM), offering real-time glucose data and the potential for improved glycemic control. Unlike traditional self-monitoring of blood glucose (SMBG), which provides intermittent readings, CGM captures continuous glucose fluctuations, including postprandial and nocturnal changes, which are critical in GDM management.
OBJECTIVE: This systematic review aimed to assess the effectiveness of CGM compared with SMBG in managing glycemic control in women with GDM, focusing on key glycemic metrics such as time in range (TIR) and glycemic variability (GV), and exploring their associations with maternal and neonatal outcomes.
METHODS: A comprehensive search of PubMed and Google Scholar was conducted, adhering to PRISMA guidelines. Studies included randomized controlled trials, observational studies, and prospective cohort studies comparing CGM and SMBG, with 35 studies ultimately reviewed.
RESULTS: Compared with SMBG, CGM demonstrated significant improvements in maintaining TIR and reducing GV, which correlated with favorable maternal and neonatal outcomes, including lower rates of large-for-gestational-age (LGA) infants, preterm birth, and NICU (neonatal intensive care unit) admissions. Furthermore, CGM detected more hyperglycemic and hypoglycemic events, particularly nocturnal fluctuations. However, the studies also highlighted the need for standardized metrics to optimize CGM use in GDM management.
CONCLUSION: Continuous glucose monitoring offers substantial advantages over SMBG for managing GDM by providing continuous, real-time glucose data, enabling timely treatment adjustments. These findings support the integration of CGM into clinical practice to improve maternal and neonatal outcomes in GDM. Further research is needed to establish standardized CGM metrics specific to GDM management.

Keywords:  CGM; GDM; SMBG; diabetes; glycemic variability; time in range

DOI:  https://doi.org/10.1177/19322968251357873
Diabetes Metab Syndr. 2025 Jul 16. pii: S1871-4021(25)00083-9. [Epub ahead of print]19(6): 103266

Continuous glucose monitoring versus fasting blood glucose basal insulin titration: a retrospective analysis.

Thomas W Martens, Jennal Johnson, Michelle L Katz, Michael B Davidson, Karen Schneck, Jie Xue, Xinyue Chang, Eyal Dassau.

   AIMS: Continuous glucose monitoring (CGM) may complement or potentially replace fasting blood glucose (FBG) for basal insulin dose titration in type 2 diabetes (T2D). This retrospective analysis compared CGM-based titration with FBG-based titration using 7354 pairs of FBG and blinded CGM data from a clinical study in 68 people with T2D.
METHODS: Based on pharmacokinetic/pharmacodynamic simulations, the median of 3 lowest CGM values in the hour preceding the FBG timepoint ("1-h am nadir") was selected as basis for titration. Basal insulin doses were determined using 3 algorithms (Canadian INSIGHT, Treat2Target, AT.LANTUS). Absolute/relative dose adjustment differences, mean absolute relative differences, and relative dose errors between CGM- and FBG-based doses were calculated.
RESULTS: The 1-h am nadir was essentially equivalent to FBG for basal titration across all 3 algorithms. There was >90 % probability of the absolute dose adjustment difference being within tolerance. Mean absolute relative difference values were generally low, although higher for Treat2Target. Relative dose errors were mostly between -10 % and 10 %, indicating high agreement between CGM- and FBG-based titration and low clinical risk.
CONCLUSIONS: This study established that the 1-h am nadir can potentially be used as an FBG surrogate for basal insulin titration in T2D.

Keywords:  Algorithms; Basal insulin; Continuous glucose monitoring; Insulin titration; Self-monitored blood glucose; Type 2 diabetes

DOI:  https://doi.org/10.1016/j.dsx.2025.103266
Curr Opin Nephrol Hypertens. 2025 Jul 15.

Continuous glucose monitoring and automated insulin delivery systems in the management of diabetes among individuals with chronic kidney disease on dialysis.

Alexandros L Liarakos, Ashveer Randhay, Emma G Wilmot.

   PURPOSE OF REVIEW: To describe the current evidence and emerging role of continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems in the management of diabetes among individuals with advanced chronic kidney disease (CKD) undergoing dialysis.
RECENT FINDINGS: Recent studies have shown that CGM provides accurate and clinically useful glucose data in people with advanced CKD requiring dialysis. CGM enables the detection of glycaemic variability and hypoglycaemia patterns that are often missed by traditional monitoring methods, such as capillary blood glucose testing and haemoglobin A1c. While observational studies show benefits, randomised controlled trial data are limited. Early trials and case series suggest that AID, especially fully closed-loop systems, may improve glycaemia in dialysis-dependent individuals with diabetes, though evidence is currently sparse and primarily focused on type 2 diabetes. Several ongoing and planned studies aim to address these knowledge gaps.
SUMMARY: CGM represents a valuable tool for improving glucose management and safety in people with diabetes and advanced CKD, but barriers to widespread use, such as cost, access, and healthcare provider familiarity, remain significant. AID technologies show promise but require further evaluation in this population. Future research should prioritise long-term outcomes, cost-effectiveness, and patient-reported outcomes to support the integration of these technologies into routine care for this high-risk group.

Keywords:  automated insulin delivery; chronic kidney disease; continuous glucose monitoring; diabetes; dialysis; hybrid closed loop systems

DOI:  https://doi.org/10.1097/MNH.0000000000001106
Clin Chem. 2025 Jul 25. pii: hvaf080. [Epub ahead of print]

Continuous Glucose Monitors Have Acceptable Accuracy but High Discordance at High and Low Glucose Concentrations in Pediatric Hospitalized Patients.

Isaiah K Mensah, Vahid Azimi, Christopher W Farnsworth.

BACKGROUND: Continuous glucose monitors (CGMs) assess interstitial glucose concentrations and improve diabetes management in outpatient settings. However, limited studies have assessed CGM performance in hospitalized pediatric patients, especially at high and low glucose thresholds near clinical decision limits.
METHODS: This retrospective study included 72 hospitalized pediatric patients with dysglycemia who used CGMs during hospitalization. Paired CGM results within 10 min of laboratory (Lab) and point-of-care (POC) glucose results were retrieved. The mean absolute relative difference (MARD) and percentage of glucose values in acceptable Parkes error zones were assessed. Concordance of CGM and POC results and the frequency that CGM results <70 mg/dL and >180 mg/dL were confirmed (-15 min to +30 min) using POC was assessed.
RESULTS: There were 2228 paired CGM and Lab or POC glucose results with a MARD of 14.8%, and 99.2% of results were in Parkes zones A and B. The MARD was 20.2% and 13.6% in the hypoglycemic and hyperglycemic ranges. The MARD for POC glucose meters was 15.6% and 8.2% for the hypoglycemic and hyperglycemic ranges. The Cohen kappa between CGM and POC was 0.66 (95% CI, 0.63-0.69). CGM results in the hypoglycemic and hyperglycemic ranges were repeated 80.2% and 16.5% of the time, respectively, with POC methods.
CONCLUSION: The MARD of CGM in hospitalized pediatric patients is clinically acceptable but there is high discordance between CGM and POC. This implies a clinical need to confirm high and low glucose concentrations with Lab or POC methods but confirmatory testing is commonly not performed.

DOI: https://doi.org/10.1093/clinchem/hvaf080
Diabetol Metab Syndr. 2025 Jul 21. 17(1): 291

Consensus statement on standardizing CGM evaluation metrics in Latin America: an expert approach.

Mauro Scharf, Karen Feriz, Carlos Yepes, Álvaro Contreras, Lorena Lequi, David Sanhueza, Marcio Krakauer, Eduardo Márquez, Matías Ré, Roopa Mehta.

   BACKGROUND: Latin America has no accepted performance standards for continuous glucose monitoring (CGM) technology evaluation. This has resulted in the emergence of various CGM devices in the market that do not meet strict quality, accuracy, reliability or safety standards. CGM systems are crucial for managing diabetes, as they provide frequent glucose measurements and help detect hypoglycemia or hyperglycemia episodes or even predict these events. Ensuring the reliability and accuracy of CGM devices is essential for patient safety. This consensus statement aims to establish a consensus-driven framework of expert recommendations regarding the metrics that should be evaluated to achieve high standards in CGM devices.
MATERIALS AND METHODS: A modified Delphi methodology was employed, engaging endocrinologists, pediatric endocrinologists and diabetologists from Latin America. Experts participated in multiple rounds of surveys and discussions to reach consensus on key characteristics measures, including accuracy thresholds, clinical validation protocols, and post-market surveillance requirements. Quantitative and qualitative data were analyzed to ensure robust recommendations.
RESULTS: The expert panel identified major gaps in existing CGM regulations and established 12 key recommendations and one checklist to align Latin American standards with international best practices. These included the implementation of minimum accuracy thresholds, the adoption of standardized clinical validation protocols, and the enforcement of post-market surveillance measures. The panel also emphasized the importance of patient education, healthcare provider involvement in decision-making, and accessibility to enhance CGM adoption and usability. We underscore the necessity of these measures to improve patient outcomes, patient safety, and regulatory consistency in the region, while also enhancing CGM reliability and accuracy.
CONCLUSION: This consensus statement highlights the urgent need for a standardized metrics to evaluate CGM devices in Latin America. Implementing standardized accuracy requirements, rigorous validation protocols, and enhanced patient education will ensure device reliability, improve clinical outcomes, and foster a more equitable healthcare landscape for diabetes management in the region.

Keywords:  Accuracy standards; CGM regulation; Clinical validation; Consensus statement; Continuous glucose monitoring; Diabetes management; Latin America; Patient safety

DOI:  https://doi.org/10.1186/s13098-025-01851-0
J Diabetes Sci Technol. 2025 Jul 24. 19322968251358830

Accuracy of Glucose Trends by Subcutaneous Continuous Monitoring vs Intermittent Arterial Measurements in Critically Ill Patients.

Ola Friman, Marcus Lind, Ragnar Thobaben, Pia Zetterqvist, Anders Perner, Olav Rooijackers, Anders Oldner, Johan Mårtensson.

   BACKGROUND: Continuous glucose monitoring (CGM) has the potential to improve glucose control in critically ill patients, provided that its trend accuracy is reliable. We evaluated the trend accuracy of a subcutaneous CGM system (Dexcom G6) compared with intermittent arterial blood gas (ABG) measurements in intensive care unit (ICU) patients receiving insulin.
METHODS: We enrolled 40 adult ICU patients receiving insulin and organ-supportive therapies. We assessed trend accuracy using the Rate Error Grid Analysis (R-EGA) and the Diabetes Technology Society Trend Accuracy Matrix (DTS-TAM), overall, across different ABG levels, and over time from CGM initiation.
RESULTS: A total of 2701 paired CGM-ABG trends were analyzed, with a median (IQR) time difference between readings of 83 (65-125) minutes. Overall, 99.7% of trends were classified in R-EGA Zone A and 0.3% in Zone B. On DTS-TAM analysis, 98.6% of trends fell in the No Risk category, while 1.7% were in the adjacent Mild-to-Moderate Risk categories. Trends were more frequently categorized as Mild-to-Moderate Risk when ABG values were <100 mg/dL (5.56 mmol/L) (3.6%) compared with 100 to 180 mg/dL (5.56 to 10 mmol/L) (1.3%) or >180 mg/dL (10 mmol/L) (1.6%). During the first 24 hours of CGM use, 2.9% of trends fell into the Mild-to-Moderate Risk categories, compared with 0.9% beyond 24 hours.
CONCLUSIONS: In critically ill patients receiving insulin, CGM demonstrated high overall trend accuracy relative to ABG. Trend accuracy was reduced at lower glucose ranges and during the initial 24 hours of CGM use.

Keywords:  accuracy; blood glucose; continuous glucose monitoring; critical care; diabetes; glucose control

DOI:  https://doi.org/10.1177/19322968251358830
Biosensors (Basel). 2025 Jul 14. pii: 451. [Epub ahead of print]15(7):

The Role of Nanomaterials in the Wearable Electrochemical Glucose Biosensors for Diabetes Management.

Tahereh Jamshidnejad-Tosaramandani, Soheila Kashanian, Kobra Omidfar, Helgi B Schiöth.

  The increasing prevalence of diabetes mellitus necessitates the development of advanced glucose-monitoring systems that are non-invasive, reliable, and capable of real-time analysis. Wearable electrochemical biosensors have emerged as promising tools for continuous glucose monitoring (CGM), particularly through sweat-based platforms. This review highlights recent advancements in enzymatic and non-enzymatic wearable biosensors, with a specific focus on the pivotal role of nanomaterials in enhancing sensor performance. In enzymatic sensors, nanomaterials serve as high-surface-area supports for glucose oxidase (GOx) immobilization and facilitate direct electron transfer (DET), thereby improving sensitivity, selectivity, and miniaturization. Meanwhile, non-enzymatic sensors leverage metal and metal oxide nanostructures as catalytic sites to mimic enzymatic activity, offering improved stability and durability. Both categories benefit from the integration of carbon-based materials, metal nanoparticles, conductive polymers, and hybrid composites, enabling the development of flexible, skin-compatible biosensing systems with wireless communication capabilities. The review critically evaluates sensor performance parameters, including sensitivity, limit of detection, and linear range. Finally, current limitations and future perspectives are discussed. These include the development of multifunctional sensors, closed-loop therapeutic systems, and strategies for enhancing the stability and cost-efficiency of biosensors for broader clinical adoption.

Keywords:  continuous glucose monitoring; diabetes mellitus; glucose oxidase; nanomaterials; non-enzymatic glucose biosensors; sweat-based biosensors; wearable electrochemical biosensors

DOI:  https://doi.org/10.3390/bios15070451
Nord J Psychiatry. 2025 Jul 22. 1-9

Flash glucose monitoring and continuous glucose monitoring among patients with coexisting diabetes and severe mental illness - a convergent mixed-methods study.

Anne B Hansen, Vicki Zabell, Anette Juel, Lene Lauge Berring, Lise Tarnow, Stephen F Austin.

   AIM: Technology is seen as a potential tool to improve the management of diabetes although few studies have examined sensor use within psychiatric populations. This study investigated the integration of glucose sensors for patients' diabetes and severe mental illness.
METHODS: The study applied a mixed methods convergent design with focus on glucose monitoring implementation. Quantitative data collected (n = 15) summarized patient characteristics and sensor use over time. Changes in HbA1c levels were also monitored. Qualitative data was collected using semi-structured interviews and focus groups capturing the experiences of patients (n = 10) and clinicians (n = 7) respectively.
RESULTS: Users utilized data from sensors to facilitate diabetes management although sensor use decreased over time. Analysis from patient interviews constructed three themes: 'Sensor use - improved awareness of blood glucose', 'Sensor use - promoting sharing of glucose readings', and 'Sensor use - increased visibility and public awareness of diabetes'. Focus groups with clinicians described two themes: 'Perceived treatment benefits gained from glucose sensors', and 'Treatment challenges posed by glucose sensors'.
CONCLUSION: Results indicated that sensors were accepted and meaningfully integrated into clinical practice within this population. Patients and clinicians were largely positive about the integration and usefulness of sensors in diabetes management although some challenges were described.

Keywords:  Diabetes; flash glucose monitoring; glycemic control; severe mental illness

DOI:  https://doi.org/10.1080/08039488.2025.2530629
J Manag Care Spec Pharm. 2025 Aug;31(8): 752-763

Real-time continuous glucose monitoring vs self-monitoring of blood glucose in distinct multi-ethnic cohorts of patients living with insulin-treated type 2 diabetes in the United States: A cost-utility analysis from a Medicare perspective.

Hamza Alshannaq, Jessica Matuoka, Richard F Pollock, Waqas Ahmed, Peter Lynch, Gregory J Norman.

BACKGROUND: For individuals living with type 2 diabetes (T2D) requiring insulin therapy, the use of real-time continuous glucose monitoring (rt-CGM) yields significant clinical benefits relative to self-monitoring of blood glucose (SMBG).
OBJECTIVE: To determine the cost-utility of rt-CGM vs SMBG in a US setting, for a simulated cohort of individuals with T2D receiving insulin therapy.
METHODS: The IQVIA CORE Diabetes Model version 10 was employed for this analysis, which was conducted over a remaining lifetime horizon. Clinical effectiveness data were sourced from a large-scale, retrospective cohort study set in the United States. Direct medical costs were obtained from a range of published studies for the Medicare setting and by using relevant Healthcare Common Procedure Coding System codes for Medicare. A willingness- to-pay (WTP) threshold of $50,000 per quality-adjusted life-year (QALY) was used, with future effects and costs discounted at 3% per annum. The base case was conducted from a Medicare perspective. One-way and probabilistic sensitivity analyses were performed.
RESULTS: From a Medicare perspective, the use of rt-CGM yielded mean total direct medical costs of $107,215, alongside 7.584 QALYs over a time horizon of 50 years. Comparatively, SMBG was associated with lower mean total direct medical costs of $100,116 while yielding only 6.818 QALYs. The final incremental cost-utility ratio was $9,265 per QALY gained, showing that at a WTP threshold of $50,000 per QALY gained, rt-CGM was cost-effective relative to SMBG. Results from the 1-way sensitivity analysis showed rt-CGM to be dominant when a commercial plan perspective was adopted and more cost-effective for 100% Black, Native American, and Hispanic cohorts when compared with a 100% White cohort.
CONCLUSIONS: In a simulated cohort representative of individuals living with T2D and receiving insulin therapy, rt-CGM may be cost-effective compared with SMBG from a Medicare perspective. Therefore, rt-CGM plausibly possesses the potential to address existing racial and ethnic disparities in diabetes-related outcomes for patients within the United States.

DOI: https://doi.org/10.18553/jmcp.2025.31.8.752
J Diabetes Sci Technol. 2025 Jul 18. 19322968251356239

Increased Glycemic Variability in Patients With Chronic Pancreatitis and Diabetes Compared to Type 2 Diabetes.

Line Davidsen, Morten Hasselstrøm Jensen, Thomas Kronborg, Stine Hangaard, Peter Vestergaard, Asbjørn Mohr Drewes, Filip Krag Knop, Simon Lebech Cichosz, Søren Schou Olesen.

   BACKGROUND: Glycemic variability in diabetes secondary to pancreatic diseases (pancreatic diabetes) remains unclear. We compared glycemic control and variability in patients with pancreatic diabetes and a matched group of individuals with type 2 diabetes using continuous glucose monitoring (CGM).
METHODS: We included 30 patients with chronic pancreatitis and insulin-treated secondary diabetes and 30 individuals with insulin-treated type 2 diabetes (matched on HbA1c, age, and sex). Participants wore a blinded CGM for 20±2 days. Glycemic variability was assessed using coefficient of variation (CV), standard deviation (SD), mean amplitude of glycemic excursions (MAGE), and continuous overall net glycemic action (CONGA) at 1 and 2-hour intervals. Glycemic control was evaluated based on time spent in predefined glucose ranges: >250 mg/dL, 181 to 250 mg/dL, 70 to 180 mg/dL (target range), 54 to 69 mg/dL, and <54 mg/dL. CGM parameters were compared between groups.
RESULTS: All CGM-derived measures of glycemic variability (CV, SD, MAGE, CONGA1, and CONGA2) were significantly higher in patients with chronic pancreatitis and diabetes compared to individuals with type 2 diabetes (P < 0.01). Patients with chronic pancreatitis spent more time with glucose >250 mg/dL (8.8% vs 3.1%, P = 0.008), less time in the target range (70-180 mg/dL; 56.7% vs 68.5%, P = 0.044), and more time at 54-69 mg/dL (0.2% vs 0.0%, P = 0.041). Their glycemia risk index for hyperglycemia was also higher (25.5 vs 16.5, P = 0.033).
CONCLUSION: Patients with pancreatic diabetes have higher glycemic variability than individuals with type 2 diabetes despite comparable levels of HbA1c.

Keywords:  continuous glucose monitoring; glycemic variability; hypoglycemia; pancreatic diabetes

DOI:  https://doi.org/10.1177/19322968251356239
J Diabetes Res. 2025 ;2025 1021066

Correlation Between Blood Glucose Variability Indices Using Continuous Glucose Monitoring in Gestational Diabetes Patients and Abnormal Glucose Levels 42 Days Postpartum.

Rui Wang, Yuping Zhang, Huiqian Zeng, Jinyan Xiao, Mingming Qi, Lei Bao, Ruifen Jiao, Jing Liu, Yichun Li, Shuli He, Yunlong Li, Rui Li, Fan Ping, Yanping Liu.

  Objective: This study was aimed at analyzing the impact of blood glucose variability (GV) in gestational diabetes mellitus (GDM) patients on glucose outcomes 42 days postpartum and pregnancy outcomes. Additionally, it explored differences between various GV indices and evaluated their predictive values. Methods: This retrospective study included 75 pregnant women diagnosed with GDM. Continuous glucose monitoring (CGM) was initiated postdiagnosis, and outcomes were followed up. Oral glucose tolerance tests (OGTTs) were conducted 42 days postpartum to assess glucose response. Results: A total of 75 patients were included, among whom 8 (10.67%) exhibited impaired fasting glucose (IFG) and 7 (9.33%) impaired glucose tolerance (IGT) in the 42-day postpartum OGTT. No cases of diabetes were diagnosed. The results of the postpartum OGTT were significantly correlated with various GV indexes. In multivariate analysis, LBGI (OR: 1.437; 95% CI: 1.015-2.035; p = 0.041), M value (OR: 1.215; 95% CI: 1.030-1.434; p = 0.021), and TBR% (OR: 1.138; 95% CI: 1.020-1.271; p = 0.021) independently influenced IFG. Receiver operating characteristic (ROC) analysis indicated areas under the curve (AUCs) of 0.877 (95% CI: 0.760~0.994), 0.853 (95% CI: 0.730~0.975), 0.869 (95% CI: 0.748~0.991), and 0.793 (95% CI: 0.622~0.963) of IFG prediction model performance of TBR%, LBGI, M value, and HbA1c% combined with age, BMI, and family history of diabetes, respectively. Conclusion: Blood GV is an independent factor influencing IFG 42 days postpartum in GDM women, especially with hypoglycemia. It can increase the predictive efficiency of the postpartum abnormal blood glucose prediction model. Trial Registration: Chinese Clinical Trial Registry number: ChiCTR2100054833.

Keywords:  continuous glucose monitoring; gestational diabetes mellitus; glucose variability; postpartum OGTT; pregnancy outcomes

DOI:  https://doi.org/10.1155/jdr/1021066
J Korean Med Sci. 2025 Jul 21. 40(28): e222

Erratum: Correction of Authors and Supplementary Tables in the Article "Quality of Life in Women With Gestational Diabetes Mellitus and Treatment Satisfaction Upon Intermittently Scanned Continuous Glucose Monitoring".

Joon Ho Moon, Hyeon Ji Kim, Jee Yoon Park, Kyung Joon Oh, Sung Hee Choi, Hak Chul Jang.

This corrects the article on p. e46 in vol. 40, PMID: 40259722.

DOI: https://doi.org/10.3346/jkms.2025.40.e222
Diabetes Obes Metab. 2025 Jul 25.

Differential effects of lifestyle interventions on continuous glucose monitoring metrics in persons with type 2 diabetes: Potential for personalised treatment.

Iris M de Hoogh, Tim Snel, Regina J M Kamstra, Tanja Krone, Albert A de Graaf, Hanno Pijl.

   AIMS: The effects of lifestyle on glucose metabolism significantly differ between individuals. Hyperglycaemia in type 2 diabetes is driven by tissue-specific insulin resistance and reduced beta-cell capacity, whose relative contribution varies between persons, potentially affecting the impact of lifestyle interventions. We quantified effects of lifestyle on continuously measured glucose (CGM) metrics and evaluated how these differ between type 2 diabetes subtypes.
MATERIALS AND METHODS: This is a repeated-measures study with 40 persons with type 2 diabetes. Participants wore a CGM for 11 self-monitoring periods of 4 days, of which 3 were control and 4 were duplicated intervention periods (2× low carbohydrate diet, 2× Mediterranean diet, 2× walking after each meal and 2× 'active day' (hourly 5-min exercise bouts)). The order of the intervention periods was randomised. Tissue-specific insulin resistance and beta-cell function were quantified using an OGTT and were used to assign participants to diabetes subtypes or 'diabetypes'. A linear mixed effects model quantified lifestyle impact on CGM metrics.
RESULTS: On average, a low carbohydrate diet, walking after meals, and an active day, but not the Mediterranean diet, resulted in lower mean glucose (-0.95 (CI: -1.13, -0.77), -0.28 (CI: -0.46, -0.1), -0.2 (CI: -0.38, -0.02) and -0.13 (CI: -0.13, 0.05) mmol/L, respectively) as compared with control (8.73 mmol/L, CI: 8.02-9.44) in participants who did not restrict carbohydrate intake at baseline. Preliminary analysis suggests the magnitude and direction of effects may vary between diabetypes.
CONCLUSIONS: Traditional lifestyle interventions improved CGM metrics within 4 days. Preliminary analysis suggests the effects may vary depending on the diabetes phenotype.

Keywords:  continuous glucose monitoring; diabetes mellitus type 2; lifestyle intervention; multilevel modelling; personalised health; real‐life setting

DOI:  https://doi.org/10.1111/dom.16654
Diabetes Obes Metab. 2025 Jul 22.

Diabetes technology use in U.S. hospitals: A survey of user experiences.

Michael S Hughes, Marci Morgan, Ying-Ting Liu, Ming Yeh Lee, Sarah J Hanes, Korey K Hood, Bruce A Buckingham, Rayhan Lal.



Keywords:  automated insulin delivery; closed‐loop systems; continuous glucose monitoring (CGM); hospital care; inpatient diabetes

DOI:  https://doi.org/10.1111/dom.16634
Isr Med Assoc J. 2025 Jul;27(7): 411-416

Continuous Glycemic Monitoring Metrics of Children and Adolescents with Type 1 Diabetes During the Iron Swords War.

Yossi Steier, Eyal Cohen-Sela, Shay Averbauch, Asaf Oren, Ori Eyal, Yael Lebenthal, Avivit Brener.

BACKGROUND: The Iron Swords war created stressful circumstances that could negatively impact glycemic control in individuals with type 1 diabetes (T1D).
OBJECTIVES: To evaluate changes in continuous glucose monitoring (CGM) metrics in pediatric T1D patients during the war.
METHODS: This retrospective study included T1D patients monitored by CGM. Metrics from three selected 2-week periods were compared (before the war, after the war outbreak, and 4 months later). Study variables included time-in-range (70-180 mg/dl; 3.9-10 mmol/L), time-in-tight-range (70-140 mg/dl; 3.9-7.8 mmol/L), time-in-marked-hypoglycemia (< 54 mg/dl; < 3 mmol/liter), and time-in-severe-hyperglycemia (> 250 mg/dl; >13.3 mmol/liter). Patients were treated with either a multiple daily insulin (MDI) regimen or insulin pump, with or without an open-source automated insulin delivery (OS-AID) system.
RESULTS: Data of 99 patients were analyzed (mean age 12.2 ± 4.0 years, mean diabetes duration 4.6 ± 3.9 years, 52.5% males). No significant changes in CGM metrics were observed across the entire cohort at any time point. Patients with higher socioeconomic position (SEP; cluster > 7) had better CGM metrics, with an increase in time-in-tight-range in the lower SEP group and in time-in-severe-hyperglycemia in the higher SEP group (P = 0.003). OS-AID users (n=20) had superior pre-war CGM metrics and maintained stable glycemia during the war, MDI users showed increased time-in-severe-hyperglycemia post-outbreak (P = 0.05).
CONCLUSIONS: Throughout the war, children and adolescents with T1D treated with insulin pumps maintained relatively stable glycemic control. Susceptibility to change following the onset of war was influenced by SEP and mode of insulin therapy.
Biosensors (Basel). 2025 Jul 08. pii: 439. [Epub ahead of print]15(7):

Assessment of Microvascular Disturbances in Children with Type 1 Diabetes-A Pilot Study.

Anna Wołoszyn-Durkiewicz, Edyta Dąbrowska, Marcin Hellmann, Anna Jankowska, Mariusz J Kujawa, Dominik Świętoń, Agata Durawa, Joanna Kuhn, Joanna Szypułowska-Grzyś, Agnieszka Brandt-Varma, Jacek Burzyński, Jędrzej Chrzanowski, Arkadiusz Michalak, Aleksandra Michnowska, Dalia Trzonek, Jacek Wolf, Krzysztof Narkiewicz, Edyta Szurowska, Małgorzata Myśliwiec.

  Endothelial dysfunction appears early in type 1 diabetes (T1D). The detection of the first vascular disturbances in T1D patients is crucial, and the introduction of novel techniques, such as flow-mediated skin fluorescence (FMSF) and adaptive optics retinal camera (Rtx) imaging, gives hope for better detection and prevention of angiopathies in the future. In this study, we aimed to investigate microcirculation disturbances in pediatric patients with T1D with the use of FMSF and Rtx imaging. This research focused especially on the relationship between microvascular parameters obtained in FMSF and Rtx measurements, and the glycemic control evaluated in continuous glucose monitoring (CGM) reports. We observed significantly increased wall thickness (WT) and wall-to-lumen ratio (WLR) values in T1D patients in comparison to the control group. Although we did not observe significant differences between the T1D and control groups in the FMSF results, a trend toward significance between the time in range (TIR) and hyperemic response (HRmax) and an interesting correlation between the carotid intima-media thickness (cIMTmax) and HRmax. were observed. In conclusion, FMSF and Rtx measurments are innovative techniques enabling the detection of early microvascular disturbances.

Keywords:  carotid intima-media thickness; diabetic angiopathies; microcirculation; type 1 diabetes

DOI:  https://doi.org/10.3390/bios15070439
Clin Chim Acta. 2025 Jul 22. pii: S0009-8981(25)00388-2. [Epub ahead of print] 120509

Electrochemical glucose sensors for detection of diabetic retinopathy.

Lei Su, Farzam Kiarasi.

  Diabetic retinopathy necessitates continuous blood glucose monitoring, prompting the industry to develop affordable, rapid, and accurate glucose sensor devices, such as electrochemical glucose sensors, for clinical research. The domain of electrochemical glucose biosensing has undergone substantial expansion since the initial enzyme electrode was documented in 1962. The advancement of sensing platforms has been propelled by the creation of sophisticated nanostructures and their Nano-composites, including gold nanoparticles, carbon nanotubes, carbon/graphene quantum dots, and chitosan hydrogel composites. These nanomaterials have enhanced the immobilization process and electrocatalytic activity for glucose. This review outlines the progression of glucose biosensing, with a focus on the application of nanostructures for glucose detection, both with and without the enzyme, in diabetic retinopathy. We investigate the historical development of biosensors, advancements in surface science to improve electron transfer, and the array of sensing platforms created utilizing nanomaterials.

Keywords:  Electrochemical glucose sensing; Nano-composites

DOI:  https://doi.org/10.1016/j.cca.2025.120509