Diabetes technology & therapeutics最新文献

{"title":"Preventing Diabetic Ketoacidosis with Continuous Ketone Monitoring: Insights from a Clinical Research Case.","authors":"Yee Wen Kong, Hanna C Jones, Jennifer Ngan, Jenna Goad, Alicia J Jenkins, Christopher J Nolan, Dale Morrison, Elif I Ekinci, Richard J MacIsaac, Spiros Fourlanos, Stephen Stranks, David N O'Neal","doi":"10.1177/15209156251362494","DOIUrl":"https://doi.org/10.1177/15209156251362494","url":null,"abstract":"<p><p>Delayed identification of impending diabetic ketoacidosis (DKA) often results in hospitalizations. We describe a case where continuous ketone monitor (CKM) use facilitated prompt identification and intervention for impending DKA, avoiding hospitalization. A 55-year-old male (total daily insulin dose of 0.5 units/kg/day; HbA1c 6.9% [51.9 mmol/mol]) with type 1 diabetes using automated insulin delivery (AID) wore a CKM (Abbott) and was educated in responses to ketone information as part of a clinical trial (ACTRN12624000448549). Insulin pump cannula dislodgement resulted in a rapid rise in ketone levels. Initial CKM alarm notification for elevated ketones >1.0 mmol/L prompted initiation of management, including cannula replacement and additional insulin administration. Ketosis resolved following a rise to >3.1 mmol/L without need for hospitalization. He remained asymptomatic throughout. This case highlights the potential for CKM to act as an early warning system to facilitate timely intervention for ketonemia and reduce the risk of DKA and associated hospitalizations.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Specialized Team in Diabetes on Glucometric Parameters and Efficiency Indicators During Hospital Admission in Medical Units.","authors":"Pedro Gil, Judit Amigó, Ángel Ortiz-Zúñiga, Mónica Sánchez, Marcos Dos Santos, Fátima Cuadra, María José Abadias, Cristina Hernández, Rafael Simó, Olga Simó-Servat","doi":"10.1177/15209156251362705","DOIUrl":"https://doi.org/10.1177/15209156251362705","url":null,"abstract":"<p><p>The study aimed to assess the impact of a specialized diabetes team (SDT) on medical units in terms of the improvement of glycemic parameters and hospital efficiency indicators such as length of stay (LOS) and readmissions. For this purpose, a prospective study including 289 patients under standard of care and 149 under the management of SDT was conducted. The SDT comprised two endocrinologists and two nurses specialized in diabetes. Patients under SDT management presented a significant reduction of both hypoglycemia prevalence 8.8% versus 17.6% (<i>P</i> = 0.013) and LOS (12.56 ± 11.94 vs. 16.28 ± 15.54; <i>P</i> = 0.005). In the multivariate analysis, hypoglycemia was independently related to LOS. In addition, the management by SDT resulted in a reduction in readmissions due to acute hyperglycemia at 3 months after the discharge (<i>P</i> = 0.019). We conclude that the management of diabetes by an SDT in medical units is an effective and cost-benefit strategy.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Beyond Accuracy: Clinical Considerations for Personal Continuous Glucose Monitoring Use During Hospitalization.","authors":"Yadi Li, Zheng Wei, Jianlong Zhou","doi":"10.1177/15209156251362492","DOIUrl":"https://doi.org/10.1177/15209156251362492","url":null,"abstract":"","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Patterns in Automated Insulin Delivery and Carbohydrate Announcement: A 24-Month Follow-Up.","authors":"Estelle Godard, Alfred Penfornis, Coralie Amadou","doi":"10.1177/15209156251362499","DOIUrl":"https://doi.org/10.1177/15209156251362499","url":null,"abstract":"<p><p>We evaluated long-term (24 months) consistency in carbohydrate counting and meal announcements among Control-IQ users using two parameters: auto-bolus percentage (i.e., automatic correction boluses divided by total boluses) and daily carbohydrate announcement (DCA). In this single-center retrospective cohort study (October 2021-October 2024), we analyzed trends in auto-bolus percentage-alongside DCA and metabolic control-and its associations with age, sex, DCA, and time in range (TIR) using mixed-effects linear models. Among 2751 person-quarters (57% women, mean age 37 years), the mean auto-bolus percentage was 61% and increased by 0.4% per quarter (<i>P</i> < 0.001). DCA declined from 132 to 100 g/day, while TIR slightly decreased from 61% to 58%. Auto-bolus percentage was inversely associated with age, TIR, and DCA, with the latter association strengthening over time. The modest change in TIR suggests sustained effectiveness of automated insulin delivery despite decreasing carbohydrate reporting-likely reflecting adaptive user behavior.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Safety and Effectiveness of U200 Insulin Use in Automated Insulin Delivery Systems in Adolescents and Young Adults with Type 1 Diabetes.","authors":"Patricia Y Chu, Neha Parimi, Risa M Wolf, Elizabeth A Brown, Andrea Kelly, Brynn E Marks","doi":"10.1177/15209156251359167","DOIUrl":"https://doi.org/10.1177/15209156251359167","url":null,"abstract":"<p><p>Limited insulin pump cartridge volumes can present challenges to automated insulin delivery (AID) system use for adolescents and young adults (AYA) with type 1 diabetes (T1D) and high insulin requirements. We assessed the real-world safety and effectiveness of U200 concentrated insulin use in AID (U200-AID) among AYAs with T1D. We conducted a two-center, retrospective cohort study assessing glycemia, pump utilization, and safety outcomes pre-/post-U200-AID. Among 50 AYAs initiating U200-AID (age 15.4 years, T1D duration 5.5 years, hemoglobin A1c 8.5%), time in range (70-180 mg/dL) increased (44.6% ± 12.6% vs. 48.9% ± 11.4%, <i>P</i> = 0.012) and time below range (<70 mg/dL) did not change significantly. Days between cartridge changes increased (2.2 ± 0.5 vs. 3.0 ± 0.5 days, <i>P</i> < 0.001) despite increased total daily insulin dose (102.6 ± 23.5 vs. 125.8 ± 38.9 U100 insulin units, <i>P</i> < 0.001). No severe hypoglycemia or diabetic ketoacidosis occurred (median follow-up 290 days [interquartile range 227, 476]). These data suggest that U200-AID is a viable option for individuals with T1D and high insulin requirements.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum Continuous Glucose Monitor Data Required to Assess Glycemic Control in Youth with Type 1 Diabetes.","authors":"Sonia Gera, Andrew Rearson, Robert J Gallop, Brynn E Marks","doi":"10.1089/dia.2025.0173","DOIUrl":"https://doi.org/10.1089/dia.2025.0173","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Consensus guidelines recommend reviewing 14 days of continuous glucose monitor (CGM) data when assessing glycemia in people with type 1 diabetes (T1D). Adult studies have shown that 7 days of CGM data provide a reliable assessment of glycemia. <b><i>Objectives:</i></b> To understand the minimum amount of CGM data required to assess glycemia in the pediatric T1D population. <b><i>Methods:</i></b> Real-world Dexcom G6 CGM data were extracted from cloud-based CGM software for 8 time windows (3, 5, 7, 10, 14, 30, 60, and 90 days), all starting on March 1, 2023. Youth <21 years with T1D and ≥70% CGM active time in each window were included. Pearson correlation and interclass correlation coefficients (ICCs) between 14-day data and other windows were calculated. Differences in the percentage of youth within predetermined thresholds of 14-day CGM metrics (±0.3% glucose management indicator [GMI]; ±5% time in range [TIR]/time in tight range; ±1% time below range <70 and <54 mg/dL) were assessed using chi-squared analyses. Sub-analyses were conducted according to categorical groupings of 14-day TIR, coefficient of variation (CV), and age. <b><i>Results:</i></b> A total of 1316 youth were included (45.0% female, 76.9% non-Hispanic White, median age 14.6 years). Median 14-day CGM active time was 97.2% and GMI and TIR were 7.4% (7.0, 7.9) and 60.5% (48.6, 70.6), respectively. Pearson correlation coefficients and ICCs between 14-day and GMI and TIR for all 8 windows were >0.9; however, categorical agreement as defined by the percentage of subjects acceptable thresholds for GMI and TIR only exceeded 90% at 10 days. Although there was no difference in agreement for CGM metrics according to categorical groupings of age, agreement was stronger for youth with TIR ≥70% and CV <36%. <b><i>Conclusions:</i></b> Although 14 days of CGM data are considered the gold standard, assessing ∼9.6 days of data in youth with T1D provides a reliable assessment of glycemia. For youth with higher TIR (≥70%) and lower CV (<36%), 7-day CGM data may prove sufficient.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Ketone Monitoring in Pregnancy.","authors":"Celeste Durnwald, Sarit Polsky","doi":"10.1089/dia.2025.0300","DOIUrl":"https://doi.org/10.1089/dia.2025.0300","url":null,"abstract":"<p><p>Diabetic ketoacidosis (DKA) occurring during pregnancy is an obstetric emergency that can result in significant adverse outcomes for both the pregnant person and the fetus. While DKA generally presents with glucose levels >250 mg/dL, up to 30% of DKA cases involve euglycemic DKA (euDKA) wherein glucose levels <200 mg/dL have been reported. However, detection and prevention of DKA in pregnancy can be challenging for both the pregnant individual and health care providers due to variable clinical presentations of the disease and the limitations of current ketone monitoring technologies. Abbott Diabetes Care (Alameda, CA) is developing a dual monitoring system that utilizes a single sensor to enable continuous monitoring of interstitial glucose and β-hydroxybutyrate, the primary metabolic product of blood ketones. This article reviews the challenges of monitoring ketones during pregnancy and discusses how continuous ketone monitoring could be considered for use in clinical practice once it becomes commercially available.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finerenone in Type 1 Diabetes with Chronic Kidney Disease: A Case Series Demonstrating Reduced Albuminuria with Manageable Safety Profile.","authors":"Chuping Chen, Jiande Liu, Ping Zhu, Jianmin Ran","doi":"10.1177/15209156251359310","DOIUrl":"https://doi.org/10.1177/15209156251359310","url":null,"abstract":"","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Tirzepatide in Type 1 Diabetic Obese Patient Using Hybrid Closed-Loop.","authors":"Maja Baretić","doi":"10.1089/dia.2025.0245","DOIUrl":"https://doi.org/10.1089/dia.2025.0245","url":null,"abstract":"","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on Management of Gestational Diabetes Mellitus and the Role of Continuous Glucose Monitor Technology.","authors":"Amber Lachaud, Celeste Durnwald","doi":"10.1089/dia.2025.0148","DOIUrl":"https://doi.org/10.1089/dia.2025.0148","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) complicates 5%-25% of pregnancies worldwide and is the most prevalent metabolic complication of pregnancy. Risk factors for GDM include maternal obesity, advanced maternal age, family history of type 2 diabetes mellitus (T2DM), diagnosis of Polycystic ovarian syndrome (PCOS), and a prior history of GDM. GDM has both implications for the pregnant person and the offspring with increased risks of adverse pregnancy outcomes as well as increased chance of developing T2DM later in life. The first-line treatment for GDM includes behavior modification followed by pharmacologic therapy with insulin being preferred medication of choice. Standard of care for the management of continuous glucose monitors (CGM) currently includes self-monitored blood glucoses or finger sticks 4× per day and this can increase stress and anxiety in pregnancies. Continuous glucose monitorings have been used commonly in nonpregnant diabetic patients and patients with type 1 diabetes but their use in patients with GDM are increasing. Although there are no specific Continuous glucose monitoring targets for patients with GDM, CGMs have been used to help determine normative data in patients without GDM, which has helped provide expert opinion on GDM targets. In research studies, CGMs have also been used to explore glycemic profiles for patients early in pregnancy who go on to develop GDM as well as looking at adverse pregnancy outcomes in patients with higher Continuous glucose monitoring metrics. Using CGMs has the potential to provide more information about glycemia, ultimately leading to treatment recommendations in patients with GDM with the ultimate goal to improve adverse pregnancy outcomes and improve health and well-being at large.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}