Diabetes technology & therapeutics最新文献

{"title":"Medication Use in Type 1 Diabetes and the Association with Socioeconomic Disadvantage: Analysis of a National Linked Dataset.","authors":"Ella Zomer, Jedidiah I Morton, Lei Chen, Stella Talic, Sybil A McAuley, Elizabeth A Davis, Timothy W Jones, Kate E Lomax, Dianna J Magliano, Jonathan E Shaw, Sophia Zoungas","doi":"10.1177/15209156251383516","DOIUrl":"https://doi.org/10.1177/15209156251383516","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To explore trends in the receipt of commonly prescribed medications (beyond insulin) in people with type 1 diabetes in Australia, including polypharmacy, and to investigate socioeconomic disparities across these trends. <b><i>Methods:</i></b> A retrospective analysis of 68,287 people with type 1 diabetes registered on the National Diabetes Services Scheme between 2013 and 2019, and linked to the Australian pharmaceutical claims database to capture medication use. The proportion of people with type 1 diabetes dispensed a medication class was assessed in each year, and by levels of Index of Relative Social Disadvantage. <b><i>Results:</i></b> The study population comprised 37,055 (54.3%) males and 31,232 (45.7%) females captured between 2013 and 2019, with an overall median age of 38.8 (interquartile range [IQR]: 26.1-53.3) years and median diabetes duration of 17.0 (IQR: 7.9-25.7) years. The median number of medications used in the study population was five (IQR: 3-8). Trends in receipt of commonly prescribed medications remained relatively stable between 2013 and 2019, except for the use of noninsulin (adjuvant) glucose-lowering agents, which increased. In 2019, compared with people in the least disadvantaged areas, those in the most disadvantaged areas were more likely to be receiving adjuvant glucose-lowering therapy (crude rates 21.5% vs. 11.6%), antihypertensive therapies (36.1% vs. 28.8%), lipid-lowering therapies (35.7% vs. 29.7%), antithrombotic medication (8.9% vs. 5.6%), proton pump inhibitors (25.2% vs. 17.1%), medications for asthma (13.2% vs. 8.4%), and medications for mental health (27.5% vs. 21.5%). Polypharmacy (defined as ≥5 medications) was more likely in those in the most disadvantaged areas compared with those in the least disadvantaged areas (58.8% vs. 48.5%). Even after adjustment for patient factors, differences in medication use and polypharmacy across socioeconomic strata persisted. <b><i>Conclusions:</i></b> Receipt of commonly prescribed medications in type 1 diabetes and polypharmacy were associated with increased socioeconomic disadvantage.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211955","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":"Lack of Association Between Hemoglobin A1c and Continuous Glucose Monitor Metrics Among Individuals with Prediabetes and Normoglycemia.","authors":"Jorge A Rodriguez, Nadine E Palermo, Wenyu Song, Stuart Lipsitz, A Enrique Caballero, Lipika Samal, Nicole L Spartano","doi":"10.1177/15209156251379506","DOIUrl":"https://doi.org/10.1177/15209156251379506","url":null,"abstract":"<p><p>Continuous glucose monitors (CGMs) are becoming increasingly available, yet the relationship between CGM metrics and hemoglobin A1c (HbA1c) among individuals with prediabetes and normoglycemia remains unclear. We examined associations between HbA1c and eight CGM metrics across glycemic status. Our cohort included 972 individuals: 421 (43.3%) with type 2 diabetes, 319 (32.8%) with prediabetes, and 232 (23.9%) with normoglycemia. Associations were strongest in type 2 diabetes, with mean glucose showing the strongest relationships (standardized β = 0.79, <i>P</i> < 0.001). In prediabetes, associations were substantially attenuated, with mean glucose showing moderate association (standardized β = 0.22, <i>P</i> < 0.001). Among individuals with normoglycemia, CGM metrics showed minimal associations with HbA1c, with mean glucose demonstrating a weak association (standardized β = 0.10, <i>P</i> = 0.022) and time in range showing no significant relationship. All interaction terms were statistically significant (<i>P</i> < 0.001). These findings suggest that standard CGM metrics should not be interpreted to reflect HbA1c for individuals with prediabetes and normoglycemia.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198841","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":"Developing and Evaluating a Natural Language Processing Algorithm to Detect Insulin Pump and Continuous Glucose Monitor Use in Electronic Health Records of Patients with Type 1 Diabetes.","authors":"Estelle Everett, Ryan A Tiu, Bing Zhu, Jeffrey Feng, Nicholas Jackson, Joyce Graham, Eli Ipp, Nestoras Mathioudakis, Alex A T Bui, Tannaz Moin","doi":"10.1177/15209156251383828","DOIUrl":"https://doi.org/10.1177/15209156251383828","url":null,"abstract":"<p><p><b><i>Objective:</i></b> We aimed to develop and validate natural language processing (NLP) algorithms to identify insulin pump and continuous glucose monitor (CGM) users using unstructured clinical note data from the electronic health record (EHR). <b><i>Methods:</i></b> We reviewed a random sample of outpatient clinical notes from endocrinologists to catalog how insulin pump and CGM use was documented. We translated these patterns into regular expressions and used them to build rule-based NLP algorithms, which we iteratively refined. We evaluated the final algorithms in a University of California Los Angeles (UCLA) holdout dataset that included the most recent note from 667 unique patients. We then externally validated the algorithms in a second health system with a different EHR and patient population. Manual chart review served as the gold standard. We assessed performance with measures including sensitivity and specificity. To contextualize algorithm performance, we evaluated the accuracy of billing codes for insulin pump and CGM use within the same UCLA holdout dataset. <b><i>Results:</i></b> In the UCLA holdout dataset, our insulin pump algorithm achieved a sensitivity of 0.90 and specificity of 0.89. The CGM algorithm achieved a sensitivity of 0.85 and specificity of 0.84. The combined algorithm identifying both insulin pump and CGM use showed a sensitivity of 0.76 and specificity of 0.92. In comparison, billing codes underperformed: International Classification of Diseases/Current Procedural Terminology (CPT) codes identified insulin pump use with a sensitivity of 0.09 and specificity of 1.00, whereas CPT codes identified CGM use with a sensitivity of 0.68 and specificity of 0.86. For combined device use, billing codes had a sensitivity of 0.06 and specificity of 1.00. External validation demonstrated similarly strong algorithm performance in the second health system. <b><i>Conclusions:</i></b> We showed that NLP can accurately identify insulin pump and CGM users from unstructured EHR notes, substantially outperforming billing code-based methods. This scalable approach can support system- and population-level evaluations of diabetes technologies.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185012","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 Glucose Monitoring and Long-Term Assessment of Islet Function in Autologous Islet Transplantation after Total Pancreatectomy for Neoplasm: Preliminary Insights from a Prospective Study.","authors":"Alessandro Csermely, Massimiliano Tuveri, Gabriella Lionetto, Martina Fontana, Giancarlo Mansueto, Anna Turazzini, Sara S Sheiban, Manuel Colombini, Federica Nocilla, Carlotta Marruganti, Raffaella Melzi, Rita Nano, Alessandro Mantovani, Riccardo C Bonadonna, Maddalena Trombetta, Lorenzo Piemonti, Roberto Salvia","doi":"10.1177/15209156251380857","DOIUrl":"https://doi.org/10.1177/15209156251380857","url":null,"abstract":"<p><p><b><i>Background and Aims:</i></b> Total pancreatectomy with islet autotransplantation (TPIAT) is a surgical option to mitigate the risk of anastomotic complications and preserve endogenous insulin secretion in patients undergoing pancreaticoduodenectomy. However, the utility of continuous glucose monitoring (CGM) in assessing islet graft performance remains poorly characterized. Thereby, the aim of this study was to investigate the relationship between CGM-derived glycemic metrics and islet function following TPIAT. <b><i>Materials and Methods:</i></b> Ten patients with pancreatic neoplasms (male/female 5/5, median age 60 [IQR 55-68] years) underwent TPIAT between September 2023 and March 2025 at the Verona University Hospital, receiving a median islet dose of 1912 IEQ/kg [IQR 1724-3074]. CGM data were collected at 3 (<i>n</i> = 10), 6 (<i>n</i> = 8), and 12 (<i>n</i> = 7) months post-transplantation. Islet metabolic function was assessed using Igls criteria and BETA-2 score. CGM metrics were compared across Igls-defined graft function categories and correlated with BETA-2 scores. <b><i>Results:</i></b> Of 25 total assessments, islet function was classified as optimal (<i>n</i> = 10), good (<i>n</i> = 6), marginal (<i>n</i> = 8), or failure (<i>n</i> = 1). Median BETA-2 score decreased significantly across these groups (19.4, 13.6, 5.3, 1.4, respectively; <i>P</i> < 0.001). Optimal function was associated with superior glycemic control (time in range, TIR: 97.0%; time in tight range, TITR: 86.5%; time above range, TAR: 1.5%) and lower glycemic variability (coefficient of variation, CV: 20.5%; glycemia risk index, GRI: 44.0), compared with good and marginal groups (all <i>P</i> < 0.01). These same CGM metrics were significantly correlated with both Igls classification and BETA-2 score (all <i>P</i> < 0.015). <b><i>Conclusions:</i></b> CGM parameters reflect islet graft performance following TPIAT and are strongly correlated with established markers of β-cell function. Metrics such as TIR, TITR, TAR, CV, and GRI may serve as practical and sensitive tools for post-transplant metabolic surveillance in endocrine clinical practice. [Figure: see text].</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191338","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":"Current Clinical Features of Diabetic Ketoacidosis in Adults: A German Multicenter Study 2022-2023.","authors":"Jonas A Linck, Christian Michels, Annekatrin Schwanstecher, Imke Schamarek, Dorothea Hinsch, Christoph Terkamp, Clemens F Ringel, Annika Hoyer, David J F Holstein, Marcus Altmeier, Andreas Holstein","doi":"10.1177/15209156251380863","DOIUrl":"https://doi.org/10.1177/15209156251380863","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To obtain clinical features of diabetic ketoacidosis (DKA) in adults leading to hospital admission. <b><i>Methods:</i></b> Multicenter observational study investigating DKAs treated in five German tertiary hospitals between 2022 and 2023. <b><i>Results:</i></b> A total of 179 patients with 203 episodes of DKA were registered: 64% of cases in pre-existing type 1 diabetes mellitus (T1DM), 14% in new-onset T1DM, 14% in pre-existing type 2 diabetes mellitus (T2DM), 3% in new-onset T2DM, 6% in latent autoimmune diabetes in adults, and 6% in pancreatogenic diabetes. Seven cases of SGLT 2 inhibitor (SGLT 2-I)-associated euglycemic DKA (EDKA) were encountered. In pre-existing T1DM, DKA occurred despite continuous glucose monitoring in 51% of patients and insulin pumps or automated insulin delivery in 24%. Only 21% of individuals with T1DM were in possession of ketone test and only 6% applied ketone testing. In total, 71% of patients with pre-existing T1DM experienced recurrent episodes of DKA. Suboptimal adherence to diabetes therapy was the most common triggering factor for DKA in known T1DM (56%), whereas infections contributed most in pre-existing T2DM (32%). The entirety of patients pretreated with SGLT2-Is and particularly also those with SGLT2-I associated EDKA were not educated concerning sick-day-rules. The inpatient mortality risk of DKA was 2.3% and restricted to multimorbid patients with known T2DM. <b><i>Conclusions:</i></b> The clinical and etiological pattern of DKA is heterogeneous. Patients with pre-existing T1DM showed educational deficits concerning diagnostic and therapeutic measures to prevent DKA. Individuals with recurrent episodes of DKA require individual therapeutic concepts within the multidisciplinary diabetes care team. Emphasizing sick-day-rules in patients being treated with SGLT 2-Is is indispensable to prevent EDKA. Individuals with pre-existing T2DM represent a vulnerable group with severe comorbidities and high mortality risk due to DKA.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174113","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":"Advanced Hybrid Closed-Loop Systems in Perioperative Care: Safety During Anesthesia.","authors":"Ana Maria Gómez, Diana Henao-Carrillo, Oscar Muñoz-Velandia, Maira García-Jaramillo, Daniela Hurtado, Carolina Vargas, Gabriel Rojas-Acosta, Carlos Zhong-Lin","doi":"10.1177/15209156251376011","DOIUrl":"https://doi.org/10.1177/15209156251376011","url":null,"abstract":"<p><p><b><i>Background:</i></b> There is limited evidence regarding the safety and efficacy of advanced hybrid closed-loop (AHCL) systems during the perioperative period. Specific management guidelines for these systems are lacking. <b><i>Objective:</i></b> To describe glycemic control metrics in patients with AHCL system during the intraoperative and postoperative periods. <b><i>Methods:</i></b> Analytical study based on a prospective cohort of adults with type 1 diabetes (T1D) or type 2 diabetes who are treated with AHCL system (MiniMed™780G, Medtronic, USA) and are undergoing surgical procedures. The study compared time in range (%TIR) between 70 and 180 mg/dL, time below range (%TBR) <70 and <54 mg/dL, time above range (%TAR) >180 and >250 mg/dL, and time in normoglycemia range (%TINR) between 70 and 140 mg/dL during the intraoperative, immediate postoperative, and late postoperative periods, with baseline measurements. <b><i>Results:</i></b> The analysis included 15 patients (86% T1D; 55.4 ± 16.3 years) and 17 surgical procedures (70% elective; mean duration 65.3 ± 36.3 min). Baseline data obtained 24 h prior to the admission: %TIR 78.4 ± 17.5%, %TINR 58.6 ± 22.9%, and %TBR <70 mg/dL 3.7 ± 4.2%. During the intraoperative period, %TIR increased to 99.6 ± 1.5% (<i>P</i> < 0.001), and %TBR <70 mg/dL decreased to 0 (<i>P</i> < 0.001). %TAR >180 mg/dL decreased from 17.8 ± 16.8% to 0.1 ± 1.5% (<i>P</i> < 0.001). No hypoglycemic events <70 mg/dL or <54 mg/dL were documented in the intraoperative and immediate postoperative periods. No severe adverse events related to device use were recorded. <b><i>Conclusions:</i></b> During the perioperative period, continuing insulin infusion using AHCL system is feasible, maintaining high levels of %TIR and %TINR, without hypoglycemia or serious adverse events. Randomized clinical trials are needed to compare the use of this technology with usual care.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174166","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":"A Real-World Study Comparing Advanced Hybrid Closed-Loop Systems During Pregnancy in Women with Type 1 Diabetes.","authors":"Carmen Quirós, Ana M Wägner, Sharona Azriel, Berta Soldevila, Pilar I Beato-Vibora, Mayte Herrera Arranz, Lía Nattero, María José Picón-César, Elisenda Climent, Judit Amigó, Natalia Colomo, María Durán-Martínez, Macarena Alpañes Buesa, Ana Megía, Irene Vinagre, Begoña Vega Guedes, Gonzalo Díaz-Soto, Orosia Bandrés, Beatriz Barquiel, Cristina López Tinocco, Rosa Márquez-Pardo, Maria A Martínez-Brocca, Rosa Corcoy, Mercè Codina, María Piedra, Ángel Rebollo Román, Martín Cuesta, Gema López-Gallardo, Maria M Goya Canino, Fernando Bugatto, Lilian C Mendoza, María Del Pilar Olvera Márquez, Verónica Perea","doi":"10.1177/15209156251379488","DOIUrl":"https://doi.org/10.1177/15209156251379488","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To compare maternal glucose metrics and pregnancy outcomes of three advanced hybrid closed-loop (aHCL) systems (MiniMed 780G®, CamAPS® FX, and Tandem Control-IQ) in a real-world, multicenter cohort of pregnant women with type 1 diabetes. <b><i>Research Design and Methods:</i></b> Cohort study including 137 pregnant women with type 1 diabetes using aHCL from 27 hospitals in Spain. Participants were grouped according to the aHCL system used: 85 MiniMed 780G (62%), 38 CamAPS FX (27.7%), and 14 Control-IQ (10.2%). Maternal glucose metrics (HbA1c and time spent within [TIRp], below [TBRp], and above [TARp] the pregnancy-specific glucose range 3.5-7.8 mmol/L), as well as pregnancy outcomes, were analyzed. Adjusted models were applied to account for potential confounding factors. <b><i>Results:</i></b> No between-group differences in HbA1c levels were observed at baseline. By the third trimester, CamAPS FX and Control-IQ users had significantly lower HbA1c levels compared with the MiniMed 780G group (β_adjusted -4.77 mmol/mol, 95% confidence interval [CI] -7.40 to -2.13; and β_adjusted -4.79, 95% CI -8.53 to -1.06; respectively). In the second trimester, CamAPS FX was associated with a higher percentage of time in range (β_adjusted +5.88%, 95% CI 1.09 to 10.67) and a lower percentage of time above range (β_adjusted -6.36%, 95% CI -11.46 to -1.26) compared with MiniMed 780G, with no other significant differences observed in other trimesters. Both CamAPS FX and Control-IQ were associated with lower odds of large-for-gestational-age (LGA) infants (CamAPS FX: OR_adjusted 0.25, 95% CI 0.08 to 0.77; Control-IQ: OR_adjusted 0.10, 95% CI 0.01 to 0.99) compared with MiniMed 780G. <b><i>Conclusions:</i></b> In this multicenter observational study, CamAPS FX and Control-IQ users achieved better glycemic metrics and lower odds of delivering LGA infants compared with those using MiniMed 780G. These findings warrant investigation to confirm associations and inform individualized clinical decision-making in pregnant women with type 1 diabetes.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174111","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":"Carbohydrate Counting/Bolus Calculator Mobile Application Improves Time in Range in Adults with Type 1 Diabetes Subjects.","authors":"Sara A AlBabtain, Nora O AlAfif, Mohammed S Almehthel, Anwar A Jammah, Tariq A Wani, Tarfa A Aldahham, Ramzi A Ajjan, Saad H AlZahrani","doi":"10.1177/15209156251376012","DOIUrl":"https://doi.org/10.1177/15209156251376012","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate the effectiveness and safety of a mobile application for carbohydrate counting and bolus calculation (CHOC-BC) in adults with type 1 diabetes mellitus (T1DM). <b><i>Research Design and Methods:</i></b> A 12-week randomized controlled trial was conducted at King Fahad Medical City, Riyadh, Saudi Arabia. Adults with T1DM on multiple daily insulin injections and using Libre 2 glucose monitors were randomized to either CHOC-BC or conventional treatment. The primary endpoint was time in range (TIR; 70-180 mg/dL). <b><i>Results:</i></b> A total of 127 participants (70 females) were included: 64 in the intervention group and 63 in the control group with a mean age of 26.56 ± 4.8 and 26.74 ± 6.52 years, respectively. After 3 months, the intervention group achieved better TIR than the control group (51.20% ± 11.61% vs. 46.17% ± 13.02%; mean difference [MD], 5.03; 95% confidence interval [CI], 0.70-9.36; <i>P</i> = 0.023). Application users showed a significant reduction in level 2 time above range (17.25% ± 11.61% vs. 24.10% ± 15.74%; MD, -6.85; 95% CI, -11.70 to -1.99; <i>P</i> = 0.006). No significant differences were observed in body weight or time below range. <b><i>Conclusions:</i></b> The CHOC-BC mobile application empowered users to achieve better glycemic control while maintaining a safe profile that avoids hypoglycemia and weight gain.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136920","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":"A Retrospective Real-Life Study to Compare Glycemic Control Between Simplified Meal Size Estimation and Precise Carbohydrates Counting in Type 1 Diabetes Patients Using DBLG1 Hybrid Closed-Loop System.","authors":"Julie Blervaque, Aurélien Vésin, Pierre-Yves Benhamou, Sandrine Lablanche","doi":"10.1177/15209156251362700","DOIUrl":"https://doi.org/10.1177/15209156251362700","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Qualitative meal size estimation (QMSE) could be an interesting alternative to precise carbohydrates counting (PCC) for patients equipped with hybrid closed-loop systems (HCL). The aim is to compare postprandial glycemic control following meals declared by QMSE of the DBLG1 system with PCC. <b><i>Methods:</i></b> We randomly selected a 20% sample of patients from the commercial database of type 1 diabetes patients equipped with the DBLG1 system in Europe. We assumed that when the carbohydrates (CHO) amount was identical to the predefined average meal value (small, medium, or large meal), the patient used the semiquantitative method, and the corresponding meals were assigned to the QMSE group. The others were assigned to the PCC group. The glucose metrics of the meals were computed during the postprandial period, defined as [t_meal; t_meal + 4 h], provided that there was no other meal during this 4-h period or during the previous 4 h. <b><i>Results:</i></b> A total of 1959 patients from seven Western European countries were included (mean HbA1c 7.6% ± 1.2%; mean age 43.9 ± 14.7 years). Overall, 287,000 meals (47%) were declared with PCC and 327,819 (53%) with QMSE and the mean meal size was 47.2 ± 32.5 g and 48.4 ± 28.6 g, respectively. The postprandial TIR was 62.39% ± 30.86% with QMSE and 63.21% ± 30.62% with PCC. The mean TIR difference of 0.81% was statistically significant but not clinically relevant. Time below range (TBR) was low for both methods of declaration (TBR < 70 mg/dL of 1.4% ± 5.0% with QMSE and 1.4% ± 4.8% with PCC). <b><i>Conclusion:</i></b> The semi-quantitative CHO declaration achieves similar glycemic results as CHO counting in this retrospective study. This method could help to reduce the burden of diabetes and offers an alternative to patients reluctant to use CHO counting.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136971","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 Simplification Strategies on Postmeal Glucose Excursions in Older Adults with Type 1 Diabetes and Hypoglycemia.","authors":"Elena Toschi, Molly Savory, Colin Conery, Noa Krakoff, Atif Adam, Christine Slyne, Medha Munshi","doi":"10.1177/15209156251370985","DOIUrl":"https://doi.org/10.1177/15209156251370985","url":null,"abstract":"<p><p>Continuous glucose monitoring with simplification strategies reduces hypoglycemia in older adults with type 1 diabetes (T1D), however the impact on postmeal glycemia is not known. A post-hoc analysis of older adults with T1D randomized to intervention with mealtime simplification strategies, or control, assessed weekly postmeal hypoglycemia and hyperglycemia. At baseline, 88 older adults with T1D (71 ± 5 years) in intervention (n = 47) and control (n = 41) had similar number of episodes of postmeal hypo- and hyperglycemia. The mean decrease from baseline to 6 months in episodes of postmeal hypoglycemia was: after breakfast (-0.77 vs. -0.32; <i>P</i> = 0.02), lunch (-0.80 vs. -0.32; <i>P</i> = 0.05), and dinner (-0.73 vs. -0.22; <i>P</i> = 0.04); and the mean change in episodes of postmeal hyperglycemia was: after breakfast (-2.05 vs. -1; <i>P</i> = 0.04), lunch (-1.23 vs. -0.87; <i>P</i> = 0.09), and dinner (-1.45 vs. -1.66; <i>P</i> = 0.33), respectively in intervention and control. Simplification strategies in older adults with T1D resulted in fewer episodes of postmeal hypoglycemia without worsening episodes of postmeal hyperglycemia.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136936","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}