Nathan L Haas, Frederick K Korley, Ryan M Schneider, Sai Likhita Mamillapalli, Emily Hepworth, James A Cranford, Yu Kuei Lin, Richard T Griffey
{"title":"Continuous Ketone Monitoring in Diabetic Ketoacidosis: Prospective Multicenter Method-Comparison and Feasibility Study.","authors":"Nathan L Haas, Frederick K Korley, Ryan M Schneider, Sai Likhita Mamillapalli, Emily Hepworth, James A Cranford, Yu Kuei Lin, Richard T Griffey","doi":"10.1177/15209156261428034","DOIUrl":"10.1177/15209156261428034","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous ketone monitoring (CKM) could optimize diabetic ketoacidosis (DKA) treatment by monitoring beta-hydroxybutyrate (BOHB) continuously and minimally invasively. However, data on the agreement between interstitial and venous BOHB during DKA is lacking. Our objectives were to assess the feasibility of CKM during DKA and the agreement between interstitial and venous BOHB.</p><p><strong>Methods: </strong>This was a prospective multicenter method-comparison study conducted at two U.S. emergency departments. Adults (>18 years) in DKA were included. BOHB was measured via SiBio CKM and compared with simultaneously collected venous BOHB every 2 h during DKA treatment. Following DKA resolution, study staff removed CKM and assessed for complications. The primary outcome was level of agreement via Bland-Altman analysis between simultaneously collected CKM and venous BOHB values. Additional outcomes included correlation (<i>r</i>) between concurrent CKM and venous BOHB values, first detection of DKA resolution, and feasibility (uncomplicated application and removal of CKM).</p><p><strong>Results: </strong>Thirty-four patients were enrolled, with a mean age of 40.8 years, 56% male, 50% Black, 79% type I diabetes, and mean presenting BOHB 7.0 mmol/L (range 2.5-13.5). We analyzed 164 paired CKM and venous BOHB values (mean [standard deviation (SD)] paired values per patient: 4.8 [3.8], range 1-16). Bland-Altman analysis found the average difference between CKM and venous BOHB was -0.38 mmol/L (95% confidence interval [CI] -1.63, 0.88). CKM values were strongly correlated with venous BOHB (<i>r</i> = 0.96, <i>p</i> < 0.001). The CKM value was lower than venous for 79% of paired values. DKA resolution was detected 55 min earlier (mean, 95% CI 26-84, <i>p</i> = 0.001) via CKM than standard care. No device-related complications occurred, and CKM application and removal were well tolerated by all patients.</p><p><strong>Conclusion: </strong>CKM during DKA treatment was feasible, provided clinically accurate BOHB readings, and detected DKA resolution earlier than standard care. CKM-guided DKA treatment is a promising strategy with the potential to improve the quality and value of DKA care.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"992-998"},"PeriodicalIF":7.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376203","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}
Marina Gradiser, Ines Bilic-Curcic, Ines Okun, Goran Toplek, Silvija Canecki Varzic, Vjekoslav Cigrovski, Lana Ruzic, Maja Cigrovski Berkovic
{"title":"Intermittently Scanned Continuous Glucose Monitoring Enhances Weight Loss and Adherence in Women with Obesity: A Randomized Controlled Trial.","authors":"Marina Gradiser, Ines Bilic-Curcic, Ines Okun, Goran Toplek, Silvija Canecki Varzic, Vjekoslav Cigrovski, Lana Ruzic, Maja Cigrovski Berkovic","doi":"10.1177/15209156261423952","DOIUrl":"10.1177/15209156261423952","url":null,"abstract":"<p><strong>Background: </strong>Lifestyle interventions focusing on diet and physical activity often fail to achieve sustained weight loss, primarily due to low adherence. Intermittently scanned continuous glucose monitoring (isCGM) may serve as a behavioral feedback tool, enhancing motivation and compliance in individuals with obesity.</p><p><strong>Objectives: </strong>To evaluate whether incorporating isCGM into a structured lifestyle intervention improves weight loss, body composition, and metabolic outcomes in women living with obesity.</p><p><strong>Methods: </strong>In this 12-week randomized controlled trial, 35 women with overweight or obesity (body mass index [BMI] > 25 kg/m<sup>2</sup>) were assigned to either an intervention group (<i>n</i> = 17) using isCGM at baseline, mid-intervention, and study end, or a control group (<i>n</i> = 18) using isCGM only at baseline and end. Both groups participated in supervised exercise (3 sessions/week) and received identical dietary counseling. Primary outcomes included changes in body weight and BMI; secondary outcomes comprised body composition, adherence to dietary recommendations, and CGM metrics (time in range [TIR], time below range [TBR], coefficient of variation, HbA1c).</p><p><strong>Results: </strong>Compared with controls, the intervention group achieved significantly greater reductions in body weight (-5.5 ± 2.3 kg vs. -0.2 ± 1.8 kg, <i>P</i> < 0.001), BMI (-1.9 ± 0.6 vs. -0.1 ± 0.4 kg/m<sup>2</sup>, <i>P</i> < 0.001), waist-to-height ratio, body fat, and visceral fat, alongside increased muscle mass and improved dietary adherence (<i>P</i> < 0.05). Clinically meaningful weight loss (≥3% BMI and body fat reduction) occurred in 35% of the intervention group versus 0% of controls. TIR improved modestly in the intervention group (<i>P</i> = 0.03).</p><p><strong>Conclusions: </strong>Integrating isCGM into lifestyle interventions enhances adherence and supports clinically significant improvements in body composition and glycemic control among women with obesity. Larger, longer-term studies are warranted to confirm these findings.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"907-915"},"PeriodicalIF":7.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212690","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}
Alexia Aouba, Bleuenn Dreves, Julia Morera, Anne Rod, Mona Guetlin, Michael Joubert
{"title":"Subcutaneous Catheter Type and Wear Duration in Automated Insulin Delivery Systems: Associations with Glycemic Control in Patients Living with Type 1 Diabetes.","authors":"Alexia Aouba, Bleuenn Dreves, Julia Morera, Anne Rod, Mona Guetlin, Michael Joubert","doi":"10.1177/15209156261423554","DOIUrl":"10.1177/15209156261423554","url":null,"abstract":"<p><strong>Introduction: </strong>Automated insulin delivery (AID) systems represent a major advancement in the management of type 1 diabetes (T1D). While their metabolic efficacy is well established, limited data are available on the impact of catheter type and/or wear duration on glycemic outcomes. This study aimed to evaluate these parameters in real-life conditions.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective, observational study including 321 adults with T1D using an AID system. Analyses focusing on infusion set characteristics were restricted to the 279 patients using tubed pumps. Clinical and glycemic data were extracted from medical records and device software (pumps and sensors). The main parameters assessed were catheter type (perpendicular or angled), cannula length, wear duration, and continuous glucose monitoring (CGM) derived glycemic outcomes.</p><p><strong>Results: </strong>The cohort included 321 patients (51% female), with a mean age of 48 ± 15.1 years, diabetes duration of 25 ± 13.3 years, and a mean body mass index (BMI) of 27 ± 4.9 kg/m<sup>2</sup>. The mean time in range was 70% ± 16.2, time below range 2% ± 2.5, and coefficient of variation 34% ± 7.1. Comparisons between perpendicular (88.9%) and angled catheters (11.1%), as well as between different cannula lengths, showed no significant differences in glycemic outcomes. The mean wear duration was 4.6 ± 2.0 days, longer than recommended, but not associated with poorer glycemic control. Conversely, wear duration was inversely correlated with body weight, BMI, and total daily insulin dose, particularly for perpendicular catheters.</p><p><strong>Conclusion: </strong>Infusion set type, cannula length, and wear duration were not significantly associated with glycemic outcomes among patients using tubed pumps in real-life AID use. Wear duration was associated with anthropometric parameters and insulin requirements.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"899-906"},"PeriodicalIF":7.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164608","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}
Pilar I Beato-Víbora, Maria-Eleni Syleouni, Tara T M Lee, Aesha Khan-Mirón, Carmen Quiros, Federica Carrieri, Eleanor M Scott, Helen R Murphy
{"title":"Optimizing Diabetes Management During Type 1 Diabetes Pregnancy with Automated Insulin Delivery Therapy: Clinical Impact and Economic Consequences in Spain.","authors":"Pilar I Beato-Víbora, Maria-Eleni Syleouni, Tara T M Lee, Aesha Khan-Mirón, Carmen Quiros, Federica Carrieri, Eleanor M Scott, Helen R Murphy","doi":"10.1177/15209156261423217","DOIUrl":"10.1177/15209156261423217","url":null,"abstract":"<p><strong>Background and aim: </strong>The CamAPS FX automated insulin delivery (AID) system is extensively evaluated and uniquely tailored for T1D pregnancies. This study evaluated the clinical and economic implications of improving glycemia with CamAPS FX AID compared with the current standard of care (SoC).</p><p><strong>Methods: </strong>A cost-consequence model was built leveraging data from the AiDAPT study and was adapted to the Spanish health care perspective, using local costs obtained from the literature or hospital databases. As observed in AiDAPT, women treated with AID began with an average glycated hemoglobin (HbA1c) of 7.6% (±1.1) and reached a post-treatment average of 6.0% (±0.5), demonstrating significant improvement in glycemic control. However, in the model, clinical outcomes and the resulting cost impact are based on the incremental 0.3% HbA1c reduction from the first to the third trimester using AID over SoC treatment.</p><p><strong>Results: </strong>Using CamAPS FX AID instead of SoC in pregnancies complicated by T1D resulted in estimated cost savings of €1,002 per treated woman for the Spanish health care system within the first year of treatment. Of these cost savings, the majority (81%) were driven by reductions in intensive neonatal care admissions, reflecting not only marked financial savings but, more importantly, a reduction in complications and suffering among newborns.</p><p><strong>Conclusion: </strong>This conservative analysis captures a clinically significant impact and subsequent economic value, despite being based on only a limited number of perinatal complications. This study provides valuable insights to guide clinical practice, shape health care decision-making, and support broader adoption of technologies that improve maternal and neonatal outcomes.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"933-940"},"PeriodicalIF":7.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212633","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}
David Rodbard, Petra Augstein, Peter Heinke, Eckhard Salzsieder, Andreas Thomas, Jörg Reindel
{"title":"Quality-Score (Q-Score) Can Be More Sensitive than %Time in Range and Several Other CGM Metrics in Detecting Responses to Therapeutic Interventions.","authors":"David Rodbard, Petra Augstein, Peter Heinke, Eckhard Salzsieder, Andreas Thomas, Jörg Reindel","doi":"10.1177/15209156261423504","DOIUrl":"10.1177/15209156261423504","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the relative sensitivity of several available CGM metrics for the detection of the effects of clinical interventions in people with type 1 diabetes (T1D) and type 2 diabetes (T2D).</p><p><strong>Methods: </strong>Real-world data from people with poor glycemic control (hemoglobin A1c 8.2 ± 1.3%) for 120 people with T1D and 92 people with T2D, using Libre 2 CGM. Analysis of CGM data from 3 days prior to admission and 2 days immediately before discharge from ∼8 days of in-hospital care with changes in therapy as prescribed by hospital-based diabetes specialists. CGM metrics included: quality-score (Q-Score), Time in Range (TIR) (3.9-10 mmol/L), Time Above Range (>10 mmol/L), Time Below Range (<3.9 mmol/L), Mean Sensor Glucose, Glucose Management Indicator, Glycemia Risk Index, Glucose Daily Range, and Mean of Absolute Daily Differences (MODD). We evaluated the paired differences in all metrics pre- and postintervention within subjects using classical paired Student's <i>t</i> tests.</p><p><strong>Results: </strong>The Q-Score showed the largest effects in terms of Student's <i>t</i>-values for T1D, for T2D, and for all (T1D and T2D) subjects after pooling, indicating better sensitivity for detection of an effect than TIR or seven other metrics. One of the five components of the Q-Score, MODD, a classical measure of stability of glucose patterns from day to day, showed the second-best sensitivity in evaluating changes within subjects specifically for people with T1D.</p><p><strong>Conclusion: </strong>We observed consistent differences in sensitivity for the detection of the effects of therapeutic interventions, with Q-Score being superior to eight alternatives. This study needs replication using additional patient populations and multiple types of interventions to evaluate its generalizability and applicability to both randomized controlled clinical trials and real-world clinical data.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"924-932"},"PeriodicalIF":7.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510427","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}
Marek Protus, Barbora Voglova Hagerf, Antonin Jabor, Janka Franekova, Lenka Nemetova, Eva Uchytilova, Veronika Indrova, Jana Beckova, Alexander Macek, Martina Doleckova, Milos Mraz, Martin Haluzik, Peter Girman, Martina Viravova, Jan Benes, David C Klonoff, Eva Kieslichova
{"title":"Real-Time Continuous Glucose Monitoring Improves Glycemic Control in the Early Postoperative Period Following Liver Transplantation: A Randomized Controlled Trial.","authors":"Marek Protus, Barbora Voglova Hagerf, Antonin Jabor, Janka Franekova, Lenka Nemetova, Eva Uchytilova, Veronika Indrova, Jana Beckova, Alexander Macek, Martina Doleckova, Milos Mraz, Martin Haluzik, Peter Girman, Martina Viravova, Jan Benes, David C Klonoff, Eva Kieslichova","doi":"10.1177/15209156261480872","DOIUrl":"https://doi.org/10.1177/15209156261480872","url":null,"abstract":"<p><strong>Background: </strong>Early postoperative glycemic control after orthotopic liver transplantation (OLTx) is challenging because of surgical stress, corticosteroid and calcineurin-inhibitor immunosuppression, and parenteral nutrition. We evaluated whether adding real-time continuous glucose monitoring (rtCGM) to standard care increases time in the target glucose range.</p><p><strong>Methods: </strong>In this single-center randomized controlled trial, OLTx recipients were randomized after surgery to open (Active) or blinded (Control) rtCGM (Dexcom G6); in the Active group, sensor data guided insulin titration. The primary endpoint was time in target range (TIR, 6.0-10.0 mmol/L), analyzed in a modified intention-to-treat population. Secondary endpoints included glycemic metrics, insulin requirements, and predefined clinical outcomes.</p><p><strong>Results: </strong>We randomized 154 patients; 142 with available data were analyzed (82 Active, 60 Control). The Active group spent more time in target range (68.9% vs. 60.8%; median difference 7.2 percentage points [95% CI: 2.7-12.0]; <i>P</i> = 0.003), with less time in Level 1 hyperglycemia (<i>P</i> = 0.025) and fewer extended hyperglycemic episodes (incidence rate ratio 1.65 [1.03-2.65] for Control vs. Active; <i>P</i> = 0.039). TIR improved similarly in patients with and without pretransplant diabetes; the only significant treatment-by-diabetes interaction was a greater reduction in Level 2 hyperglycemia among patients with diabetes (<i>P</i> < 0.001). Hypoglycemia was minimal in both groups. Infectious complications were less frequent in the Active group (45.1% vs. 63.3%; <i>P</i> = 0.041).</p><p><strong>Conclusions: </strong>Adding rtCGM to standard postoperative care improved glycemic control after liver transplantation, with consistent benefit regardless of diabetes status and the greatest effect on Level 2 hyperglycemia in patients with diabetes. The lower infection rate is a hypothesis-generating finding warranting a dedicated trial.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261480872"},"PeriodicalIF":7.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812139","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}
Ana Piñar-Gutiérrez, José María Madruga-Rubio, Noelia Gros-Herguido, Sandra Amuedo, Gema López-Gallardo, Carmen Amelia Ruiz-Trillo, Fernando López Herrero, María Loreto Saez Ortega, Ana Muñoz Morales, Virginia Bellido, Alfonso Soto-Moreno
{"title":"Natural History of Mild Non-Proliferative Diabetic Retinopathy in Adults with Type 1 Diabetes Under Contemporary Diabetes Care.","authors":"Ana Piñar-Gutiérrez, José María Madruga-Rubio, Noelia Gros-Herguido, Sandra Amuedo, Gema López-Gallardo, Carmen Amelia Ruiz-Trillo, Fernando López Herrero, María Loreto Saez Ortega, Ana Muñoz Morales, Virginia Bellido, Alfonso Soto-Moreno","doi":"10.1177/15209156261481005","DOIUrl":"https://doi.org/10.1177/15209156261481005","url":null,"abstract":"<p><strong>Background: </strong>Contemporary data on the natural history of mild non-proliferative diabetic retinopathy (NPDR) in adults with type 1 diabetes managed under intensive therapy and continuous glucose monitoring (CGM) are limited. We aimed to characterize the long-term evolution of mild NPDR in this modern care setting and to explore clinical and glycemic factors associated with regression or progression, including CGM-derived metrics.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults with type 1 diabetes and mild NPDR identified by digital fundus photography within a screening program between 2018 and 2020. Participants underwent follow-up retinal evaluation after approximately 5 years. Retinopathy outcomes were classified as regression (absence of retinopathy), stability (persistent mild NPDR), or progression (moderate/severe NPDR and/or diabetic macular edema [DME]). Clinical, biochemical, and glycemic variables, including HbA1c and CGM-derived metrics, were collected. Multivariable logistic regression identified factors independently associated with regression of mild NPDR.</p><p><strong>Results: </strong>Among 113 participants (median age 39 years; median diabetes duration 21 years), regression occurred in 57.5%, 31.0% remained stable, and 11.5% progressed. Lower HbA1c at follow-up was observed in participants with regression compared with those without. Several CGM-derived metrics, including time in range and glucose management indicator, were associated with regression in univariate analyses; however, these associations were not independent of HbA1c due to strong collinearity. In multivariable analysis, lower HbA1c was the only independent predictor of regression.</p><p><strong>Conclusions: </strong>In this real-world screening-based cohort of adults with T1D, mild NPDR demonstrated a highly dynamic course, with more than half of patients experiencing regression over 5 years. Overall glycemic control, reflected by HbA1c, was the primary determinant of regression. CGM-derived metrics did not provide additional predictive value beyond HbA1c in this setting. These findings highlight the potential reversibility of early diabetic retinopathy under contemporary care and underscore the importance of intensive long-term glycemic management.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261481005"},"PeriodicalIF":7.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789336","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}
Ola Friman, Samuel Wiqvist, Marcus Lind, Pia Zetterqvist, Olav Rooijackers, Anders Oldner, Johan Mårtensson
{"title":"Determinants of Continuous Glucose Monitoring Accuracy in Critically Ill Patients Requiring Mechanical Ventilation and Vasopressor Support.","authors":"Ola Friman, Samuel Wiqvist, Marcus Lind, Pia Zetterqvist, Olav Rooijackers, Anders Oldner, Johan Mårtensson","doi":"10.1177/15209156261479816","DOIUrl":"https://doi.org/10.1177/15209156261479816","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) accuracy in critically ill patients may be influenced by altered physiology and concurrent therapies. We assessed independent associations between sensor wear time, arterial blood glucose (ABG), noradrenaline-equivalent (NE) dose, erythrocyte volume fraction, pH, lactate, body-mass index and dialysis to CGM performance (Dexcom G6<sup>®</sup>) in this setting.</p><p><strong>Methods: </strong>Secondary analysis of a prospective observational study including 40 critically ill adults receiving intravenous insulin, mechanical ventilation and vasopressor therapy. Paired ABG and CGM values (<i>n</i> = 2946) were analyzed. The primary outcome was percentage absolute relative difference (ARD). Secondary outcomes were the proportions of CGM readings meeting ISO 15197:2013 and CLSI POCT12-A3 criteria. Multivariable generalized linear mixed models with patient-level random intercepts were fitted, applying B-splines for continuous covariates.</p><p><strong>Results: </strong>Median (IQR) ARD was 10.8% (5.2-18.8) (mean ARD 12.7 [95% CI 10.7-15.3] %); 64.5% and 56.0% of readings met ISO and CLSI criteria, respectively. Sensor wear time (<i>P</i> < 0.001) and pH (<i>P</i> ≤ 0.02) were independently associated with ARD and both categorical accuracy metrics. Predicted ARD decreased, and the probability of meeting ISO/CLSI criteria increased, during the first 50 h after sensor insertion and then stabilized. The pH-accuracy relationships were approximately linear; in linear-term sensitivity analyses, each 0.1-unit increase in pH was associated with a 1.5 percentage-point higher ARD (<i>P</i> = 0.009) and 32% lower odds of meeting CLSI criteria (<i>P</i> = 0.001). NE-dose (<i>P</i> = 0.006) and ABG (<i>P</i> < 0.001) were independently associated with ISO-defined accuracy. Spline analyses suggested reduced accuracy at higher NE-doses (>0.6 µg/kg/min) and lower ABG (<5 mmol/L [<90 mg/dL]), although observations were limited in these ranges.</p><p><strong>Conclusions: </strong>In critically ill patients receiving mechanical ventilation and vasopressor therapy, CGM accuracy improves substantially with increasing sensor wear time and is independently associated with arterial pH. Early postinsertion sensor instability and acid-base disturbances appear to be important determinants of CGM performance in critical illness.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261479816"},"PeriodicalIF":7.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789364","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}
Maya Laron-Hirsh, Sapir Barel, Anirban Roy, George Mallas, Benyamin Grossman, Robert A Vigersky, Ohad Cohen, Amir Tirosh
{"title":"<i>Letter:</i> Authors' Response to LTE by Scaramuzza et al.","authors":"Maya Laron-Hirsh, Sapir Barel, Anirban Roy, George Mallas, Benyamin Grossman, Robert A Vigersky, Ohad Cohen, Amir Tirosh","doi":"10.1177/15209156261481250","DOIUrl":"https://doi.org/10.1177/15209156261481250","url":null,"abstract":"","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261481250"},"PeriodicalIF":7.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789372","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}
Andrea E Scaramuzza, Riccardo Bonfanti, Enza Mozzillo, Riccardo Schiaffini, Ivana Rabbone
{"title":"<i>Letter:</i> Impact of Sensor Technical Specifications on Automated Insulin Delivery Performance: Does the Sensor Really not Matter?","authors":"Andrea E Scaramuzza, Riccardo Bonfanti, Enza Mozzillo, Riccardo Schiaffini, Ivana Rabbone","doi":"10.1177/15209156261481237","DOIUrl":"https://doi.org/10.1177/15209156261481237","url":null,"abstract":"","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261481237"},"PeriodicalIF":7.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789380","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}