Diabetes technology & therapeutics最新文献

{"title":"Glucose Predictions Improve Glycemic Control: A Digital Twin Evaluation.","authors":"Pau Herrero, Magí Andorrà, Marc D Breton, Ajandek Peak, Matthias Koehler, Yannick Klopfenstein, Eemeli Leppäaho, Mattia Zanon, Christian Ringemann, Patrick Lustenberger, Timor Glatzer","doi":"10.1177/15209156261432144","DOIUrl":"10.1177/15209156261432144","url":null,"abstract":"<p><strong>Background: </strong>Glucose predictions aim to empower continuous glucose monitoring (CGM) users by enabling preventive actions to reduce adverse glycemic events. The Accu-Chek^® SmartGuide Predict app offers several AI-enabled predictive features, driven by machine learning algorithms. These include notifications for a low glucose predict within 30 min (LGP) and for nighttime low glucose risk, as well as a 2-h continuous glucose forecast.</p><p><strong>Aims: </strong>This study aimed to quantify the potential glycemic benefits of using the Predict app's predictive features in an adult population with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>A comparative in silico study was conducted using the clinically backed University of Virginia Replay digital twin simulator. A control arm, simulating standard hypoglycemia and hyperglycemia mitigation strategies in line with international guidelines, was compared against intervention arms that incorporated probabilistic user behavior models responding to the app's predictive features. The evaluation was performed on 204 digital twins, representing 29,929 days of data, generated from the REPLACE-BG clinical trial dataset.</p><p><strong>Results: </strong>Results demonstrated that using the app's predictive features has the potential to improve glycemic control in adults with T1D. The simulated intervention led to an average 2.9 percentage point reduction in time below range (<70 mg/dL), and a clinically significant increase of more than 3.6 percentage points in time in range (70-180 mg/dL). Furthermore, the daily number of CGM hypoglycemia alarms (<70 mg/dL) was reduced by 67%. The findings also suggest that consuming 10 g of fast-acting carbohydrates in response to LGP notifications provides an optimal balance, effectively preventing hypoglycemia while limiting rebound hyperglycemia.</p><p><strong>Conclusions: </strong>This in silico evaluation provides strong evidence supporting the potential clinical utility of the Accu-Chek SmartGuide Predict app for improving glycemic management in adults with T1D.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"1052-1062"},"PeriodicalIF":7.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431385","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":"Temporal Discontinuity in Continuous Glucose Monitoring: How Midnight Segmentation Generates Systematic Measurement Artifact.","authors":"Mark Paull","doi":"10.1177/15209156261435242","DOIUrl":"10.1177/15209156261435242","url":null,"abstract":"<p><p>Continuous glucose monitoring (CGM) generates dense physiological time-series data sampled every 5 min across 24-h periods. Standard analytical approaches impose calendar-based temporal boundaries-treating midnight as a natural segmentation point-despite glucose homeostasis operating through continuous circadian oscillators that recognize no such delimiter. This structural misalignment introduces a systematic measurement artifact: biologically continuous overnight patterns are bisected at 00:00, artificially inflating glycemic variability estimates and obscuring individual circadian phase relationships. We analyzed approximately 60 days of CGM data, comparing three binning strategies: (1) 24 linear hour-bins (conventional), (2) 36 linear 40-min bins (resolution control), and (3) 36 angular 10° bins (circular topology). Shannon entropy with variance-weighted probabilities quantified information content. Bootstrap resampling (1000 iterations) and null topology permutation (random within-day time-permutation, 1000 iterations) distinguished genuine temporal structure from mathematical artifact. Circular representation demonstrated 12.1% higher information entropy compared to linear binning at matched resolution (3.56 vs. 3.18 bits, <i>P</i> < 0.001, bootstrap percentile method), with nonoverlapping confidence intervals (95% CI: 3.41-3.71 vs. 3.06-3.30). Increasing from 24 to 36 bins in linear space produced zero entropy change (3.18→3.18), isolating topological continuity as the information-preserving factor. Midnight boundary created 2.8-fold reduction in continuity correlation (<i>r</i> = 0.31 vs. <i>r</i> = 0.87, <i>P</i> < 0.001) for biologically adjacent timepoints. Analysis showed nonrandom angular variance structure (<i>P</i> < 0.001), with 1.97-fold variance differential between evening (21:20-00:00) and midday (11:20-14:00) zones. Midnight segmentation introduces quantifiable information loss through temporal discontinuity. Circular time representation-mapping 24-h cycles onto angular coordinates using established directional statistics-eliminates this artifact while preserving temporal information. Current glycemic variability metrics (coefficient of variation, time-in-range) calculated within midnight-bounded periods inherit discontinuity artifacts, potentially misclassifying normal circadian oscillations as pathological variability. Adoption of circular frameworks would align CGM analytics with chronobiological principles and enable individual circadian phenotyping without data manipulation. This represents methodological infrastructure requiring prospective validation for clinical utility.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"1104-1109"},"PeriodicalIF":7.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497792","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":"MiniMed^<b>TM</b> 780G System Users Achieve Similar Glycemic Outcomes Regardless of Socioeconomic Disadvantage.","authors":"Margaret Liu, Fang Niu, Caroline Yovanovich, Venkat Putcha, Naveen Sathiyanathan, Amanda Kinnischtzke, Diana Miller, John J Shin, Toni L Cordero, Robert A Vigersky, Jennifer J F McVean","doi":"10.1177/15209156261441462","DOIUrl":"10.1177/15209156261441462","url":null,"abstract":"<p><p>Socioeconomic disadvantage, as measured by the Area Deprivation Index (ADI), is associated with health disparities in diabetes management. This real-world analysis evaluated glycemic outcomes among United States users of the MiniMed^™ 780G system, stratified by ADI percentile. Data from 40,975 users revealed consistent glycemic metrics across ADI groups, with a mean time in range (TIR) of 73%, time below range (TBR) of 1.3%, and time above range (TAR) of 25%, regardless of ADI grouping. Although statistically significant associations were observed between ADI and TBR, effect sizes were minimal and not clinically meaningful. Adoption of recommended optimal settings (ROS, an active insulin time of 2 h and a glucose target of 100 mg/dL, both for >95% of the time) significantly improved outcomes, with at least 68% of users achieving consensus-recommended glycemic targets compared to ∼50% in the overall analyzed population. These findings suggest the MiniMed^™ 780G system delivers consistent glycemic outcomes across socioeconomic levels, offering a promising avenue for reducing diabetes-related health disparities.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"1110-1114"},"PeriodicalIF":7.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671175","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":"Ultrasound-Guided Infusion Site Rotation Improves Glycemic Outcomes in Children and Adolescent Users of Automated Insulin Delivery Systems.","authors":"Julian Bjerrekær, Anna Korsgaard Berg, Merete Bechmann Christensen, Tommi Suvitaival, Kirsten Nørgaard, Jannet Svensson","doi":"10.1177/15209156261433362","DOIUrl":"10.1177/15209156261433362","url":null,"abstract":"<p><strong>Objective: </strong>Challenges with infusion sets and skin sites may hinder optimal glycemic levels in automated insulin delivery (AID). This study investigated how infusion set wear time affects glycemic control, insulin doses, and infusion site tissue characteristics and evaluated the impact of ultrasound-guided site rotation.</p><p><strong>Research design and methods: </strong>Children and adolescents (6-18 years) using AID completed a 28-day prospective study. Skin assessments and ultrasound imaging were performed at baseline, day 14, and day 28. Hyperechogenicity was interpreted as early lipohypertrophy. Analyses were intention-to-treat. Time in range (TIR) and insulin dose/kg/day were modeled as piecewise functions by days since infusion set change.</p><p><strong>Results: </strong>Of 40 participants, 31 had sufficient continuous glucose monitoring data (mean age 11.3 years, diabetes duration 5.6 years, 55% male, HbA1c 54 mmol/L [7.1%]). After guiding, TIR increased by 2.5% points/day for 2 days post set change (<i>P</i> < 0.0001) and then decreased by 4.7% points/day (<i>P</i> < 0.0001). Insulin doses rose by 0.036 U/kg/day after day 2 (<i>P</i> = 0.009). Hyperechogenicity was associated with lower TIR after day 2 and correlated with clinical lipohypertrophy (<i>P</i> < 0.001, risk ratio = 3.63). Participants with ultrasound-only tissue changes had higher TIR than those with both ultrasound and clinical signs (73% vs. 67%, <i>P</i> < 0.0001).</p><p><strong>Conclusions: </strong>TIR declines from day 2 of infusion set wear despite rising insulin doses, indicating reduced absorption not fully compensated by AID. Ultrasound-guided site selection improves glycemic outcomes, likely by supporting more consistent and effective site rotation.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"1025-1033"},"PeriodicalIF":7.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485078","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":"Comparison of Blood Glucose Values Used for Impending Non-Severe Hypoglycemia Management with Corresponding Continuous Glucose Monitoring Data in Type 1 Diabetes: A Secondary Analysis of the REVERSIBLE Trial.","authors":"Andréanne Marquis, Ran Cheng, Sara Al-Mahayni, Ahmed Osman, Josephine Molveau, Virginie Messier, Rémi Rabasa-Lhoret, Nadine Taleb","doi":"10.1177/15209156261493676","DOIUrl":"https://doi.org/10.1177/15209156261493676","url":null,"abstract":"<p><strong>Background: </strong>To assess continuous glucose monitoring (CGM) data corresponding to blood glucose (BG) values used for impending non-severe (NS) hypoglycemia management in people living with type 1 diabetes (PwTID).</p><p><strong>Methods: </strong>We performed a secondary analysis of the REVERSIBLE trial, a three-arm open-label crossover study assessing the efficacy of 16 g oral carbohydrates (CHO) for preventing NS hypoglycemia at different BG levels: <72 mg/dL (4 mmol/L, level 1), ≤80 mg/dL (4.5 mmol/L), or ≤90mg/dL (5.0 mmol/L). CGM data (DexcomG6^®) were compared with BG to assess their variances and mean absolute relative differences (MARDs).</p><p><strong>Results: </strong>In all three arms CGM values overestimated BG levels (<i>P</i> < 0.001). MARDs were higher with lower BG values. Despite these differences, we did not observe rebound hyperglycemia (BG > 180 mg/dL; 10 mmol/L).</p><p><strong>Conclusion: </strong>When using CGM, PwTID may need to treat or prevent NS hypoglycemia at a higher threshold than 72 mg/dL (4.0 mmol/L) and 80 mg/dL (4.5 mmol/L), respectively.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261493676"},"PeriodicalIF":7.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105476","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":"Exploratory Analysis of Continuous Glucose Monitoring Patterns in First-Degree Relatives with Dysglycemia at Risk of Progression to Stage 3 Type 1 Diabetes.","authors":"Olivier Pollé, Tadej Battelino, Pieter-Jan Martens, Lut Overbergh, Chantal Mathieu, M Loredana Marcovecchio","doi":"10.1177/15209156261492040","DOIUrl":"10.1177/15209156261492040","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous glucose monitoring (CGM) can characterize subtle glucose changes in early-stage type 1 diabetes (T1D). We assessed whether CGM metrics predict Stage 3 T1D in first-degree relatives (FDRs) with positive islet autoantibodies (IAbs) and dysglycemia participating in INNODIA.</p><p><strong>Methods: </strong>We analyzed IAb-positive FDRs with dysglycemia and available CGM data. CGM metrics were analyzed longitudinally and in a restricted analysis limited to the last assessment before Stage 3 T1D in progressors. CGM metrics were compared using linear mixed models. Predictive performance of single and combined CGM metric models was evaluated using receiver operating characteristic curve analyses.</p><p><strong>Results: </strong>Data from 27 participants (14 females [52%], median [interquartile range] age: 16.8 [11.9-39.8] years) were analyzed. Nine participants progressed to Stage 3 T1D after a median of 163 [129-244] days from CGM assessment. In the restricted analysis, progressors had higher mean glucose (132 vs. 111 mg/dL, <i>P</i> = 0.001), time >140 mg/dL (36% vs. 10%, <i>P</i> = 0.003), and time >180 mg/dL between 9 PM and 2 AM (8.1% vs. 1.0%, <i>P</i> = 0.005), whereas time <70 mg/dL between 4 and 7 AM was lower (0% vs. 1.2%, <i>P</i> = 0.001). Time >140 mg/dL yielded an area under the curve (AUC) of 0.83 (95% confidence interval [CI] 0.66-1.00). Combining time >140 mg/dL with time-specific percentages >180 and <70 mg/dL increased AUC to 0.93 (95% CI 0.84-1.00). A model incorporating time between 70 and 140 mg/dL, mean glucose, early morning <70 mg/dL, and MAGE achieved 100% sensitivity and 86% specificity.</p><p><strong>Conclusions: </strong>CGM may help identify FDRs with IAbs and dysglycemia at higher risk of progressing to Stage 3 T1D. Combining CGM metrics improved prediction compared with time >140 mg/dL alone.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261492040"},"PeriodicalIF":7.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073299","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":"Factors Associated with Utilization and Underutilization of Diabetes Technology in Underrepresented Families Living with Type 1 Diabetes.","authors":"Ananta Addala, Daniel Garfias Silva, Lauren E Figg, Sarah J Hanes, Ricardo Medina Peñaranda, Gary M Shaw, Lisa J Chamberlain, Diana Naranjo, Jennifer K Raymond, David M Maahs, Korey K Hood","doi":"10.1177/15209156261489913","DOIUrl":"https://doi.org/10.1177/15209156261489913","url":null,"abstract":"<p><p>Continuous glucose monitoring (CGM) and insulin pumps improve glycemic outcomes and quality of life for youth with type 1 diabetes, yet utilization remains suboptimal. We analyzed cross-sectional data from 84 parent-youth dyads in the Building the Evidence to Address Disparities in Type 1 Diabetes study. Youth using both CGM and pump were classified as technology utilizers. Adjusted prevalence ratios (aPR) evaluated associations of sociodemographic variables with utilization. Parents of utilizers were older (standardized mean difference [SMD] = 0.74), had higher education (SMD = 0.91), and youth had longer diabetes duration (SMD = 0.49). Underutilizers endorsed higher youth discrimination (4.23 vs 2.49, <i>P</i> = 0.016) and greater CGM-burden (2.34 vs 1.84, <i>P</i> < 0.001), while technology acceptance was higher among utilizers (4.40 vs 3.91, <i>P</i> = 0.007). Parental age (aPR = 1.03, 95% CI: [1.01,1.05], <i>P</i> = 0.003), parental education (aPR = 1.10, 95% CI: [1.01,1.19], <i>P</i> = 0.03), and Non-White + non-English caregivers (aPR = 1.58, 95% CI: [1.01,2.48], <i>P</i> = 0.046) were associated with higher utilization. Youth discrimination (aPR = 0.94, 95% CI: [0.89,1.00], <i>P</i> = 0.04) was associated with lower utilization. Technology utilization was associated with structural characteristics and youth-reported experiences, with youth discrimination identifying experiential factors that may influence adoption of diabetes technologies.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261489913"},"PeriodicalIF":7.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037048","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":"Three-Year Real-World Performance of Bihormonal Fully Closed-Loop Therapy in Type 1 Diabetes.","authors":"Theodorus J P Jansen, Carmen den Drijver, Lyan B Vlaskamp, Arianne C van Bon","doi":"10.1177/15209156261492793","DOIUrl":"https://doi.org/10.1177/15209156261492793","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes management continues to advance through novel treatment options, such as bihormonal fully closed-loop (FCL) systems. Real-world data on these systems are currently limited to a maximum of 1 year. Extended follow-up spanning several years would provide valuable insights into long-term performance of a bihormonal FCL.</p><p><strong>Methods: </strong>In a retrospective, observational, real-world cohort study, adults with type 1 diabetes who were treated with the bihormonal FCL system for 3 years were included. Endpoints were determined per 6 months (semester) and included continuous glucose monitoring-derived outcomes. Linear mixed-effects models were used to evaluate changes in outcome measures over time.</p><p><strong>Results: </strong>A total of 102 users were included in the study. Limited availability of initial glucagon (GlucaGen [GG]) led to a necessary switch to an alternative (Glugon) for a part of the users. GG-only users (<i>n</i> = 60) demonstrated stable glucose outcomes over the 3-year period, whereas a decline was observed in the total group during the final period. In the GG-only group, time in range (TIR; 3.9-10.0 mmol/L [70-180 mg/dL]) ranged from 79.5% to 80.8% and from 77.4% to 80.8% in the total group. For time below range (<3.9 mmol/L [<70 mg/dL]), this was 0.95%-1.56% (GG-only) versus 1.03%-1.69% (total). TIR decreased from 79.3 ± 7.1 to 75.8 ± 7.9 in the 3-month period after the glucagon switch compared to the period before (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Real-world data demonstrated long-term stability of bihormonal FCL system performance among individuals treated with GG. A slight decline in performance was observed in the total population, and outcomes significantly deteriorated for users after the glucagon switch, indicating a negative effect on FCL performance of the alternative glucagon. Overall, the long-term findings point toward the benefits of the bihormonal FCL to maintain adequate glycemic control in people with type 1 diabetes over several years.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261492793"},"PeriodicalIF":7.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037060","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 Hospitalization Outcomes in Adults with Insulin-Treated Type 2 Diabetes and Complex Care Needs: A Population-Based Study.","authors":"Pablo Rodríguez de Vera Gómez, Ángel Manuel Mesa Díaz, Eduardo Mayoral Sánchez, Fernando Gómez-Peralta, Guillermo E Umpierrez, María Asunción Martínez Brocca","doi":"10.1177/15209156261492377","DOIUrl":"https://doi.org/10.1177/15209156261492377","url":null,"abstract":"<p><strong>Aim: </strong>Continuous glucose monitoring (CGM) improves glycemic outcomes in insulin-treated type 2 diabetes (T2D), but evidence in individuals with complex care needs (CCN) is limited. We evaluated the association between CGM initiation and hospitalization outcomes in a population-based cohort of adults with insulin-treated T2D and CCN.</p><p><strong>Methods: </strong>We conducted a population-based quasi-experimental study including all eligible adults with insulin-treated T2D and CCN who initiated CGM through the Andalusian Public Health System. Rates of acute diabetes-related complications and cardiovascular admissions were compared before and after CGM initiation using Poisson regression models adjusted for person-time. Interrupted time-series analyses, length of stay (LOS), and hospitalization costs were also evaluated.</p><p><strong>Results: </strong>Of 17,561 adults initiating CGM, 5281 met criteria for CCN and were included (mean age 79 years; 55.1% aged ≥ 80 years). Acute diabetes-related hospitalization rates decreased from 144.27 to 41.04 per 10,000 person-years (rate ratio [RR] 0.28, 95% CI 0.19-0.42), and cardiovascular admission rates decreased from 387.25 to 251.96 per 10,000 person-years (RR 0.65, 95% CI 0.54-0.78). Interrupted time-series analyses showed post-intervention hospitalization rates consistently below counterfactual estimates. Mean LOS decreased by 3.68 days (95% CI -5.26 to -2.10; <i>P</i> < 0.001), and hospitalization costs decreased by USD657.39 per patient-year.</p><p><strong>Conclusion: </strong>In this population-based cohort of adults with insulin-treated T2D and CCN, CGM initiation was associated with fewer hospitalizations, shorter hospital stays, and lower hospitalization costs, supporting the integration of diabetes technology into chronic care strategies for highly vulnerable populations.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261492377"},"PeriodicalIF":7.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037103","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":"Association Between Continuous Glucose Monitoring Utilization and Glucagon-Like Peptide-1 Receptor Agonist Discontinuation in Type 2 Diabetes: A Real-World Study.","authors":"Eugene E Wright, Eileen Huang, Anila Bindal","doi":"10.1177/15209156261489904","DOIUrl":"10.1177/15209156261489904","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous glucose monitoring (CGM) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) when used jointly are associated with significant improvement in glycemic outcomes. However, it is unknown if using CGM enhances GLP-1 RA continuation. This study assesses the relationship between adherent CGM utilization and GLP-1 RA adherence among people living with type 2 diabetes (T2D) on nonintensive therapy.</p><p><strong>Methods: </strong>This retrospective matched-cohort study analyzed data from Inovalon^® Insights administrative claims from March 1, 2017, to April 30, 2024, for adults aged ≥18 years diagnosed with T2D, treated with basal insulin or noninsulin therapy, and CGM-naïve before starting GLP-1 RA. Adherent CGM utilization was defined as having a proportion of days covered (PDC) ≥0.8 within 1-year post GLP-1 RA initiation. CGM users were matched with non-CGM users based on age, sex, race/ethnicity, basal insulin/noninsulin therapy, GLP-1 RA type, comorbidities, insurance type, and one fill/multiple refills of GLP-1 RA. The primary outcome was GLP-1 RA discontinuation over the 12-month observation period, which was defined as the first gap of ≥90 days without GLP-1 RA supply post-index. Kaplan-Meier model was used to estimate the time to discontinuation, and hazard ratios (HRs) were calculated using a multivariable Cox proportional hazards regression model.</p><p><strong>Results: </strong>The study included 934 adherent CGM users matched with 3747 non-CGM users. One year post GLP-1 RA initiation, 68.4% (95% confidence interval [CI]: 65.5%-71.5%) of adherent CGM users remained on GLP-1 RA compared with 51.9% (95% CI: 50.3%-53.5%) of non-CGM users (<i>P</i> < 0.001). After adjusting for covariates, adherent CGM users were significantly less likely to discontinue GLP-1 RA compared to non-CGM users (HR: 0.56 [95% CI: 0.49-0.63], <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>This study suggests that adherent CGM utilization is associated with a significantly lower risk of GLP-1 RA discontinuation and may potentially enhance adherence to GLP-1 RA medication in people living with T2D on nonintensive therapy.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261489904"},"PeriodicalIF":7.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007883","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}