Diabetes technology & therapeutics最新文献

{"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}

{"title":"Sustained Glycemic Outcomes with the MiniMed^™ 780G System: Real-World Evidence from >16,000 Users Across 18 Latin American Countries Over Two Years.","authors":"Matias Castro, Bruno Grassi, Alejandro Daín, Ana María Gómez, Antonio Saleme, Luis Eduardo Calliari, Rodrigo Siqueira, Marcela Raggio, Francisca Riera, Miguel Angel Gómez Sámano, Margaret Liu, Robert Vigersky, Jennifer McVean","doi":"10.1177/15209156261486558","DOIUrl":"https://doi.org/10.1177/15209156261486558","url":null,"abstract":"<p><strong>Background and aims: </strong>Automated insulin delivery (AID) systems achieve consistent glycemic outcomes in real-world settings, yet access across Latin America (LATAM) remains critically low, with marked disparities driven by demographic, structural, and health care infrastructure heterogeneity across the region. This study characterizes the real-world performance of the MiniMed™ 780G (MM780G) advanced hybrid closed-loop (AHCL) system across 18 LATAM countries and evaluates the durability of glycemic outcomes over 24 months.</p><p><strong>Methods: </strong>Data from 16,669 individuals with type 1 diabetes using the MM780G system across 18 LATAM countries (January 2020-October 2025) were analyzed; 27.1% were pediatric (<16 years) and 70.8% adult (≥16 years). Primary outcomes included time in range (TIR), time in tight range (TITR), glucose management indicator (GMI), and time below range (TBR), stratified by age, sex, country, and recommended optimal settings (ROS: glucose target 100 mg/dL, active insulin time 2 h, ≥95% of time). A longitudinal sub-analysis followed 1204 users across 24 consecutive monthly time points.</p><p><strong>Results: </strong>Overall, mean TIR was 73.4% and GMI 6.9%, with TBR within consensus targets; approximately two-thirds of users achieved TIR > 70% and GMI < 7.0%. ROS was adopted by 19.2% of users, which was associated with substantially improved outcomes, with mean TIR 77.5%, TIR > 70% attainment occurred in 83.9% of users, and composite target of GMI < 7, TIR > 70, TB70 < 4 and TB54 < 1 attainment rising to 66.4%. Pediatric users met or exceeded (with ROS) the internationally recommended 70%TIR threshold (mean overall TIR 70.0% and 74.2% with ROS), while adults (mean TIR 74.6%) aligned closely with US and Europe, Middle East and Africa real-world benchmarks. TITR exceeded 50% in adults (50.3% overall and 54.1% with ROS) and exceeded the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2024 recommended threshold of 50% in pediatric users (mean TITR 51.2% with ROS). Outcomes were consistent across sex and all five national cohorts. In the 24-month longitudinal sub-analysis, TIR remained clinically stable within one and a half percentage points throughout both age groups.</p><p><strong>Conclusion: </strong>The MiniMed™ 780G AHCL system delivered consistent and durable glycemic control over 24 months across the full demographic and structural heterogeneity of Latin America. Performance was aligned with internationally recommended consensus targets and was independent of age, sex, country, and health care infrastructure. Eliminating barriers to AID access is an immediate and achievable priority in the region and may improve the health of hundreds of thousands of people with diabetes in Latin America.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261486558"},"PeriodicalIF":7.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007904","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":"Use of Continuous Glucose Monitoring Indicators to Guide Dose Titration of Weekly Basal Insulin Efsitora Alfa in Insulin-Naive and Basal Insulin-Experienced Adults with Type 2 Diabetes: A Retrospective Analysis.","authors":"Richard M Bergenstal, Michael B Davidson, David Ahn, Grazia Aleppo, Thomas W Martens, Eden M Miller, David L Duke, Michael Case, Liza L Ilag, Jennal Johnson, Eyal Dassau","doi":"10.1177/15209156261485755","DOIUrl":"10.1177/15209156261485755","url":null,"abstract":"<p><strong>Introduction: </strong>Basal insulin dose titration has historically relied on fasting self-monitoring blood glucose (SMBG) and hypoglycemic events. This retrospective analysis of the QWINT-2 and QWINT-3 Phase 3 trials aimed to evaluate the use of continuous glucose monitoring (CGM)-derived indicators for weekly insulin efsitora alfa (efsitora) titration in insulin-naive and basal insulin-experienced adults with type 2 diabetes (T2D) through dose-to-dose comparisons with self-monitoring fasting plasma glucose (FPG) and CGM-derived hypoglycemic events, and by assessing concordance between CGM fasting indicators and FPG independent of insulin dose adjustment.</p><p><strong>Methods: </strong>CGM and self-monitoring FPG data from QWINT-2 (insulin-naive, <i>N</i> = 466) and QWINT-3 (basal insulin-experienced, <i>N</i> = 655) efsitora-treated participants were analyzed. CGM fasting indicators were compared with FPG through weekly dose-to-dose titration decisions following the SMBG-based Phase 3 trial dose titration algorithm, and by assessing concordance between CGM fasting indicator and FPG values. CGM hypoglycemia indicators were assessed weekly for agreement with CGM-derived hypoglycemic events below 70 mg/dL and 54 mg/dL following the SMBG-based Phase 3 trial hypoglycemia criteria. User burden was considered, with low burden meaning a CGM indicator was readily available in an ambulatory glucose profile (AGP) report.</p><p><strong>Results: </strong>CGM hypoglycemia indicators demonstrated 91.5%-98.3% agreement with CGM-derived hypoglycemic events in QWINT-2 and QWINT-3. CGM fasting indicators \"Lowest median of AGP,\" and \"Typical fasting 25% from AGP\" demonstrated clinical equivalency with FPG, with dose differences within 20 weekly units for 90.7%-93.4% of dose decisions for both studies.</p><p><strong>Conclusion: </strong>In insulin-naive and basal insulin-experienced populations treated with weekly efsitora, CGM indicators of hypoglycemia and fasting glucose yielded clinically equivalent dose titration decisions as CGM-derived hypoglycemic events and self-monitoring FPG, respectively. These findings support translation of established titration practices to a CGM-based workflow in insulin-naive and basal insulin-experienced adults with T2D, consistent with recommendations for CGM use in adults with diabetes on insulin therapy.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261485755"},"PeriodicalIF":7.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988749","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 Hypoglycemia Alarms in Critical Care: Clinical Utility and Workflow Integration.","authors":"Eileen R Faulds, Melanie Natasha Rayan, Emily S Patterson, Molly McNett, Matthew Exline, Abigail Shoben, Chyongchiou J Lin, Laureen Jones, Brooke Lee, Amanie Rasul, Matthew Mlachak, Christian Ruvalcaba, Changchang Yin, Zang Ping, Kathleen M Dungan","doi":"10.1177/15209156261487821","DOIUrl":"https://doi.org/10.1177/15209156261487821","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) has been associated with reductions in inpatient hypoglycemia; however, little is known about the performance and integration of CGM hypoglycemia alerts and alarms in the intensive care unit (ICU). We evaluated hypoglycemia signal frequency, clinical response, and contributing factors within an ICU implementation study.</p><p><strong>Methods: </strong>This prespecified secondary analysis was conducted within a prospective hybrid effectiveness-implementation study of adults in a medical ICU. Hypoglycemia signals included low alerts (<100 mg/dL), urgent low soon alerts, and urgent low alarms (<55 mg/dL). Signal frequency, progression to hypoglycemia <70 mg/dL, nursing response times, and protocol fidelity were evaluated. Consecutive signals occurring within 15 min were clustered into signal events. Confirmatory point-of-care (POC) glucose response time was calculated from the initial signal to the first subsequent POC measurement. All POC-confirmed hypoglycemic events (<70 mg/dL) underwent structured multidisciplinary root cause review.</p><p><strong>Results: </strong>Among 100 participants, 60% experienced at least one hypoglycemia signal, generating 1060 signals (3.6 ± 6.8 signals/patient-day) that clustered into 378 signal events. Fifty-one percent of signal events remained between 80 and 100 mg/dL, without falling below the institutional treatment threshold (<80 mg/dL). Ninety-five percent of urgent low alarms were preceded by an urgent low soon alert, a mean of 10.0 ± 7.8 min earlier. Median confirmatory POC response time was 33 min (interquartile range 12-51) and was significantly faster for lower glucose values and validated CGM signals. All, but one hypoglycemic event, were preceded by a validated CGM hypoglycemia signal. Case review identified intravenous insulin, carbohydrate coverage, and enteral feed-related factors as the most common contributors to hypoglycemia.</p><p><strong>Conclusions: </strong>CGM hypoglycemia signaling integrated into ICU workflows can provide advance warning before hypoglycemic events while maintaining a modest contribution to alarm burden. Signal characteristics influenced nursing response, supporting further optimization of inpatient CGM alarm thresholds and implementation strategies.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov NCT#05571397 https://clinicaltrials.gov/study/NCT05571397.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261487821"},"PeriodicalIF":7.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976109","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 Clinical and Economic Impact of Automated Insulin Delivery Systems Use in Pediatric and Adolescents Type 1 Diabetes: Results Across Australia, Canada, the UK, and the USA.","authors":"Laurent Legault, Jennifer L Sherr, Elizabeth A Davis, Mónica Cerezales, Aesha Khan Mirón, Maria-Eleni Syleouni, Sze May Ng","doi":"10.1177/15209156261486122","DOIUrl":"https://doi.org/10.1177/15209156261486122","url":null,"abstract":"<p><strong>Background and aims: </strong>Automated Insulin Delivery (AID) systems are the recommended standard of care for Type 1 Diabetes (T1D) management in children and adolescents, according to latest international guidelines. This study aims to assess the cost-effectiveness of AID systems for pediatric T1D care in Australia, Canada, the United Kingdom (UK), and the United States (USA).</p><p><strong>Materials and methods: </strong>The IQVIA Core Diabetes Model was used to compare AID systems with Multiple Daily Injections and Continuous Glucose Monitoring (MDI+CGM). Data were sourced from the National Health System (NHS<b>)</b> England real-world AID pilot initiative, a prospective follow-up study of 251 children and adolescents with T1D that showed a 0.63% reduction in HbA1c following the first year of system use. Clinical and economic outcomes were analyzed over a 55-year time horizon from a health care system perspective, applying country-specific discount rates and direct costs to estimate cost-effectiveness ratios (ICERs).</p><p><strong>Results: </strong>AID systems were associated with Quality-Adjusted Life Years (QALYs) gains ranging from 1.35 to 2.72 across all countries. AID use resulted in significant relative risk reduction for long-term complications, such as proliferative diabetic retinopathy (51.3%), end-stage renal disease (39.5%), and severe vision loss (38.8%). Total cost savings ranged from USD-9340 in Australia to USD-28,798 in Canada. AID use was associated with an ICER of 14,590 in Australia, 25,798 in Canada, 32,459 in the UK, and 35,648 in USA per QALY gained (all values in USD).</p><p><strong>Conclusions: </strong>AID therapy was predicted to reduce mid- and long-term diabetes-related complications and improve quality of life while concomitantly reducing the economic burden on health care systems. AID was projected to be cost-effective versus MDI+CGM for pediatrics and adolescents with T1D in all analyzed countries. These findings highlight the need to accelerate the adoption of AID systems and to secure universal access and funding during this vulnerable period of life.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261486122"},"PeriodicalIF":7.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918800","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":"Pediatric Inpatient Continuous Glucose Monitor Accuracy by Sensor Wear Day, Hospital Day, and Glucose Rate of Change.","authors":"Jessica L Ruiz, Amy B Stein, Alexander Wheelock, Bennett Stewart, Allison S Bernique, Emily Jost, Katharine C Garvey, Christina M Astley, Erin C Cobry","doi":"10.1177/15209156261486139","DOIUrl":"10.1177/15209156261486139","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) improves glycemic outcomes but inpatient use in the United States is not FDA approved, despite the potential need for frequent glycemic monitoring during hospitalization. We sought to assess CGM accuracy in the pediatric hospital setting and to evaluate the impact of potential modifiers of accuracy, including sensor wear day, hospitalization day, and glucose changes.</p><p><strong>Methods: </strong>In this retrospective cross-sectional accuracy study among youth and young adults with diabetes hospitalized at two pediatric centers, reference point-of-care (POC) capillary glucose values were compared with Dexcom G7 CGM glucose readings (paired within 5 min). Accuracy was assessed using standard metrics, including mean absolute relative difference (MARD) and Parkes error grids, overall, and stratified by sensor wear day, hospital day, and CGM glucose rate of change.</p><p><strong>Results: </strong>We analyzed 544 POC-CGM glucose pairs from 68 participants with diabetes aged 2-22 years (mean 12.4 ± 5.8 years old, 58.8% female, 66.2% White, 8.8% Hispanic) during 80 hospital encounters. The overall MARD was 12.5%. Accuracy was comparable on sensor wear day 1 and days 2-6 (MARD 12.3% vs 13.6%, respectively) and was best on wear days 7-10 (MARD 10.6%). Accuracy improved from hospital day 1 (MARD 13.7%) to hospital days 2-4 and 5-30 (MARD 10.4% and 12.5%, respectively). Overall and on wear day 1, almost all glucose pairs (99%) fell within low-risk Parkes error grid zones A and B. Accuracy was best with a flat [-1 to 1 mg/(dL·min)] rate of change (MARD 11.5%-11.9%) and was reduced with rapidly rising or falling [beyond -2 or 2 mg/(dL·min)] CGM values (MARD 16.6%-18.4%).</p><p><strong>Conclusions: </strong>In this pediatric hospital CGM accuracy study, MARD was within a favorable range of <14% overall and throughout sensor wear and hospitalization. Reduced accuracy with rapidly changing glucose highlights the need to incorporate trend arrows into hospital CGM protocols.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261486139"},"PeriodicalIF":7.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Data from U.S. Commercial Users of the 365-Day Implantable Eversense Continuous Glucose Monitoring System, Including with the Twiist Automated Insulin Delivery System Integration.","authors":"Francine Kaufman, Ishaan Jain, Shaoling Han, Colleen Mdingi","doi":"10.1177/15209156261486125","DOIUrl":"https://doi.org/10.1177/15209156261486125","url":null,"abstract":"<p><strong>Background: </strong>The Eversense 365 Continuous Glucose Monitoring (CGM) System is the first implantable, 1-year CGM approved in the United States and Europe. In February 2026, Eversense 365 became available in the United States with the twiist automated insulin delivery (AID) pump and twiist loop algorithm. While clinical trial performance has been reported, this article describes the real-world experience with the Eversense 365 CGM system using open-loop therapies and with the twiist AID system.</p><p><strong>Methods: </strong>Deidentified sensor glucose (SG) data from the Eversense Data Management System were analyzed for the first 12,360 sensors used with open-loop therapies. Analysis included mean SG, glucose management indicator (GMI), percent in glycemic ranges and achieving hypoglycemia targets, and median transmitter wear time. Performance across the full 365-day duration and between the first and second 180-day periods was evaluated. For the twiist AID system, analysis included 153 sensors with >30 days following twiist pairing.</p><p><strong>Results: </strong>For the 365 CGM system in open-loop, the mean age was 57 years. A mean of 43,225 (±32,394) CGM readings per sensor were available. Mean SG was 161 mg/dL, and GMI was 7.16%. Mean percent time < 54 mg/dL was 0.6%, <70 mg/dL 2.7%, 70-180 mg/dL (time in range, TIR) 66.2%, >180 mg/dL 31.2%, and >250 mg/dL 9.8%. Median transmitter wear time was 93%. Glycemic outcomes remained stable across the first and second 180-day periods. For users of the twiist + Eversense 365 AID system, mean SG was 145 mg/dL, GMI 6.78%, and TIR 76.1%, with 2.3% <70 mg/dL and 0.5% <54 mg/dL, and 99% median transmitter wear time.</p><p><strong>Conclusion: </strong>In this large real-world dataset, the 365-day CGM system demonstrated high adherence and favorable glucometrics sustained over extended wear. Early data from the twiist + Eversense 365 system support integration of the implantable CGM within an AID system to support consistent and reliable insulin delivery.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261486125"},"PeriodicalIF":7.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911199","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":"Adjunctive Treatments for Patients with Type 1 Diabetes Using Automated Insulin Delivery Systems. A Narrative Review.","authors":"Konstantinos Kitsios, Christina-Maria Trakatelli","doi":"10.1177/15209156261486127","DOIUrl":"https://doi.org/10.1177/15209156261486127","url":null,"abstract":"<p><p>Automated Insulin Delivery (AID) systems represent the most effective and safe treatment for the management of type 1 diabetes (T1D). Antidiabetic agents used for the treatment of type 2 diabetes, such as the Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists (RAs), the dual Glucose-dependent Insulinotropic Polypeptide and GLP-1 RA and the Sodium-Glucose co-Transporter 2 inhibitors are associated with clinically significant weight loss and cardioprotective effect. Given the increased prevalence of overweight, obesity, and cardiovascular risk in patients with T1D, the addition of these medications to AID treatment is of considerable clinical interest. In this review limited data from randomized controlled and observational trials show that in overweight and obese patients with T1D treated with AID, the addition of weekly semaglutide, or tirzepatide is associated with significant weight loss, reduction in total daily insulin dose and increase in Time In target Range (TIR) without increased risk for hypoglycemia and Diabetic Ketoacidosis (DKA). Similarly, adjunctive treatment with empagliflozin resulted in increased TIR without increase in hypoglycemia, reduction in insulin requirements, and increase in the mean plasma ketone value, although DKA remained rare. However, studies of longer duration with more participants are required to establish the long-term safety and efficacy of these interventions in patients with T1D treated with AID.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261486127"},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891232","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":"Optimizing Continuous Glucose Monitoring for Older Adults with Diabetes: From Clinical Evidence to a Practical Implementation Pathway.","authors":"Tong Yang, Jinghao Cai, Jiaying Ni, Jingyi Lu, Jian Zhou","doi":"10.1177/15209156261485635","DOIUrl":"https://doi.org/10.1177/15209156261485635","url":null,"abstract":"<p><p>Older adults represent a growing proportion of people with diabetes and often experience hypoglycemia, glycemic variability (GV), multimorbidity, frailty, and treatment-related vulnerabilities that are not fully captured by glycated hemoglobin A1c (HbA1c) alone. Continuous glucose monitoring (CGM) provides time-resolved glucose profiles, trend information, alerts, and remote data sharing, making it well suited to safety-focused geriatric diabetes care.In this narrative review, we synthesize evidence on CGM features, randomized and real-world outcomes, patient and caregiver experience, barriers to sustained use, and practical implementation in older adults. Across studies, the principal benefits of CGM vary by diabetes type and treatment context. In older adults with type 1 diabetes, randomized evidence most consistently supports reduced hypoglycemia exposure and time below range, whereas in basal-insulin-treated type 2 diabetes, CGM primarily improves time in range and reduces hyperglycemia. CGM may also support individualized treatment adjustment by revealing nocturnal hypoglycemia, GV, and postprandial patterns that are missed by intermittent testing.Real-world studies associate CGM use with fewer acute diabetes events and hospitalizations in selected insulin-treated populations, but residual confounding limits causal interpretation. Implementation evidence shows that benefit depends on more than device performance. Usability, skin tolerability, education, alert burden, caregiver workflows, digital literacy, cost, and equitable access strongly influence sustained use.We propose a pragmatic geriatric CGM pathway with an explicit triage algorithm that emphasizes risk-based candidate selection, functional assessment, tailored device and support models, individualized alerts and glycemic goals, focused review of CGM metrics, structured education, and early follow-up. Current evidence supports CGM primarily as a safety and decision-support technology for selected older adults, particularly those using insulin or at elevated hypoglycemia risk. Future studies should include frail and cognitively impaired populations and prioritize severe hypoglycemia, falls, treatment burden, caregiver burden, acute care use, quality of life, and scalable delivery models.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261485635"},"PeriodicalIF":7.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879317","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}