Diabetes technology & therapeutics最新文献

{"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}

{"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/m². 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}

{"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}

{"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}

{"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}

{"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}

{"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^®) 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}

{"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}

{"title":"Continuous Glucose Monitoring and Automated Insulin Delivery in Infants with Type 1 Diabetes: Real-World Evidence to Support Future International Guidelines.","authors":"Marco Marigliano, Andrea E Scaramuzza, Claudia Arnaldi, Riccardo Bonfanti, Valentino Cherubini, Roberto Franceschi, Fortunato Lombardo, Giulio Maltoni, Enza Mozzillo, Marta Bassi, Ivana Rabbone, Riccardo Schiaffini, Valentina Tiberi, Davide Tinti, Claudio Maffeis","doi":"10.1177/15209156261479814","DOIUrl":"https://doi.org/10.1177/15209156261479814","url":null,"abstract":"<p><p>To evaluate efficacy and safety of continuous glucose monitoring (CGM) and automated insulin delivery (AID) in infants. A retrospective multicenter study (13 centers) of 76 children diagnosed with antibody-positive type 1 diabetes before age 2. Outcomes at 12 months were compared between AID users (<i>n</i> = 47) and multiple daily injections (MDI)/SAP users (<i>n</i> = 29). AID systems included Medtronic 780 G (38%), Tandem Control-IQ (38%), and CamAPS FX (24%). CGM median wear time was 97.0% (93.3; 98.1). AID users achieved significantly higher TIR (65% vs. 56%, <i>P</i> = 0.041) and time in tight range (TITR) (42% vs 32.5%, <i>P</i> = 0.038). In multivariable regression, AID was the sole independent predictor of lower HbA1c (<i>P</i> = 0.035). Zero severe hypoglycemia (SH) events occurred in the AID group (vs. 7.1% in MDI/SAP). Use of CGM is safe in very young children, with AID systems proving superior to traditional therapy. This real-world evidence supports incorporating AID consideration into future international guidelines from the time of pediatric diagnosis.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261479814"},"PeriodicalIF":7.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789408","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":"CGM Metrics and the Risk of Pregnancy Complications in Type 1 Diabetes: A Secondary Exploratory Analysis of the CRISTAL Trial.","authors":"Ina Geerts, Kaat Beunen, Liese Berger, Nancy Van Wilder, Dominique Ballaux, Gerd Vanhaverbeke, Youri Taes, Xavier-Philippe Aers, Frank Nobels, Liesbeth Van Huffel, Joke Marlier, Dahae Lee, Joke Cuypers, Vanessa Preumont, Sarah E Siegelaar, Rebecca C Painter, Annouschka Laenen, Pieter Gillard, Chantal Mathieu, Katrien Benhalima","doi":"10.1177/15209156261477154","DOIUrl":"https://doi.org/10.1177/15209156261477154","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations between continuous glucose monitoring (CGM) metrics, including glucose management indicator (GMI) and overnight glucose levels, and pregnancy outcomes in women with type 1 diabetes.</p><p><strong>Research design and methods: </strong>Secondary exploratory analysis of the CRISTAL trial including 95 pregnant women with type 1 diabetes using CGM. Associations were assessed using logistic regression and Spearman correlations, presented as odds ratios (95% confidence intervals [CIs]) adjusted for baseline HbA1c. GMI validity was assessed using scatter and Bland-Altman plots.</p><p><strong>Results: </strong>Each 5% increase in overall pregnancy-specific time-in-range (TIRp) decreased the odds of gestational hypertension (odds ratio [OR] 0.63, 95% CI 0.41-0.97), birthweight >4.5 kg (OR 0.56, 95% CI 0.32-0.96), and neonatal hypoglycemia requiring hospital care (OR 0.09, 95% CI 0.01-0.57). Each 5% increase in overnight TIRp decreased the odds of gestational hypertension (OR 0.71, 95% CI 0.52-0.98) and neonatal hypoglycemia requiring hospital care (OR 0.15, 95% CI 0.03-0.79). Each 5% increase in overall time-above-range (TARp) increased the odds of birthweight >4.5 kg (OR 1.76, 95% CI 1.05-2.96), respiratory distress (OR 1.55, 95% CI 1.02-2.37), and neonatal hypoglycemia requiring hospital care (OR 5.10, 95% CI 1.14-22.78). Each 5% increase in TARp overnight increased the odds of hospital care for neonatal hypoglycemia (OR 2.55, 95% CI 1.15-5.66). Each 0.28 mmol/L increase in mean glucose and 0.5% increase in GMI were associated with increased respiratory distress (OR 1.54, 95% CI 1.07-2.23 and OR 6.15, 95% CI 1.33-28.40). Every 0.28 mmol/L increase in glycemic variability (SD) was associated with gestational hypertension (OR 1.69, 95% CI 1.02-2.80) and birthweight >4.5 kg (OR 2.31, 95% CI 1.20-4.43). Several combinations of CGM metrics (TIRp[-night], TARp[-night], SD, mean glucose) improved discriminative performance for pregnancy outcomes. GMI and HbA1c values were discordant.</p><p><strong>Conclusions: </strong>Specific combinations of CGM metrics, including overnight TIRp/TARp, may be informative for predicting pregnancy outcomes. GMI and HbA1c should not be considered interchangeable for glycemic control during pregnancy.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"15209156261477154"},"PeriodicalIF":7.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711634","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}