Endocrine Practice最新文献

{"title":"Primary Aldosteronism Surgery Outcomes Under Current Blood Pressure Guidelines.","authors":"Kidmealem Zekarias, Jacob Kohlenberg, Sayeed Ikramuddin","doi":"10.1016/j.eprac.2025.09.003","DOIUrl":"10.1016/j.eprac.2025.09.003","url":null,"abstract":"<p><strong>Objective: </strong>Historical studies report complete clinical success rates of 37% following adrenalectomy for primary aldosteronism (PA), based on the former blood pressure (BP) threshold of <140/90 mmHg. This study evaluated outcomes using the current guideline BP threshold of <130/80 mmHg.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Epic COSMOS database of 1320 adults who underwent adrenalectomy for PA (2013-2024). Inclusion criteria included preoperative plasma aldosterone measurement and ambulatory BP measurements within 6 months and 6-18 months post-adrenalectomy. After excluding patients who had pre-adrenalectomy BP < 130/80 mmHg without antihypertensive therapy, 1079 patients were analyzed.</p><p><strong>Results: </strong>Complete clinical success (BP < 130/80 mmHg without medications post-adrenalectomy) occurred in 16.5% (178/1079; 95% CI: 14.3-18.7). Partial clinical success (improved BP control and/or reduced medications post-adrenalectomy) was achieved by 73.5% (793/1079; 95% CI: 70.9-76.1). Absent clinical success occurred in 10% (108/1079; 95% CI: 8.2-11.8). The combined rate of complete and partial clinical success was 90% (971/1079; 95% CI: 88.2-91.8). Multivariable logistic regression identified significant predictors of absence of complete clinical success: more preoperative antihypertensive medications (P < .001), higher social vulnerability (P = .02), and higher baseline systolic (P = .01) and diastolic BP (P = .003). Age, gender, race, body mass index, stroke history, sleep apnea, pre-adrenalectomy serum potassium, and estimated glomerular filtration rate were not significantly associated with outcomes.</p><p><strong>Conclusion: </strong>When applying current BP guidelines, 90% of patients achieve complete or partial clinical success after adrenalectomy for PA, demonstrating meaningful clinical outcomes. However, complete clinical success occurs in fewer patients (16.5%) than previously reported under traditional thresholds.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Risk of Adverse Pancreatic Events with GLP-1 Receptor Agonists, SGLT2 Inhibitors, DPP4 Inhibitors, and Sulfonylureas among Adults with Type 2 Diabetes at Moderate Cardiovascular Disease Risk.","authors":"Urja N Kalathiya, Jeph Herrin, Kavya Sindu Swarna, Yihong Deng, Eric C Polley, Joshua J Neumiller, Rodolfo J Galindo, Guillermo E Umpierrez, Joseph S Ross, Mindy M Mickelson, Rozalina G McCoy","doi":"10.1016/j.eprac.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.09.004","url":null,"abstract":"<p><strong>Objective: </strong>Evidence on acute pancreatitis and pancreatic cancer with glucagon-like peptide-1 receptor agonist [GLP-1RA] and dipeptidyl peptidase-4 inhibitor [DPP-4i] therapy is mixed and no studies examined this risk directly across all commonly used classes of type 2 diabetes (T2D) medications, particularly sodium-glucose cotransporter 2 inhibitors (SGLT2i) and sulfonylureas.</p><p><strong>Methods: </strong>De-identified claims data from OptumLabs Data Warehouse and fee-for-service Medicare were used to emulate a target trial examining the risks of incident acute pancreatitis and pancreatic cancer among adults with T2D and moderate cardiovascular risk. Propensity scores (estimated using the SuperLearner ensemble method) and inverse probability of treatment weighting emulated random treatment assignment to GLP-1RA, DPP-4i, SGLT2i, or sulfonylurea.</p><p><strong>Results: </strong>The weighted study cohort included 388,262 patients starting GLP-1RA (N=44,084), DPP-4i (N=82,079), SGLT2i (N=56,463), or a sulfonylurea (N=205,636). SGLT2i was associated with lower risk of acute pancreatitis compared to DPP-4i (HR 0.82; 95% CI 0.68-0.98). Conversely, sulfonylurea was associated with higher risk compared to GLP-1RA (HR 1.28; 95% CI 1.03-1.56) and SGLT2i (HR 1.32; 95% CI 1.12-1.57). There was no difference in acute pancreatitis risk between GLP-1RA and DPP-4i or GLP-1RA and SGLT2i. The risk of pancreatic cancer was lower with GLP-1RA compared to DPP-4i (HR 0.56; 95% CI 0.40-0.77). In contrast, risk was higher with SGLT2i and sulfonylurea compared to GLP-1RA (HR 1.67; 95% CI 1.12-2.49 and HR 1.60; 95% CI 1.17-2.19, respectively).</p><p><strong>Conclusion: </strong>GLP-1RA and DPP-4i therapy was not associated with increased risk of adverse pancreatic events. The lower risk of acute pancreatitis with SGLT2i therapy warrants further exploration.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Pituitary Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis","authors":"Zhe Li MD ,&nbsp;Ziang Liu MD ,&nbsp;Hongxia Wei MD ,&nbsp;Shuqing Jin MD ,&nbsp;Yuchen Sun MD ,&nbsp;Yi Zhang PhD ,&nbsp;Yunfeng Liu PhD","doi":"10.1016/j.eprac.2025.06.008","DOIUrl":"10.1016/j.eprac.2025.06.008","url":null,"abstract":"<div><h3>Objectives</h3><div><span><span>Immune checkpoint inhibitor (ICI)-induced </span>hypophysitis is one of the common endocrine immune-related </span>adverse events (irAEs). Our goal is to evaluate the risk of pituitary irAEs caused by ICIs.</div></div><div><h3>Methods</h3><div>The relevant literatures were retrieved from PubMed, Embase, and Cochrane Library from inception to October 31, 2024. References were screened according to inclusion and exclusion criteria, and study data were extracted. Meta-analysis was performed using Revman 5.3 and Stata 18.0 software.</div></div><div><h3>Results</h3><div><span>A total of 21 prospective single-arm trials and 17 randomized controlled trials<span><span> (RCTs) were included. In single-arm trials, the incidence of hypophysitis (4.00%) and </span>hypopituitarism<span> (3.84%) caused by cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors was the highest in monotherapy, and the incidence of hypophysitis caused by </span></span></span>programmed cell death<span><span> 1 (PD-1) inhibitors plus CTLA-4 inhibitors was the highest in ICI combination therapy (9.36%). In RCTs, the risk of pituitary irAEs caused by ICIs was higher than that of the control group (relative risk = 10.09, 95% CI: 6.90-14.75). Compared with monotherapy, ICI combination therapy has a higher risk of pituitary irAEs (relative risk = 5.42, 95% CI: 3.36-8.73). In monotherapy, CTLA-4 inhibitors caused the highest incidence of hypophysitis and </span>hypopituitarism, reaching 16.17% and 1.75%, respectively. Furthermore, the severity of adverse pituitary irAEs caused by CTLA-4 inhibitors was also the highest (5.12% in single-arm trials, 16.35% in RCTs).</span></div></div><div><h3>Conclusions</h3><div>The results showed that ICIs are associated with a significantly higher risk of pituitary irAEs, and ICI combination may further increase the risk. In monotherapy, CTLA-4 inhibitors caused the highest incidence and severity of pituitary irAEs, while PD-L1 inhibitors caused the lowest. In combination therapy, PD-1 inhibitors combined with CTLA-4 inhibitors resulted in a higher incidence of hypophysitis.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 9","pages":"Pages 1177-1184"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient vs Permanent Congenital Hypothyroidism: Does Thyroid Volume Tell the Tale?","authors":"Sarah A. Ackah MD ,&nbsp;Erica A. Eugster MD ,&nbsp;Todd D. Nebesio MD ,&nbsp;Rebeca Santos MD ,&nbsp;S. Gregory Jennings MD ,&nbsp;George J. Eckert MAS ,&nbsp;Boaz Karmazyn MD","doi":"10.1016/j.eprac.2025.05.745","DOIUrl":"10.1016/j.eprac.2025.05.745","url":null,"abstract":"<div><h3>Objectives</h3><div>Congenital hypothyroidism<span> (CH) can be transient or permanent. We evaluated if thyroid volume measured by ultrasound can be distinguish between the 2 forms.</span></div></div><div><h3>Methods</h3><div>Retrospective study (1/2005-12/2019) on patients with CH with eutopic thyroids. Permanent CH was defined as the inability to discontinue levothyroxine<span> therapy after age 3, while transient CH included a successful trial off levothyroxine. Demographic and clinical characteristics were retrieved from the electronic medical records. Fisher’s Exact tests and t-tests were used to compare categorial and continuous variables between children with transient and permanent CH. Receiver-operating characteristic curve analysis evaluated thyroid volume and thyroid-stimulating hormone (TSH) as individual predictors of transient/permanent CH. A classification tree analysis was used to combine thyroid volume and TSH for prediction.</span></div></div><div><h3>Results</h3><div>Significant differences were found between the 2 groups in terms of TSH levels and thyroid volume. Thyroid volume in patients with transient CH was significantly smaller (1.0 ± 0.5 mL) compared to those with permanent CH (2.3 ± 2.6 mL). No transient CH patient had thyroid volume below 0.3 mL or above 2.5 mL. Combining TSH level at diagnosis of ≥200 mIU/L and thyroid volume ≤0.6 mL or ≥2.5 mL provided sensitivity of 78.4% and specificity of 85.7% in differentiating between transient and permanent CH.</div></div><div><h3>Conclusion</h3><div>Thyroid volume ≥2.5 mL or ≤0.36 mL was seen only in permanent CH, potentially avoiding the need for a trial off levothyroxine. Using both TSH level and thyroid volume provides increased sensitivity and specificity for differentiating between permanent and transient CH.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 9","pages":"Pages 1089-1094"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Implant Failure and Medication-Related Osteonecrosis of the Jaw Related to Dental Implants in Patients Taking Antiresorptive Therapy for Osteoporosis: A Systematic Review and Meta-Analysis","authors":"Reza Mirza MD, MSc ,&nbsp;Mohamed El Rabbany DDS, PhD ,&nbsp;Dalal S. Ali MD, MSc ,&nbsp;Sotirios Tetradis DDS, PhD ,&nbsp;Archibald Morrison DDS, MSc ,&nbsp;Salvatore Ruggiero MD, DMD ,&nbsp;Rasha Alnajimi MD ,&nbsp;Aliya A. Khan MD ,&nbsp;Gordon Guyatt MD","doi":"10.1016/j.eprac.2025.06.003","DOIUrl":"10.1016/j.eprac.2025.06.003","url":null,"abstract":"<div><h3>Objectives</h3><div>To inform the 2024 International Task Force on Osteonecrosis of the Jaw update, we conducted a systematic review and meta-analysis evaluating dental implant failure and medication-related osteonecrosis of the jaw (MRONJ) related to antiresorptive therapy for osteoporosis.</div></div><div><h3>Methods</h3><div>We searched 5 databases (1946-2024) for interventional and noninterventional studies reporting rates of dental implant failure or osteonecrosis in those with osteoporosis or osteopenia. Two reviewers independently screened all titles, abstracts, and full texts. Risk of bias was assessed using the modified Ottawa-Newcastle scale, and the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation.</div></div><div><h3>Results</h3><div>We found 793 unique citations. Nine studies (n = 655) were included in the implant failure analysis. Random-effects meta-analysis revealed wide confidence intervals (CIs) for implant failure among those exposed to antiresorptives (relative risk, 0.82; 95% CI, 0.52-1.28; <em>P</em> = .38, very low certainty). Sensitivity analysis at the level of implant suggested that antiresorptives reduce implant failure (relative risk, 0.53; 95% CI, 0.34-0.81; <em>P</em> = .003, very low certainty). We identified 186 cases of MRONJ in implant recipients. The pooled rate of MRONJ following implantation in those exposed to antiresorptive therapy was 0.5% pooled from 21 cohorts. A single report of risk-adjusted MRONJ found that bisphosphonates increased MRONJ by 3 cases per 1000 patients (adjusted hazard ratio, 4.09; 95% CI, 2.75-6.09; <em>P</em> &lt; .001, moderate certainty).</div></div><div><h3>Conclusions</h3><div>The low-certainty evidence suggests that antiresorptive therapy for osteoporosis reduces dental implant failure. Bisphosphonates are associated with MRONJ in patients with osteoporosis receiving dental implants with moderate certainty.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 9","pages":"Pages 1189-1196"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Automated Insulin Delivery Systems","authors":"Michael S. Hughes MD ,&nbsp;Carol J. Levy MD","doi":"10.1016/j.eprac.2025.05.752","DOIUrl":"10.1016/j.eprac.2025.05.752","url":null,"abstract":"<div><div>Automated insulin delivery (AID) systems have revolutionized diabetes care by integrating continuous glucose monitoring, insulin pumps, and advanced algorithms to improve glycemic outcomes and reduce user burden. Early commercial AID systems were developed with a conservative approach, prioritizing safety and regulatory approval over full automation or extensive customization. While these systems significantly improved diabetes management, they still face limitations, including incomplete automation, accessibility barriers, and the need for better adaptation to diverse user needs and lifestyles. These challenges are now catalyzing development of next-generation AID technologies with a focus on achieving full automation, greater personalization, and broader accessibility. This review examines key limitations of current AID systems and explores future directions, including fully closed-loop control, novel insulin formulations, multi-hormonal systems, advanced sensor technologies, and integration of wearable and artificial intelligence tools. By addressing these challenges, future AID systems have the potential to deliver better effectiveness and equity in diabetes care for all individuals requiring insulin therapy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 9","pages":"Pages 1162-1170"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Diabetes-related Autoantibodies Among Individuals With Type 2 Diabetes From Primary Care and Endocrinology Community Practice Settings","authors":"Laura D. Lomeli BA ,&nbsp;Michelle D. Lundholm MD ,&nbsp;Huijun Xiao MS ,&nbsp;Keren Zhou MD ,&nbsp;Kevin M. Pantalone DO, FACE","doi":"10.1016/j.eprac.2025.05.748","DOIUrl":"10.1016/j.eprac.2025.05.748","url":null,"abstract":"<div><h3>Objective</h3><div>The full implications of diabetes-related autoantibodies for classification and management of type 2 diabetes remain undetermined. To date, there are limited data on autoantibody positivity in community-based samples in the United States. This study assessed and compared the prevalence of diabetes-related autoantibodies in a community-based population of individuals with type 2 diabetes managed by endocrinology or primary care providers (PCPs).</div></div><div><h3>Methods</h3><div>This single-center cross-sectional study enrolled 202 adults (102 in endocrinology and 100 in PCPs) with type 2 diabetes without a history of latent autoimmune diabetes of adulthood. Glutamic acid decarboyxlase-65, anti-islet cell, insulinoma-associated-2, zinc transporter 8, and anti-insulin antibodies were determined.</div></div><div><h3>Results</h3><div>Among 199 participants with full antibody panel testing results, 13.6% tested positive for at least one diabetes-related autoantibody; prevalence trended higher, but nonsignificantly, among individuals managed by endocrinologists (16.0%) vs PCPs (11.1%). GAD-65 positivity was 4.5%. No participants displayed anti-islet cell autoantibodies. After excluding an additional 12 individuals positive for only anti-insulin antibodies, 8.0% of the remaining participants were autoantibody-positive (median age, 71 years; median body mass index, 31.8 kg/m²).</div></div><div><h3>Conclusions</h3><div>The prevalence of diabetes-related autoantibodies in individuals with type 2 diabetes in a U.S. community-based care setting, most of whom did not display LADA phenotype characteristics, was notable and similar regardless of management by endocrinology or PCP practices. Although further studies are needed to assess the clinical implications of these findings, it is possible that proactive awareness of autoantibody status in individuals with type 2 diabetes could provide additional context to help guide treatment decisions.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 9","pages":"Pages 1127-1132"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Our Understanding of the Nuances of Pathologic Cortisol Secretion","authors":"Lewis S. Blevins Jr. MD","doi":"10.1016/j.eprac.2025.06.002","DOIUrl":"10.1016/j.eprac.2025.06.002","url":null,"abstract":"<div><div>Over a century has passed since Harvey Cushing reported and described the findings in his patient that led to his name being ascribed to the clinical syndrome we call Cushing syndrome. Decades of study have led to a greater understanding of the nuances of cortisol secretion associated with the various conditions that result in either relative or overt hypercortisolism. Referencing “Cushing syndrome,” and failing to recognize the subtle presentations of disordered cortisol secretion, leads to delays in diagnosis and treatment and excess morbidity in affected patients.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 9","pages":"Pages 1185-1188"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Continuous Glucose Monitoring Versus Blood Glucose Monitoring During a Carbohydrate-Restricted Nutrition Intervention in People With Type 2 Diabetes: 6-Month Follow-up Outcomes From a Randomized Clinical Trial","authors":"Holly J. Willis PhD, RDN, CDCES ,&nbsp;Stephen E. Asche MA ,&nbsp;Rebecca N. Adams PhD ,&nbsp;Caroline G.P. Roberts MD ,&nbsp;Amy L. McKenzie PhD ,&nbsp;Shannon Krizka MS, RDN ,&nbsp;Shaminie J. Athinarayanan PhD ,&nbsp;Alison R. Zoller MS, RDN ,&nbsp;Brittanie M. Volk PhD, RDN ,&nbsp;Richard M. Bergenstal MD","doi":"10.1016/j.eprac.2025.05.746","DOIUrl":"10.1016/j.eprac.2025.05.746","url":null,"abstract":"<div><h3>Objectives</h3><div>Low and very-low carbohydrate eating patterns can improve glycemia in people with type 2 diabetes (T2D). Continuous glucose monitoring (CGM) may also help improve glycemic outcomes, like time in range (TIR). This research evaluated differences in diabetes-related outcomes when people with T2D used CGM or blood glucose monitoring (BGM) to support dietary choices and medication management for 6 months during a virtual, medically supervised ketogenic diet program (MSKDP). Three-month primary outcomes are published, and here we report 6-month follow-up outcomes.</div></div><div><h3>Methods</h3><div>The IGNITE study (Impact of Glucose moNitoring and nutrItion on Time in rangE) randomized participants to use CGM (<em>N</em> = 81) or BGM (<em>N</em> = 82) to support care during 6 months in a MSKDP. Glycemia, diabetes medications, dietary intake, ketones, and weight were assessed at baseline (Base) and month 6 (M6); differences between and within arms were evaluated.</div></div><div><h3>Results</h3><div>Adults (<em>N</em> = 163) with mean (SD) T2D duration of 9.7 (7.7) years and HbA1c of 8.1% (1.2%) participated. From Base to M6, TIR improved from 61% to 87% for CGM and from 63% to 88% for BGM (<em>P</em> &lt; .001), with no difference in changes between arms (<em>P</em> = .99). HbA1c decreased at least 1.3% from Base to M6 in both arms (<em>P</em> &lt; .001). Diabetes medications were deintensified in both arms based on medication effect scores (<em>P</em> &lt; .01). Energy and carbohydrate intake decreased (<em>P</em> &lt; .001) and participants in both arms had clinically meaningful weight loss (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>The CGM and BGM arms achieved similar and significant improvements in glycemia and other diabetes-related outcomes after 6 months in this MSKDP.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 9","pages":"Pages 1116-1126"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Real-World Evidence About the Use of Automated Insulin Delivery Systems in People With Type 1 Diabetes","authors":"Sonia Gera MD ,&nbsp;Jaisree Iyer MD ,&nbsp;Seema Meighan DNP, CPNP-PC, MPH ,&nbsp;Christine A. March MD, MS ,&nbsp;Brynn E. Marks MD, MSHPEd","doi":"10.1016/j.eprac.2025.06.004","DOIUrl":"10.1016/j.eprac.2025.06.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Automated insulin delivery systems (AID) have revolutionized type 1 diabetes (T1D) management. Guidelines support offering AID to all people with T1D and engaging in shared decision making when choosing among the available AID systems.</div></div><div><h3>Results</h3><div><span>In clinical trials, AID has been shown to improve </span>glycemic control<span> and reduce hypoglycemia while also improving quality of life<span>. However, participants in clinical trials do not accurately reflect the entire T1D population and outcomes from these controlled may not generalize to clinical care. A growing body of real-world evidence seeks to understand the effect of AID systems on glycemia and person-reported outcome measures in real-world populations. These real-world studies highlight the effect of differences in engagement with AID, including time in automated mode and boluses per day, considerations about AID system selection, and approaches to educate people with T1D.</span></span></div></div><div><h3>Conclusion</h3><div>In this review, we compare glycemic and person reported outcomes in clinical trials and the real-world studies, with consideration of the effects of different systems according to user characteristics. We also review the current state of device selection and education for people with diabetes, their caregivers, and clinicians. Lastly, we summarize key findings across AID systems and opportunities for further research.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 9","pages":"Pages 1150-1161"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}