Journal of Diabetes Science and Technology最新文献

{"title":"Diabetes Distress in Caregivers of Young Children With Type 1 Diabetes Mellitus.","authors":"Elena D Georges, Neha Parimi, Karen Dimentstein, Elizabeth A Brown, Risa M Wolf","doi":"10.1177/19322968261492339","DOIUrl":"https://doi.org/10.1177/19322968261492339","url":null,"abstract":"<p><strong>Introduction: </strong>The American Diabetes Association recommends screening for diabetes distress in individuals with diabetes and their caregivers. We evaluated the clinical utility of the Problem Areas in Diabetes-Parent Revised version (PAID-PR) distress screener in caregivers of young children with type 1 diabetes mellitus (T1DM) and examined associations between diabetes distress, demographic and clinical characteristics, and diabetes technology use.</p><p><strong>Methods: </strong>In this prospective survey study, caregivers of children with T1DM aged <8 years completed the PAID-PR during multidisciplinary diabetes clinic visits. The PAID-PR scores and clinical data were collected. Associations between diabetes distress, clinical characteristics, and diabetes technology use were assessed using the Fisher exact, Wilcoxon rank sum, and 2-sample <i>t</i> tests. Distress related to theoretical vs immediate burdens was compared using paired <i>t</i> tests.</p><p><strong>Results: </strong>Thirty caregivers (73.3% mothers) of children with T1DM (mean age [SD] = 5.4y [1.9], 70% non-Hispanic White, 60% commercially insured) completed the PAID-PR. Child median diabetes duration was 1.5 years (interquartile range [IQR] = 0.6, 2.3), median HbA1c 7.6% (IQR = 6.9, 8.1). All children used continuous glucose monitors, 73.3% Omnipod 5, 6.7% Tandem Mobi, and 20% multiple daily injections. The median distress score was 30.6/100 (IQR = 22.2, 36.1; the lowest 75th percentile of distress = 24.3 [12.5, 31.9]; the highest 25th percentile = 42.9 [38.6, 52.8]). Scores did not differ by demographics, clinical characteristics, or diabetes technology use. Caregivers indicated significantly greater distress from theoretical vs immediate burdens (<i>P</i> < .0001).</p><p><strong>Conclusions: </strong>Caregivers of young children with T1DM experience greater distress related to anticipated future (theoretical) burdens than with immediate diabetes management. Understanding these distress patterns can help guide psychosocial supports.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261492339"},"PeriodicalIF":4.9,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of Insulin Glargine Administration During Intermittent Ramadan Fasting in patients With Type1 Diabetes: A Randomized Controlled Trial (GLARIF).","authors":"Reem Alamoudi, Ali Alqarni, Maram Alsubaiee, Ghofran Khogeer, Yousef Saleh, Abdulrhman Aljawharji, Hawazen Zarif, Salwa Alaidarous, Seham Khashwayn, Mohamed Hassanein","doi":"10.1177/19322968261493574","DOIUrl":"10.1177/19322968261493574","url":null,"abstract":"<p><strong>Objective: </strong>The effect of basal insulin timing on hypoglycemia during Ramadan fasting remains uncertain despite recommendations to administer basal insulin earlier in the evening. We evaluated whether early evening compared with bedtime administration of insulin glargine reduces hypoglycemia and improves glycemic outcomes in individuals with type1 diabetes (T1D) fasting during Ramadan.</p><p><strong>Methods: </strong>This multicenter open-label randomized controlled trial was conducted across 4 centers in Saudi Arabia. Participants with T1D intending to fast Ramadan were randomized to early evening or bedtime glargine administration. Glucose data were collected using self-monitoring of blood glucose (SMBG), intermittently scanned continuous glucose monitoring (FreeStyle Libre), and blinded continuous glucose monitoring (CGM; Medtronic iPro2).</p><p><strong>Results: </strong>A total of 185 participants were analyzed (91 early evening, 94 bedtime). Baseline characteristics were similar between groups. Fasting interruption occurred in 75.9% versus 76.3% of participants (<i>P</i> = .94), with hypoglycemia accounting for >90% of interruptions in both groups. Hypoglycemia occurred predominantly during the morning period regardless of basal insulin timing. Severe hypoglycemia was reported in 2 versus 5 participants, and 1 diabetic ketoacidosis admission occurred in each group. Continuous glucose monitoring-derived glycemic metrics were similar between groups. Time in range (70-180 mg/dL) was 44.6% versus 46.1% (<i>P</i> = .70), time below range (<70 mg/dL) was 7.9% versus 6.4% (<i>P</i> = .35), and time above range (>180 mg/dL) was 47.5% in both groups (<i>P</i> = .99). Self-monitoring of blood glucose-detected hypoglycemic episodes and CGM-detected low glucose excursions were also comparable. Area under the curve below range was higher in the early evening group (<i>P</i> = .04).</p><p><strong>Conclusion: </strong>Changing insulin glargine administration from bedtime to earlier evening hours during Ramadan fasting did not significantly reduce hypoglycemia or improve overall glucose profiles in individuals with T1D. These findings suggest that routine universal shifting of basal insulin timing during Ramadan may not be necessary and support an individualized approach based on patient preference and glucose patterns.</p><p><strong>Clinicaltrials: </strong>gov identifier: NCT04383990.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261493574"},"PeriodicalIF":4.9,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redistributing Insulin Pumps for Patients Facing Access Barriers.","authors":"Benjamin Lalani, Shiv S Patel, Ihewa Gaula, Tanvi Mandadi, Aditi Vannela, Benjamin Nagle, Emily Cournoyer, Anika Khandekar, Polly Bevan, Anahita Dua, Nestoras Mathioudakis, Marie E McDonnell","doi":"10.1177/19322968261493576","DOIUrl":"10.1177/19322968261493576","url":null,"abstract":"<p><p>Insulin pumps are durable, high-cost medical devices that support continuous subcutaneous insulin infusion and automated insulin delivery. Despite their utility, access to insulin pumps in the United States remains uneven across socioeconomic strata, insurance types, and racial and ethnic groups, and is far more limited internationally. Meanwhile, functional pumps accumulate through predictable lifecycle events such as device upgrades, therapy discontinuation, and patient mortality, without a defined pathway for reuse. This commentary contends that coordinated redistribution of functional pumps is an actionable, near-term equity intervention and sustainability strategy, already occurring through nonprofit programs. We outline sources of surplus, the populations most affected by inadequate access, how redistribution can be operationalized safely, and the stakeholder roles and governance needed to implement a pump redistribution pathway.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261493576"},"PeriodicalIF":4.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of a 15-Day Continuous Glucose Monitoring System in Children and Adolescents With Diabetes.","authors":"Manuela Link, Christian Denzer, Torben Biester, Jantje Weiskorn, Julian Ziegler, Franziska Liebrich, Désirée Dunstheimer, Jakob Krämer, Manuel Eichenlaub, Anne Beltzer, Martin Wabitsch, Guido Freckmann","doi":"10.1177/19322968261493981","DOIUrl":"10.1177/19322968261493981","url":null,"abstract":"<p><strong>Background: </strong>The CareSens Air (CSAir) continuous glucose monitoring system is approved for use in adults in South Korea and received adults-only CE marking in early 2024. The aim of this prospective, multicenter, pivotal study in children and adolescents with insulin-dependent diabetes mellitus was to determine if the performance and safety of CSAir in these populations are comparable to those observed in adults.</p><p><strong>Method: </strong>Sensors were worn for 15 days on the upper arm in children and adolescents aged 7 to 17 years and on the upper arm and/or upper buttock in children aged 2 to 6 years. Frequent capillary comparator measurements were performed during in-clinic sessions at the beginning, middle, and end of the sensor-wearing period. Point accuracy was assessed via agreement rates (AR) and mean absolute relative difference (MARD). Additional assessments included clinical point accuracy, technical reliability, and safety.</p><p><strong>Results: </strong>For subjects aged 7 to 17 years, %20/20 AR was 90.8%, and MARD was 8.9%. A total of 99.9% of values fell within Zones A and B of the Diabetes Technology Society error grid. Sensor survival probability reached 75.2%. In children aged 2 to 6 years, %20/20 ARs were 86.6% and 98.4%, and MARDs were 10.3% and 7.8% for arm- and buttock-worn sensors, respectively. No serious adverse events were reported. Mild and moderate adverse device effects comprised skin issues such as itching or erythema at the sensor application or insertion site.</p><p><strong>Conclusions: </strong>The observed performance and safety of CSAir in children and adolescents are similar to those in adults. These data may support an extension of regulatory approval of CSAir for children aged 2 years and older.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261493981"},"PeriodicalIF":4.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Clinician-Based Risk Score to Diabetes Complications: Validating the Glycemia Risk Index with the Virtual Diabetes Control and Complications Trial Continuous Glucose Monitoring Data.","authors":"Mohammadreza Ganji, Benjamin Lobo, Anas El Fathi, Chiara Fabris, Boris Kovatchev","doi":"10.1177/19322968261489629","DOIUrl":"10.1177/19322968261489629","url":null,"abstract":"<p><strong>Background: </strong>The glycemia risk index (GRI) is a validated continuous glucose monitoring (CGM)-derived metric of overall glycemic risk. Hemoglobin A1c (HbA1c) has been the gold-standard metric of glycemic control since the Diabetes Control and Complications Trial (DCCT). This study evaluates the relationship of GRI with long-term diabetes complications and compares its performance with HbA1c within the Virtual DCCT.</p><p><strong>Methods: </strong>The Virtual DCCT reconstructed CGM traces from HbA1c values and quarterly 7-point capillary glucose profiles collected during the original DCCT. Glycemia risk index values were computed from 14 days of CGM data. Rates of retinopathy progression were calculated across deciles of GRI and HbA1c. Poisson regressions quantified the relationship between each metric and complication risk. Receiver operating characteristic (ROC) curves evaluated the ability of GRI and HbA1c to discriminate between the DCCT intensive and conventional treatment groups.</p><p><strong>Results: </strong>Increased GRI was associated with higher rates of retinopathy progression (<math><mrow><mi>β</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>03</mn></mrow></math>, <i>P</i> < .001, <math><mrow><msup><mi>D</mi><mn>2</mn></msup><mo>=</mo><mn>0</mn><mo>.</mo><mn>97</mn></mrow></math>). Comparable results were observed using HbA1c for retinopathy progression (<math><mrow><mi>β</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>47</mn></mrow></math>, <math><mrow><mi>P</mi><mspace></mspace><mo><</mo><mo>.</mo><mn>001</mn></mrow></math>, <math><mrow><msup><mi>D</mi><mn>2</mn></msup><mo>=</mo><mn>0</mn><mo>.</mo><mn>93</mn></mrow></math>). The glycemia risk index also demonstrated separation between the intensive and conventional treatment groups, with an ROC area of 0.91 (95% CI, 0.90-0.93) compared to 0.88 (95% CI, 0.86-0.90) for HbA1c.</p><p><strong>Conclusions: </strong>Glycemia risk index demonstrated a significant association with retinopathy progression within the Virtual DCCT framework. The relationship observed between GRI and retinopathy was comparable to that obtained using HbA1c. These findings extend the validation of GRI beyond clinician-based assessment and support its potential utility as a CGM-derived metric for glycemic risk assessment and diabetes complications.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261489629"},"PeriodicalIF":4.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Continuous Glucose Monitoring in Non-Intensively Managed Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Ayman Al Hayek, Wael M Al Zahrani, Haifa F Alotaibi, Manal El Jammal, Mohammed A Al Dawish","doi":"10.1177/19322968261489265","DOIUrl":"10.1177/19322968261489265","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of continuous glucose monitoring (CGM) in adults with type 2 diabetes (T2D) not receiving intensive insulin therapy remains incompletely established, particularly regarding glycemic metrics beyond glycated hemoglobin (HbA1c).</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating real-time CGM (rtCGM) or intermittently scanned CGM (isCGM) in adults with T2D managed with non-intensive insulin regimens or non-insulin therapies. Databases were searched from inception to February 2026. Primary outcomes included HbA1c, mean glucose concentration, time in range (%TIR), time above range (%TAR), time below range (%TBR), body mass index (BMI), and patient-reported outcomes. Random-effects meta-analyses were performed using Stata 17. Risk of bias was assessed using the Cochrane Risk-of-Bias tool, version 2, and certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE).</p><p><strong>Results: </strong>Twenty-five RCTs were included. Continuous glucose monitoring significantly reduced HbA1c (mean difference [MD] -0.34, 95% confidence interval [CI], -0.46 to -0.23), mean glucose concentration (MD -13.97 mg/dL, 95% CI, -23.13 to -4.81), and %TAR (MD -6.75%, 95% CI, -10.81 to -2.70), while significantly increasing %TIR (MD +7.85%, 95% CI, 4.32-11.38). No significant effects were observed for BMI (MD -0.16 kg/m², 95% CI, -0.45 to 0.12) or %TBR (MD -0.11%, 95% CI, -0.31 to 0.08). Benefits were generally more pronounced in non-insulin-treated populations. Patient-reported outcomes were heterogeneous but suggested improved treatment satisfaction and glucose-monitoring experience with CGM. Certainty of evidence was moderate across outcomes.</p><p><strong>Conclusions: </strong>Continuous glucose monitoring probably improves glycemic control in adults with T2D not receiving intensive insulin therapy, particularly by reducing hyperglycemia and improving TIR, with limited effects on hypoglycemia or body weight.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261489265"},"PeriodicalIF":4.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Enzyme: Toward Integrated Design of Clinically Reliable Continuous Glucose Sensor.","authors":"Ariel M Lorenzo, Claudette Mine Lumibao, Winnie Alejo, Rema Ariola, Jerick Jay Briones","doi":"10.1177/19322968261496305","DOIUrl":"10.1177/19322968261496305","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261496305"},"PeriodicalIF":4.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Case for Evaluating Continuous Glucose Monitoring as a Diagnostic Tool for Diabetes.","authors":"David C Klonoff, Viral N Shah, Guillermo E Umpierrez, Curtiss B Cook, G Alexander Fleming, Alberto Gutierrez, Lutz Heinemann, Julia K Mader, Emma Y Zhang, David Kerr","doi":"10.1177/19322968261493542","DOIUrl":"10.1177/19322968261493542","url":null,"abstract":"<p><p>Continuous glucose monitoring (CGM) provides information about real-time glycemic exposure that is not captured by measurements of fasting plasma glucose (FPG), changes in glycemia during oral glucose tolerance testing (OGTT), or Hemoglobin A1c (HbA1c). We propose that (1) CGM can identify dysglycemia earlier than existing approaches, (2) CGM may serve as an adjunctive diagnostic tool, and (3) CGM may eventually support independent diagnostic criteria. The strongest case is for Stage 2 type 1 diabetes (T1D), because this stage represents a critical opportunity for intervention before progression to Stage 3 disease. CGM as a diagnostic tool could identify individuals at risk of progression to Stage 3 T1D, particularly those with islet autoantibodies, by detecting progression of dysglycemia, supporting disease staging, and identifying candidates for confirmatory testing, closer monitoring, or future prevention trials. Beyond T1D, CGM might also prove to be a reliable diagnostic test for type 2 diabetes (T2D) in selected populations. Overall, there is a need for prospective clinical studies to compare the value of using CGM-derived metrics directly with existing diagnostic standards, including OGTT and HbA1c. For both T1D and T2D, earlier diagnosis by CGM has the potential to improve patient outcomes by creating opportunities for prevention and treatment early in the natural history of the disease. This article presents an outcome-based framework for deriving and validating CGM-based diagnostic thresholds. The framework emphasizes that future diagnostic criteria should be based on clinically meaningful outcomes, rather than concordance with existing tests.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261493542"},"PeriodicalIF":4.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrieval-Augmented Simulation for Interpreting Probabilistic Digital Twins in Type 1 Diabetes.","authors":"Omer Mujahid, Ivan Contreras, Aleix Beneyto, Josep Vehi","doi":"10.1177/19322968261484150","DOIUrl":"10.1177/19322968261484150","url":null,"abstract":"<p><strong>Background: </strong>Personalized digital twins for type 1 diabetes (T1D) can simulate future glucose responses under different therapeutic conditions, but their probabilistic outputs require structured interpretation before supporting clinician-facing reasoning. We introduce retrieval-augmented simulation (RAS), a modular framework connecting probabilistic digital-twin simulation with guideline-grounded report generation.</p><p><strong>Methods: </strong>Retrieval-augmented simulation summarizes simulated glucose trajectories, converts them into structured clinical descriptors, retrieves relevant guideline evidence, and generates uncertainty-aware reports for clinician review. We evaluated RAS using data from 35 individuals with T1D in a controlled ablation study involving 2 locally hosted large language models (LLMs) (LLaMA 3.1:8b and Qwen 3:8b). Two independent LLM-based evaluators, GPT-5.5 Thinking and Kimi 2.6 Thinking, assessed report quality using a standardized rubric.</p><p><strong>Results: </strong>Structured clinical descriptors were essential for guideline selection: their removal substantially altered the retrieved evidence, demonstrating that qualitative clinical framing influenced evidence selection more strongly than numerical values alone. For LLaMA, the full RAS pipeline achieved the strongest overall performance, maintaining high numerical faithfulness (NumCov: <math><mrow><mn>0</mn><mo>.</mo><mn>98</mn><mo>±</mo><mn>0</mn><mo>.</mo><mn>03</mn></mrow></math>) and consistent guideline coupling. In contrast, Qwen exhibited substantial model-specific safety risks and frequently distorted simulation-derived numerical values (NumCov: <i>[Formula: see text]</i>). Directional bias analysis showed that Qwen systematically under-reported time in range by a mean of <math><mrow><mo>-</mo><mn>10</mn><mo>.</mo><mn>6</mn></mrow></math> percentage points and over-reported time below range, thereby inflating hypoglycemia risk. These safety findings were consistent across both independent evaluators, with a mean score difference of <math><mrow><mo>></mo><mn>2</mn><mo>.</mo><mn>1</mn></mrow></math> points.</p><p><strong>Conclusion: </strong>Retrieval-augmented simulation provides a reproducible framework for the expert-supervised interpretation of digital-twin simulations. However, aggregate framework scores alone are insufficient for clinical validation. Downstream language models must be rigorously evaluated for numerical faithfulness and directional bias to prevent unsafe, hallucinated clinical narratives.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261484150"},"PeriodicalIF":4.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Continuous Glucose Monitoring During Hospitalization in People With Type 2 Diabetes Requiring Dialysis.","authors":"Ray Wang, Mervyn Kyi, Sasha Rawlinson, Tess Cohen, Rahul D Barmanray, Karen M Dwyer, Spiros Fourlanos","doi":"10.1177/19322968261494587","DOIUrl":"10.1177/19322968261494587","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261494587"},"PeriodicalIF":4.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}