Journal of Diabetes Science and Technology最新文献

{"title":"A Randomized Clinical Trial of a Culturally Tailored Diabetes Education Curriculum With and Without Real-Time Continuous Glucose Monitoring in a Latino Population With Type 2 Diabetes: The CUT-DM With Continuous Glucose Monitoring Study.","authors":"Nicole Ehrhardt, Laura Montour, Peter Berberian, Ana Gabriela Vasconcelos, Bryan Comstock, Lorena Alarcon-Casas Wright","doi":"10.1177/19322968251331526","DOIUrl":"10.1177/19322968251331526","url":null,"abstract":"<p><strong>Background: </strong>Data on culturally tailored diabetes education with and without real-time continuous glucose monitoring (RT-CGM) in Latinos with type 2 diabetes, who are not on intensive insulin management, is lacking.</p><p><strong>Research design and methods: </strong>This is an open-label randomized control trial of Latinos with uncontrolled (HbA1c > 8.0%) type 2 diabetes conducted in a Federally Qualified Health Center (FQHC). All participants received 12 one-hour culturally tailored education sessions. Patients were randomized (1:1) to education sessions only (blinded CGM) or cyclic (50 days wear: 10 days on, 7 days off) RT-CGM. The primary outcome was a change in HbA1c from baseline to 12 weeks in those with or without CGM. Secondary outcomes included 24-week HbA1c, CGM, and metabolic parameters.</p><p><strong>Results: </strong>Participants (n = 120) were 46 years old on average, 44% female, 98% preferred Spanish language, 30% with income <$25,000, 68% uninsured and 26% using basal insulin only. Mean 1-hour session attendance and RT-CGM wear was 7.0 (±4.4) and 27.9 (±20.5) days, respectively. Mean baseline HbA1c was 10.5% (±1.8). HbA1c reduced by 1.9% (95% confidence interval [CI]: 1.5-2.3) overall (<i>P</i> < .001). Participants in the RT-CGM group reduced HbA1c at 12 weeks by 2.3% (95% CI: 1.5-3.2) compared to 1.5% (95% CI: 0.6-2.3) in the blinded CGM group (<i>P</i> =.04). At 24 weeks, overall HbA1c reduction was maintained but between-group differences attenuated.</p><p><strong>Conclusions: </strong>In a Latino type 2 diabetes population that was primarily noninsulin-requiring, virtually delivered, culturally tailored education improved HbA1c, with RT-CGM conferring greater improvement. RT-CGM should be an adjunctive therapy to diabetes education, irrespective of insulin use but continued cyclic CGM use may be needed for sustained effect.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"1650-1660"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020823","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":"Diabetes Conferences Should Go Green!","authors":"Lutz Heinemann, Sebastian Friedrich Petry, Chris Unsöld","doi":"10.1177/19322968251383916","DOIUrl":"10.1177/19322968251383916","url":null,"abstract":"<p><p>The relevant working group of the German Diabetes Society, as well as the professional association itself, has identified a number of areas where action is possible and necessary to improve sustainability. This includes organizing and holding events and conferences. These events are important for advancing scientific discourse and medical progress, but they also require considerable resources. This statement discusses a number of concepts, options, and problems that are relevant in this context for changing the situation. These activities, some of which are contradictory, require a structured and systematic approach to make diabetes conferences more sustainable in the future.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"1499-1503"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714687","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 Impact of Interfering Substances on Continuous Glucose Monitors: Part 4: Continuous Glucose Monitoring Interferents: In Vivo Performance, Clinical Implications and Future Standardization.","authors":"Steven John Setford","doi":"10.1177/19322968251377026","DOIUrl":"10.1177/19322968251377026","url":null,"abstract":"<p><p>Presented is a series of narrative reviews that summarize published information regarding the effect or potential effect of interfering substances on the accuracy of continuous glucose monitoring (CGM) devices. Whilst drawing together what is currently known regarding this topic, the future direction in this field and clinical implications posed by polypharmacy on CGM performance are considered. This fourth and final in this series of articles reviews the following topics: the benefits and drawbacks of conducting interfering substance studies in vitro versus in vivo; the balance between the cost and complexity of undertaking in vitro or in vivo studies to screen for potential interferences versus the clinical relevance of the findings; clinical factors influencing interferent behavior on CGM performance (pharmacokinetics and polypharmacy considerations); the need for standardization, including consideration of the metrological traceability of CGM readings, establishment of CGM analytical performance metrics and standardized CGM assessment procedures for measuring interferents.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"1714-1725"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313042","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":"ReplayBG-Web: A Novel Web Interface to Ease the Creation and Use of Digital Twins for Type 1 Diabetes.","authors":"Luca Cossu, Anna Ghiotto, Andrea Facchinetti, Giacomo Cappon","doi":"10.1177/19322968261481540","DOIUrl":"10.1177/19322968261481540","url":null,"abstract":"<p><strong>Background: </strong>ReplayBG is a recently released tool that acts as a digital twin (DT) of individuals with type 1 diabetes, learning glucose-insulin dynamics from real-world data and enabling users to test the effect of different therapeutic actions. However, its adoption remains limited by the technical expertise required to operate it.</p><p><strong>Methods: </strong>To lower this barrier, we developed ReplayBG-web, a web-based interface built on ReplayBG that allows any user, without programming skills, to upload standardized CSV files and automatically generate DTs.</p><p><strong>Results: </strong>ReplayBG-web enables users to interactively visualize original data and metrics, create new scenarios by modifying the dose and timing of insulin and meals, obtain the resulting alternative glucose profiles and related control metrics, and export results for downstream analysis.</p><p><strong>Conclusions: </strong>ReplayBG-web represents a step forward in filling the gap between research, clinical practice, self-learning, and potentially education, making digital twin technology for type 1 diabetes accessible to a wider range of users.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261481540"},"PeriodicalIF":4.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840436","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":"Impact of Pharmacy Benefit Manager Organizations on Diabetes Management.","authors":"Irl B Hirsch, Christopher G Parkin, Kenneth Moritsugu, Grazia Aleppo, George Grunberger, Janet B McGill, Viral N Shah, Carol J Levy, Marissa Bowdler, Bruce Taylor, Thomas C Blevins, Davida F Kruger, Guillermo E Umpierrez, Rachael Hiday, Steve V Edelman, David G Marrero, Richard M Bergenstal","doi":"10.1177/19322968261480168","DOIUrl":"10.1177/19322968261480168","url":null,"abstract":"<p><p>Pharmacy benefit managers (PBMs) administer prescription drug benefits for insurers, employers, and other payers through formulary design, rebate negotiation, pharmacy network management, and utilization controls. In diabetes care, cost-containment strategies such as formulary-driven medication switching, step therapy, and formulary exclusivity have increasingly restricted access to essential medications and technologies. These rebate-driven practices often prioritize financial incentives over clinical appropriateness, leading to forced nonmedical switching, higher out-of-pocket costs, reduced adherence, and poorer glycemic outcomes. This narrative review examines how PBM-driven policies undermine patient-centered, evidence-based diabetes care and disrupt continuity of treatment. Greater transparency, preservation of patient and clinician choice, and policies that align PBM incentives with clinical outcomes are needed to reduce harm and improve access to appropriate diabetes therapies.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261480168"},"PeriodicalIF":4.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840316","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 Virtual Glucose Monitoring: Interpreting a Complex Multicomponent Intervention.","authors":"Jomel Mabborang","doi":"10.1177/19322968261481813","DOIUrl":"10.1177/19322968261481813","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261481813"},"PeriodicalIF":4.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828662","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":"Bridging the Digital Divide: Real-World Efficacy of Commercial and Open-Source Automated Insulin Delivery Systems in a Diverse, Low-Resource Pediatric Population.","authors":"Karin Dreifuss, Floris Levy-Khademi, Carmit Avnon Ziv, Adi Auerbach","doi":"10.1177/19322968261477764","DOIUrl":"10.1177/19322968261477764","url":null,"abstract":"<p><strong>Background: </strong>Achieving optimal glycemic control in type 1 diabetes (T1D) is challenging. Automated insulin delivery (AID) systems have improved outcomes, yet data on open-source systems-particularly in low-resource, low technological literacy settings-remain limited. This study compared the efficacy and safety of an open-source system with a regulatory-approved system in a heterogeneous real-world pediatric cohort.</p><p><strong>Methods: </strong>This longitudinal observational study included 61 children with T1D treated at Shaare Zedek Medical Center: 30 using the regulatory-approved Medtronic 780G and 31 using the open-source AndroidAPS AID system. Socioeconomic status (SES) was determined by residential address. Glycemic outcomes were compared between AID use and prior sensor-augmented pump therapy. Primary endpoints included changes in time in range (TIR), average glucose, glucose management indicator (GMI), and hypoglycemia/hyperglycemia duration. Safety outcomes included rates of severe hypoglycemia and diabetic ketoacidosis (DKA).</p><p><strong>Results: </strong>Both groups demonstrated significant glycemic improvements after transitioning to AID, including an increase in %TIR (56.6 ± 14.1 vs 69.3 ± 8.8) and reduction in average blood glucose (173.3 ± 31.7 vs 149.9 ± 18.3), GMI and % time in hyperglycemia. No significant differences in glycemic outcomes were observed between groups, although a trend toward greater reduction in average blood glucose and GMI was observed in the regulatory-approved group. No episodes of severe hypoglycemia or DKA occurred in either group.</p><p><strong>Conclusions: </strong>In a heterogeneous real-world pediatric cohort including a low-resource population with limited technological access, both AID systems significantly improved glycemic outcomes without compromising safety. These findings suggest AID benefits transcend socioeconomic barriers, supporting patient autonomy in system selection.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261477764"},"PeriodicalIF":4.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818597","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":"Biotech commercialization should be treated as an engineering discipline.","authors":"Shahid N Shah","doi":"10.1177/19322968261480134","DOIUrl":"10.1177/19322968261480134","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261480134"},"PeriodicalIF":4.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813220","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":"Accessibility Barriers in Medical Devices for Diabetes.","authors":"Mariana Ribeiro Brandão, Marcella Darold, Emanuele Philippsen, Jefferson Luiz Brum Marques, Renato Garcia Ojeda","doi":"10.1177/19322968261477078","DOIUrl":"https://doi.org/10.1177/19322968261477078","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261477078"},"PeriodicalIF":4.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793894","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":"Prospective Detection of Hypoglycemia and Near-Hypoglycemia Inducing Pressure-Induced Sensor Attenuation Onset in Continuous Glucose Monitoring Time Series.","authors":"Benjamin Lobo","doi":"10.1177/19322968261469536","DOIUrl":"https://doi.org/10.1177/19322968261469536","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) sensors are vulnerable to pressure-induced sensor attenuations (PISAs). Pressure-induced sensor attenuations are characterized by a rapid but erroneous drop in blood glucose (BG) readings, and if these BG readings are hypoglycemic or near-hypoglycemic they can cause unwarranted actions to be taken (eg, triggering of hypoglycemia alarms, shut-off of an insulin pump). In this work, we propose a prospective algorithm (PA) to detect the onset of PISAs where the minimum sensor-reported BG value during the PISA is less than 85 mg/dL.</p><p><strong>Methods: </strong>The PA is composed of a screening module and a probability estimation module (PEM). The PEM was trained on a data set with 846 PISAs (59 122 hours of data, 67 patients). The optimal version of the PA was selected by assessing performance of each version of the PA on a data set with 89 PISAs (8189 hours of data, 11 patients). Given the highly imbalanced nature of the problem (baseline prevalence of PISAs onset in the testing set is 1.2%), performance was primarily assessed using precision-recall (PR) curves.</p><p><strong>Results: </strong>The final version of the PA was tested on a data set with 325 PISAs (26 890 hours of data, 33 patients), resulting in an area under the PR curve of 0.590 (95% confidence interval [0.509, 0.672]), indicating excellent performance against the baseline occurrence.</p><p><strong>Conclusions: </strong>The results indicate that the PA could feasibly be used to inform other decision-making processes, for example, canceling of hypoglycemia alarms that would otherwise be triggered.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261469536"},"PeriodicalIF":4.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793837","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}