Journal of Diabetes Science and Technology最新文献

{"title":"The Relationship Between the Percent Coefficient of Variation of Sensor Glucose Levels and the Risk of Severe Hypoglycemia or Non-Severe Hypoglycemia in Patients With Type 1 Diabetes: Post Hoc Analysis of the ISCHIA Study.","authors":"Takashi Murata, Munehide Matsuhisa, Akio Kuroda, Masao Toyoda, Yushi Hirota, Masahito Ogura, Shota Suzuki, Ken Kato, Atsuhito Tone, Yuka Matoba, Shu Meguro, Junnosuke Miura, Kunihiro Nishimura, Akira Shimada, Kiminori Hosoda, Naoki Sakane","doi":"10.1177/19322968251318756","DOIUrl":"10.1177/19322968251318756","url":null,"abstract":"<p><strong>Background: </strong>The relationship between the percent coefficient of variation (%CV) and the risk of severe hypoglycemia (SH) or non-severe hypoglycemia (NSH) in patients with type 1 diabetes (T1D) remains to be elucidated.</p><p><strong>Materials and methods: </strong>The Effect of Intermittent-Scanning Continuous Glucose Monitoring to Glycemic Control Including Hypoglycemia and Quality of Life of Patients with Type 1 Diabetes Mellitus (ISCHIA) study was a crossover, randomized, controlled trial for hypoglycemia prevention in patients with T1D using multiple daily injections (MDIs). Blinded continuous glucose monitoring (CGM) data of 93 patients obtained during the Control period (84 days) were used for the post hoc analysis. The receiver operating characteristics (ROC) curves were analyzed to determine the discrimination thresholds of %CV corresponding to the low blood glucose index (LBGI) > 5 and LBGI ≥ 2.5, and the occurrence of SH.</p><p><strong>Results: </strong>The %CV corresponding to LBGI > 5 and LBGI ≥ 2.5 was 42.2% and 37.0%, respectively. The episodes of SH were observed in three patients, and the %CV corresponding to the occurrence of SH was 40.7%.</p><p><strong>Conclusions: </strong>The identification of the discrimination threshold of %CV associated with the risk of SH or NSH in patients with T1D is needed.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251318756"},"PeriodicalIF":4.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441095","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":"Continuous and Flash Glucose Monitoring in Adults at Risk of Type 2 Diabetes: A Scoping Review.","authors":"Prince Amoh, David Broom, Ioannis Kyrou, Samuel Nartey, Anna Paul, Dale Esliger, Maxine Whelan","doi":"10.1177/19322968251315497","DOIUrl":"10.1177/19322968251315497","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) are widely used in diabetes management and increasingly being considered for type 2 diabetes mellitus (T2DM) prevention. This scoping review aims to summarize the literature published to date on CGM and FGM use in adults at risk of T2DM.</p><p><strong>Methods: </strong>A systematic search of four databases (CINAHL, PsycINFO, MEDLINE, Cochrane Library) was conducted, covering studies from 1985 to 2024. Eligible studies used CGM or FGM in interventional settings targeting adults at risk of T2DM. Rayyan software facilitated article screening, and the Johns Hopkins Evidence-Based Practice tool assessed study quality.</p><p><strong>Results: </strong>From 13 644 articles, 12 studies were included, reporting on 1144 participants (353 at-risk, mean age 47 ± 12.8 years) across eight countries. Ten studies employed FGM, focusing on health-related behaviors (diet, physical activity, or both). Significant improvements in glucose control and anthropometrics were reported in 75% and 50% of the studies, respectively, along with reductions in glycated hemoglobin, fasting glucose, and insulin resistance. Seven studies used qualitative methods, with recurrent themes including perceived benefits and motivators for behavior change and acceptability and feasibility of device use. Three studies were rated as \"high\" level and scored a \"B\" for evidence quality, while the remaining studies were lower for both level and evidence quality.</p><p><strong>Conclusions: </strong>Existing published studies deploying glucose monitoring technologies show promise in supporting interventions aimed at preventing T2DM in at-risk adults. Further robust studies are required to confirm the long-term acceptability and efficacy of these technologies.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251315497"},"PeriodicalIF":4.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441084","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":"Progression of Diabetic Retinopathy After Initiation of Automated Insulin Delivery System in Adults With Type 1 Diabetes.","authors":"Kagan E Karakus, Halis K Akturk, Janet K Snell-Bergeon, Viral N Shah","doi":"10.1177/19322968251318740","DOIUrl":"10.1177/19322968251318740","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the progression of diabetic retinopathy (DR) after the initiation of automated insulin delivery (AID) systems in adults with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>In this longitudinal study with 152 adults, retinal exams and clinical variables were collected before and after AID initiation up to 2.7 years. The DR worsening was defined as an increase in Early Treatment of Diabetic Retinopathy Study (ETDRS) scores or qualitative retinal exam.</p><p><strong>Results: </strong>A total of 152 adults with mean age of 42 years (57% female), 26 years of T1D duration, and mean baseline HbA_1c of 7.6% (60 mmol/mol) were included in this analysis. Of 152 adults with T1D, 42 (28%) adults had DR worsening after AID initiation. After adjusting for age, diabetes duration, and sex, baseline HbA_1c (odds ratio [OR] = 2.1 [1.34-3.04]) and low-density lipoprotein cholesterol (LDL-C) >100 mg/dL with HbA_1c >8% (OR = 3.33 [1.12-9.91]) were associated with two- and three-fold increased risk for DR worsening, respectively. The decline of HbA_1c with AID initiation between DR worsening and no-DR worsening groups was not significant (-0.38 ± 1.2% vs -0.47 ± 0.9%; <i>P</i> = .6).</p><p><strong>Conclusions: </strong>Higher baseline HbA_1c with LDL-C >100 mg/dL may be associated with DR worsening after initiation of AID systems in T1D. Those with elevated HbA_1c should get periodic ophthalmic examination after AID initiation to detect progression of DR. Prompt diagnosis may result in timely treatment.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251318740"},"PeriodicalIF":4.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414399","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 Prevalence and Predictors of Improper Sharps Collection Practices Among People With Diabetes in Saudi Arabia.","authors":"Mohammed E Al-Sofiani, Ghadah Alsuwailem, Maee Barakeh, Ghaida Almarshoud, Alia Zawawi, Rawan Bakader","doi":"10.1177/19322968251318747","DOIUrl":"10.1177/19322968251318747","url":null,"abstract":"<p><strong>Background: </strong>Diabetes treatment requires the use of medical sharps for glycemic control. Improper sharps collection and disposal poses substantial threats to people with diabetes (PWD), health care professionals, the environment, and public health.</p><p><strong>Objectives: </strong>To identify the prevalence and predictors of improper sharps collection practices among PWD in Saudi Arabia.</p><p><strong>Methods: </strong>We surveyed 288 PWD at King Saud University Diabetes Center in Riyadh, Saudi Arabia, from September to October 2021. We asked questions about demographics, diabetes history, sharps collection practices, and prior education on proper sharps collection practices. We defined \"proper sharps collection\" as: using a designated sharps disposal container or homemade sealed container to collect sharps.</p><p><strong>Results: </strong>Of the PWD surveyed, 60% were women, 54% were ≥35 years old, and 53% had type 1 diabetes. Most respondents (80% and 72%) reported improper collection of needles and lancets, respectively. Approximately, 56% of needle users and 61% of lancet users reported that they had never received instructions on safe sharps disposal. Receiving education on safe sharps disposal practices was associated with a 66% reduction in the risk of improper sharps collection practices (odds ratio (OR) [95% confidence interval (CI)]: 0.34 [0.16-0.68]) after adjusting for age, gender, type and duration of diabetes, income, education, and nationality of the study participants. Among those who improperly dispose their needles, 67% thought their sharps collection practices were appropriate.</p><p><strong>Conclusions: </strong>Our findings highlight the high prevalence of unsafe sharps collection practices among PWD in Saudi Arabia, and how prior education on safe sharps collection practices can help address this environmental and public health threat. Policies to reduce diabetes-related waste, unify the approach to proper sharps collection and disposal, and promote safe disposal education are needed to achieve a sustainable and safe waste management system.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251318747"},"PeriodicalIF":4.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425487","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 in People With Type 1 Diabetes Receiving Hemodialysis in Hospital.","authors":"Ray Wang, Mervyn Kyi, Brintha Krishnamoorthi, Ailie Connell, Cherie Chiang, Debra Renouf, Rahul Barmanray, Karen Dwyer, Spiros Fourlanos","doi":"10.1177/19322968251318758","DOIUrl":"10.1177/19322968251318758","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251318758"},"PeriodicalIF":4.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414397","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":"Availability of Open Dynamic Glycemic Data in the Field of Diabetes Research: A Scoping Review.","authors":"Libera Lucia Del Giudice, Agnese Piersanti, Christian Göbl, Laura Burattini, Andrea Tura, Micaela Morettini","doi":"10.1177/19322968251316896","DOIUrl":"10.1177/19322968251316896","url":null,"abstract":"<p><strong>Background: </strong>Poor data availability and accessibility characterizing some research areas in biomedicine are still limiting potentialities for increasing knowledge and boosting technological advancement. This phenomenon also characterizes the field of diabetes research, in which glycemic data may serve as a basis for different applications. To overcome this limitation, this review aims to provide a comprehensive analysis of the publicly available data sets related to dynamic glycemic data.</p><p><strong>Methods: </strong>Search was performed in four different sources, namely scientific journals, Google, a comprehensive registry of clinical trials and two electronic databases. Retrieved data sets were analyzed in terms of their main characteristics and on the typology of data provided.</p><p><strong>Results: </strong>Twenty-five data sets were identified including data from challenge tests (5 of 25) or data from Continuous Glucose Monitoring (CGM, 20 of 25). As for the data sets including challenge tests, all of them were freely downloadable; most of them (80%) related only to oral glucose tolerance test (OGTT) with standard duration (2 h), but varying for timing and number of collected blood samples, and variables collected in addition to glucose levels (with insulin levels being the most common); the remaining 20% of them also included intravenous glucose tolerance test (IVGTT) data. As for the data sets related to CGM, 7 of 20 were freely downloadable, whereas the remaining 13 were downloadable upon completion of a request form.</p><p><strong>Conclusions: </strong>This review provided an overview of the readily usable data sets, thus representing a step forward in fostering data access in diabetes field.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251316896"},"PeriodicalIF":4.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425432","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":"Expert Clinical Interpretation of Continuous Glucose Monitor Reports From Individuals Without Diabetes.","authors":"Nicole L Spartano, Brenton Prescott, Maura E Walker, Eleanor Shi, Guhan Venkatesan, David Fei, Honghuang Lin, Joanne M Murabito, David Ahn, Tadej Battelino, Steven V Edelman, G Alexander Fleming, Guido Freckmann, Rodolfo J Galindo, Michael Joubert, M Cecilia Lansang, Julia K Mader, Boris Mankovsky, Nestoras N Mathioudakis, Viswanathan Mohan, Anne L Peters, Viral N Shah, Elias K Spanakis, Kayo Waki, Eugene E Wright, Mihail Zilbermint, Howard A Wolpert, Devin W Steenkamp","doi":"10.1177/19322968251315171","DOIUrl":"10.1177/19322968251315171","url":null,"abstract":"<p><strong>Background: </strong>Clinical interpretation of continuous glucose monitoring (CGM) data for people without diabetes has not been well established. This study aimed to investigate concordance among CGM experts in recommending clinical follow-up for individuals without diabetes, based upon their independent review of CGM data.</p><p><strong>Methods: </strong>We sent a survey out to expert clinicians (<i>n</i> = 18) and asked them to evaluate 20 potentially challenging Dexcom G6 Pro CGM reports (and hemoglobin A1c [HbA1c] and fasting venous blood glucose levels) from individuals without diabetes. Clinicians reported whether they would recommend follow-up and the reasoning for their decision. We performed Fleiss Kappa interrater reliability to determine agreement among clinicians.</p><p><strong>Results: </strong>More than half of expert clinicians (56-100%, but no clear consensus) recommended follow-up to individuals who spent >2% time above range (>180 mg/dL), even if HbA1c <5.7% and fasting glucose <100 mg/dL. There were no observed trends for recommending follow-up based on mean glucose or glucose management indicator. Overall, we observed poor agreement in recommendations for who should receive follow-up based on their CGM report (Fleiss Kappa = 0.36).</p><p><strong>Conclusions: </strong>High discordance among expert clinicians when interpreting potentially challenging CGM reports for people without diabetes highlights the need for more research in developing normative data for people without diabetes. Future work is required to develop CGM criteria for identifying potentially high-risk individuals who may progress to prediabetes or type 2 diabetes.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251315171"},"PeriodicalIF":4.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399419","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 Utility of Smart Multiple Daily Injection Systems in Intensive Insulin-Treated People With Diabetes: An Italian Expert Consensus.","authors":"Francesco Giorgino, Riccardo Bonfanti, Filomena Castaldo, Concetta Irace, Andrea Laurenzi, Claudio Maffeis, Giovanni Pappagallo, Dario Pitocco, Ivana Rabbone, Emanuela Zarra, Andrea Enzo Scaramuzza","doi":"10.1177/19322968251316577","DOIUrl":"10.1177/19322968251316577","url":null,"abstract":"<p><strong>Background: </strong>Smart systems for multiple daily injections (Smart MDI) integrate continuous glucose monitoring, connected insulin pens, smartphone apps, and cloud-based data storage to provide bolus and corrective dose suggestions, reminders/alerts, automatic tracking and sharing of insulin therapy, and glycemic data to users, caregivers, and providers. This is an expert consensus on the clinical value of Smart MDI and critical points for implementation in adults and children/adolescents with diabetes.</p><p><strong>Methods: </strong>A nominal group technique combined with the estimate-talk-estimate approach was employed to achieve consensus among panel members from the Italian Intersociety Technology and Diabetes Study Group with expertise in pediatric and adult diabetes care.</p><p><strong>Results: </strong>The expert consensus indicated that glycemic profiles can be improved by using bolus dose suggestions based on glucose values, planned meals, the insulin-to-carbohydrate ratio, correction factors, and consideration of insulin-on-board. Automatic remote sharing of patient data on glycemia and insulin therapy allows clinicians to make more appropriate and timely therapeutic recommendations based on objective data. Dose tracking, bolus reminders/alerts, and reduced hypoglycemia and associated anxiety achieved through Smart MDI may improve adherence.</p><p><strong>Conclusions: </strong>Smart MDI can reduce treatment burden while improving the daily experiences and glycemic outcomes for adults and children/adolescents with type 1 or type 2 diabetes. However, high-quality clinical data are lacking, and more evidence is needed to compare the effects of Smart MDI and other advanced insulin delivery systems on glycemic and patient-reported outcomes.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251316577"},"PeriodicalIF":4.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382575","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":"A Performance-Based Adaptation Index for Automated Insulin Delivery Systems.","authors":"Jenny L Diaz C, Patricio Colmegna, Elliot Pryor, Marc D Breton","doi":"10.1177/19322968251315499","DOIUrl":"10.1177/19322968251315499","url":null,"abstract":"<p><strong>Background: </strong>Automated insulin delivery (AID) algorithms can benefit from tuning of their aggressiveness to meet individual needs, as insulin requirements vary among and within users. We introduce the Performance-Based Adaptation Index (PAI), a tool designed to enable automatic adjustment of an AID system aggressiveness based on continuous glucose monitoring (CGM) metrics.</p><p><strong>Methods: </strong>PAI integrates two CGM-based metrics-one for hypoglycemia and another for hyperglycemia exposure-over a previous time window into a single index (<math><mrow><msub><mi>α</mi><mi>θ</mi></msub></mrow></math>). We propose two methods to compute <math><mrow><msub><mi>α</mi><mi>θ</mi></msub></mrow></math>: one based on time in range (TIR, 70-180 mg/dL), and the other on glycemic risk indices. Using <math><mrow><msub><mi>α</mi><mi>θ</mi></msub></mrow></math>, we developed a multiplicative strategy to adjust the AID system's aggressiveness, accounting for situations where <math><mrow><msub><mi>α</mi><mi>θ</mi></msub></mrow></math> cannot be reliably calculated. The feasibility of this method was assessed in-silico using the UVA/Padova Type 1 Diabetes Simulator and our full closed-loop algorithm (UVA-model predictive control (MPC)) across five scenarios: optimal tuning (baseline), conservative and aggressive tunings, and temporary and permanent changes in insulin needs. Glycemic outcomes were evaluated from the simulated glucose traces.</p><p><strong>Results: </strong>Negligible performance variations were observed in the baseline scenario. For the conservative scenario, adjusting <math><mrow><msub><mi>α</mi><mi>θ</mi></msub></mrow></math> improved TIR (35.1% vs 71.8%) and increased total daily insulin (32.1 U vs 41.2 U). Conversely, for the aggressive scenario, it reduced hypoglycemia exposure (TBR: 2.6% vs 1.4%) and overall insulin usage (45.6 U vs 43.0 U).</p><p><strong>Conclusion: </strong>In-silico results demonstrated the safety and efficacy of using PAI to automatically tune the UVA-MPC controller, achieving TIR values above 70% under fully closed-loop conditions and across various physiological states. Clinical validation of these results is warranted.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251315499"},"PeriodicalIF":4.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254443","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":"Continuous Glucose Monitoring in Hospitalized Adults With Diabetic Ketoacidosis: A Prospective Open-Label Pilot Study.","authors":"Magdalena M Bogun, Chunhui Wang, Paul A Kurlansky, Nur Bedeir, Guillermo E Umpierrez","doi":"10.1177/19322968251316887","DOIUrl":"10.1177/19322968251316887","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) devices are increasingly used in critical and non-critical care hospital units. The efficacy of CGM in assessing glucose control in adults with diabetic ketoacidosis (DKA) is unknown.</p><p><strong>Methods: </strong>This single-center pilot study compared glycemic control by real-time CGM (Dexcom G6), capillary point-of-care (POC), and basic metabolic panel (BMP) during intravenous (IV) insulin treatment and after the resolution of DKA. We compared the mean absolute relative difference (MARD), median absolute relative difference (ARD) glucose values, and Diabetes Technology Society (DTS) Error Grid analyses.</p><p><strong>Results: </strong>We recruited 52 patients (49 ± 19 years, admission glucose: 503 ± 239.4 mg/dL) with type 1 diabetes (n = 24) and type 2 diabetes (n = 28). Compared with POC testing, the MARD was 17.4% ± 13.2%, and the median ARD was 14.2% (interquartile range [IQR]: 6.4, 28) during the initial IV insulin period and 19.8% ± 18.7% and 14.3% (7, 26.2) after DKA resolution. The DTS Error Grid analysis showed that 100% of values during the IV insulin treatment and 95% after the DKA resolution were in zones A+B. Compared with BMP glucose values, the MARD and median ARD were 18.5% ± 19.1% and 12.2% (5.4, 23.8) during the IV insulin treatment and 22.5% ± 24.7% and 15.1% (6.6, 27.6) after DKA resolution.</p><p><strong>Conclusion: </strong>This is the first report on the use of real-time CGM in adults with DKA. Our study indicates that CGM technology is a reliable tool for hospital use during acute insulin treatment and after the resolution of DKA. Future multicentre randomized studies are needed to determine the benefits of real-time CGM in facilitating diabetes care in hospitalized patients with hyperglycemic crises.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251316887"},"PeriodicalIF":4.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189373","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}