bims-glumda Biomed News
on CGM data in management of diabetes
Issue of 2025–08–10
fourteen papers selected by
Mott Given
  1. Personalization of continuous glucose monitoring system for diabetic patients in the Polish market in 2024.
  2. [The role of continuous glucose monitoring in diabetes screening and glycemic optimization].
  3. Assessing the accessibility and accuracy of pharmacist counseling for continuous glucose monitoring: A secret shopper study of community pharmacies.
  4. Continuous Glucose Monitoring Metrics Predict All-Cause Mortality in Diabetes: A Real-world Long-term Study.
  5. Does Continuous Glucose Monitoring Use Prompt Greater Engagement in Self-Management? A Randomized Controlled Trial Focusing on Adults With Type 2 Diabetes.
  6. Continuous glucose monitoring in noninsulin-treated type 2 diabetes: A critical review of reported trials with an updated systematic review and meta-analysis of randomised controlled trials.
  7. Insulin DEgludec/LIraglutide versus multiple daily insulin injections in the transition from hospital to outpatient management assessed by continuous glucose monitoring: the DELI transition trial.
  8. A case report of continuous glucose monitoring for a radiographer working in a 1.5T MR Linac.
  9. Mediterranean diet adherence among adolescents with type 1 diabetes: Insights into dietary patterns, glycemic control, and gender differences.
  10. A Prospective Study of the Correlation Between Time in Range and Incidence of Diabetic Cardiovascular Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus.
  11. Type 1 diabetes technology gap between high-income and developing countries: Continuous glucose monitoring access remains a challenge in Brazil.
  12. Evaluation of Glycemia Risk Index and Continuous Glucose Monitoring Outcomes Following the Transition to an Advanced Hybrid Closed-Loop System in Type 1 Diabetes.
  13. Clinical and Economic Impact of Hybrid Closed-Loop Systems for T1 Diabetes Management in Spain.
  14. FHIR-Based Information System for Type 1 Diabetes Consultations Based on Patient-Generated Health Data.
  1. Pediatr Endocrinol Diabetes Metab. 2025 ;pii: 56397. [Epub ahead of print]31(2): 75-79
    Personalization of continuous glucose monitoring system for diabetic patients in the Polish market in 2024.
    Martyna R Gąsiorek, Marcin D Niedziela, Przemysława Jarosz-Chobot.
      Continuous glucose monitoring (CGM) systems have revolutionized diabetes management by providing real-time glycemic data, improving control, and reducing the risk of both acute and chronic complications. With an increasing range of CGM systems available on the market, selecting the most appropriate system has become a challenge for both patients and healthcare professionals. This narrative review aims to analyze the available CGM systems and identify the factors that influence the personalized selection of a CGM system for patients with diabetes, based on system functions and features. Factors influencing CGM choice are discussed, including patient age, fear of puncture, physical activity, aesthetics, and financial considerations.
    Keywords:   CGM parameters; continous glucose monitoring system; continuous glucose monitoring sensors.; personalization therapy with systems CGM; diabetes
    DOI:  https://doi.org/10.5114/pedm.2025.152598
  2. Zhonghua Nei Ke Za Zhi. 2025 Aug 01. 64(8): 701-706
    [The role of continuous glucose monitoring in diabetes screening and glycemic optimization].
    Y P Wang, J Wang, Y M Mu.
      
    DOI:  https://doi.org/10.3760/cma.j.cn112138-20250401-00192
  3. J Am Pharm Assoc (2003). 2025 Aug 01. pii: S1544-3191(25)00172-4. [Epub ahead of print] 102493
    Assessing the accessibility and accuracy of pharmacist counseling for continuous glucose monitoring: A secret shopper study of community pharmacies.
    Morgan P Stewart, Lindsey J Loera, Bruno Onwukwe, Kelly R Reveles, Kathryn P Lin.
       BACKGROUND: Continuous glucose monitors (CGMs) have many benefits in diabetes care and have grown in popularity. CGMs are often dispensed in community pharmacies, placing a growing responsibility on community pharmacists to provide patient education. Limited time and resources may result in suboptimal, or even absent, patient counseling.
    OBJECTIVES: To assess the accessibility and accuracy of CGM counseling offered by community pharmacists in Austin, TX.
    METHODS: All community pharmacies in Austin, TX (N=125) were visited in person in two phases by trained auditors, simulating a patient requesting pharmacist counseling on a CGM device. The devices for counseling were Freestyle Libre 3 (Abbott Diabetes Care) in phase one and Dexcom G7 (Dexcom, Inc.) in phase two. Competency outcomes measured included glycemic targets, description of components, placement technique, checking/assessing glucose, and other tips for successful use. All responses were recorded immediately following the encounter using an eight-item online form.
    RESULTS: Data were obtained from 114 (91.2%) community pharmacies in both phases. Counseling was provided more often for Freestyle Libre versus Dexcom (88.6% vs 71.1%, p<0.01). A small proportion declined to counsel due to lack of time, limited product comfort, or a combination of the two. Competency outcomes frequently met for Freestyle Libre and Dexcom included: sensor placement (91.5% vs 88.7%), CGM components (80.3% vs 70.4%), and application technique (78.9% vs 56.3%, p<0.01). Competency outcomes rarely met included: glycemic targets (1.4% vs 0.0%), alarms and alerts (1.4% vs 2.8%), when a fingerstick is needed (0.0% vs 7.0%), and how to interpret glucose/arrows (18.3% vs 12.7%).
    CONCLUSION: Pharmacists remain accessible healthcare providers for individuals with diabetes, but deficits in CGM counseling and patient education in community pharmacies exist. Barriers may include low pharmacist comfort with CGM devices and potential lack of familiarity based on the type of device a patient is using.
    Keywords:  community pharmacist; continuous glucose monitoring; patient counseling
    DOI:  https://doi.org/10.1016/j.japh.2025.102493
  4. Diabetes Care. 2025 Aug 06. pii: dc250716. [Epub ahead of print]
    Continuous Glucose Monitoring Metrics Predict All-Cause Mortality in Diabetes: A Real-world Long-term Study.
    Tomoki Okuno, Sharon A Macwan, Gregory J Norman, Donald R Miller, Peter D Reaven, Jin J Zhou.
       OBJECTIVE: Investigate the association between continuous glucose monitoring (CGM)-derived glucose metrics and all-cause mortality in patients with type 1 or type 2 diabetes (T1D or T2D).
    RESEARCH DESIGN AND METHODS: We analyzed data from 2,752 adults (≥21 years old) with diabetes (65% T2D) from the Veterans Affairs Healthcare System who received Dexcom CGM between 2015 and 2020. All participants had ≥10 days of CGM data over landmark (LM) periods (14 days, 3 months, and 6 months) merged with electronic health records. All-cause mortality was assessed over 5 years from CGM initiation. Cox models evaluated associations between mortality and CGM metrics: mean glucose (MG, mg/dL), time in range (TIR, %), time above range (TAR, %), coefficient of variation (CV), and glycemic risk index (GRI, %).
    RESULTS: Mean age at CGM initiation was 64 years, and median CGM use was nearly 3 years. There were 407 deaths. In separate multivariable Cox models (adjusting for mortality-related variables), higher MG, TAR, CV, and GRI and lower TIR during the 6-month LM were associated with 5-year mortality (hazard ratios: MG 1.18, TAR 1.20, GRI 1.23, CV 1.18, and TIR 0.83; all P ≤ 0.01) and those associations remained significant after adjusting for LM HbA1c. Results were similar with shorter CGM LM observation windows. The association between CV and mortality was independent of other CGM metrics and appeared strongest in those with lower HbA1c levels.
    CONCLUSIONS: CGM-derived metrics were associated with all-cause mortality in patients with diabetes and may better capture long-term risk associated with glucose fluctuations and periods of hypo- and hyperglycemia than HbA1c.
    DOI:  https://doi.org/10.2337/dc25-0716
  5. J Diabetes Sci Technol. 2025 Aug 08. 19322968251361031
    Does Continuous Glucose Monitoring Use Prompt Greater Engagement in Self-Management? A Randomized Controlled Trial Focusing on Adults With Type 2 Diabetes.
    William H Polonsky, Emily C Soriano, Fleur Levrat-Guillen, Mariya Chichmarenko, Haley Sandoval, Alessandra Bastian, Addie L Fortmann, Andrew Kwist, Michael Vallis.
       BACKGROUND: Continuous glucose monitoring (CGM) promotes glycemic benefits in adults with type 2 diabetes (T2D), including insulin users as well as noninsulin users, often with minimal professional support. To investigate whether these benefits may stem from increased user engagement in self-management, we conducted a randomized controlled trial comparing the impact of CGM versus self-monitoring of blood glucose (SMBG) on self-reported engagement and HbA1c in CGM-naïve adults with T2D.
    METHODS: Potential participants completed the Impact of Glucose Monitoring on Self-Management Scale (IGMSS) and an HbA1c home test to confirm eligibility (>7.5%). N = 110 eligible participants were randomized to receive a FreeStyle Libre 3 (CGM arm) or a FreeStyle Precision Neo Blood Glucose Monitoring System (SMBG arm). The IGMSS and HbA1c home test were repeated after three months. Latent change score models estimated group differences in outcomes over time.
    RESULTS: CGM users reported significantly greater engagement with T2D self-management than SMBG users (IGMSS total b = 0.61, P < .001), including greater gains on all three major subscales, capability (b = 0.76, P < .001), opportunity (b = 0.46, P = .001), and motivation (b = 0.66, P < .001). CGM users also saw a significant HbA1c drop of ~1% (9.2% to 8.3%, P < .001, d = .65), with less than half the reduction in SMBG users (8.9% to 8.4%, P = .065, d = .30). However, the effect of group on HbA1c change did not reach statistical significance (P = .170), likely due to limited sample size.
    CONCLUSIONS: These findings suggest that introducing CGM to adults with T2D heightens users' engagement with their own diabetes care and also improves glycemic control more than providing SMBG.
    Keywords:  CGM; engagement; self-management; type 2 diabetes
    DOI:  https://doi.org/10.1177/19322968251361031
  6. Diabetes Obes Metab. 2025 Aug 04.
    Continuous glucose monitoring in noninsulin-treated type 2 diabetes: A critical review of reported trials with an updated systematic review and meta-analysis of randomised controlled trials.
    Ronnie Aronson, Alexander Abitbol, Harpreet S Bajaj, Alice Y Y Cheng, Stavroula Christopoulos, Stewart B Harris, Akshay B Jain, Ronald M Goldenberg.
       AIMS: We aimed to review the observational and randomised clinical trial evidence and provide pragmatic recommendations for using continuous glucose monitoring (CGM) in individuals living with noninsulin-treated type 2 diabetes (T2DM).
    MATERIALS AND METHODS: We first undertook a narrative review of observational studies that enrolled noninsulin-users or mixed populations of noninsulin and insulin-users with T2DM as well as randomised controlled trials (RCTs) that enrolled mixed populations with T2DM. We then performed a systematic review of the RCTs that specifically enrolled noninsulin-treated populations with T2DM and compared CGM to BGM/usual care. A meta-analysis of glycaemic outcomes was conducted with predefined subgroups based on CGM type.
    RESULTS: RCTs in mixed populations and observational studies demonstrated a largely consistent benefit of CGM on glycaemic and nonglycaemic outcomes with cost effectiveness and reduced healthcare resource utilisation. The meta-analysis of RCTs in noninsulin users included 8 studies encompassing 541 participants, among whom 297 (55%) were assigned to the CGM group. CGM was associated with significantly reduced HbA1c (weighted mean difference [WMD] -0.37%; 95% CI -0.49, -0.24; p < 0.00001; I2 = 0%), increased % time in range (WMD 8.84; 95% CI 4.62, 13.06; p < 0.0001; I2 = 0%) and lower % time above range (WMD -8.14; 95% CI -12.66, -3.63; p = 0.0004; I2 = 0%). There were no significant subgroup differences.
    CONCLUSIONS: CGM use in noninsulin-treated individuals living with T2DM was associated with improved glycaemic outcomes and patient experience, reduced health care resource utilisation, and acceptable cost-effectiveness. These findings provide additional evidence to support CGM use among people living with T2DM who are not using insulin therapy.
    Keywords:  continuous glucose monitoring; meta‐analysis; noninsulin treated; type 2 diabetes
    DOI:  https://doi.org/10.1111/dom.70008
  7. Diabetologia. 2025 Aug 04.
    Insulin DEgludec/LIraglutide versus multiple daily insulin injections in the transition from hospital to outpatient management assessed by continuous glucose monitoring: the DELI transition trial.
    Ana M Gómez-Medina, Diana C Henao-Carillo, Lina P Villamil-Castañeda, Yaline Gómez-Quesada, Oscar M Muñoz-Velandia, Carlos A Yepes, Salma N Chaim, Carlos E Pertuz-Noriega, Pablo Aschner.
       AIMS/OBJECTIVE: The aim of the study was to assess the safety profile (defined as the percentage of patients with at least one hypoglycaemic event [more than 15 min with glucose levels <3.0 mmol/l as documented by continuous glucose monitoring] in the first 4 weeks of follow-up) for insulin degludec/liraglutide (IDegLira) compared with multiple daily insulin injections (MDI) during the transition from hospital to an outpatient setting.
    METHODS: The study was an open-label, randomised, controlled clinical trial comparing IDegLira to MDI after hospital discharge in patients with type 2 diabetes. The study evaluated the percentage of patients with at least one hypoglycaemic event, the hypoglycaemia event density, the time in range (TIR 3.8-10 mmol/l), the time below range (TBR <3.0 or <3.8 mmol/l), and other glycaemic management metrics measured by continuous glucose monitoring.
    RESULTS: Sixty-four patients were included in the analysis (32 in each group). They had a baseline HbA1c of 103  ±  11.6 mmol/mol (11.6 ± 1.7%) and age of 58 ± 12.4 years (means ± SD). The proportion of patients with at least one hypoglycaemic event (plasma glucose <3.0 mmol/l) was lower in the IDegLira group than in the MDI group (6.2% vs 31.3%; p<0.010), as was the hypoglycaemia event density (incidence rate ratio 15.2; 95% CI 6.2, 48.2; p<0.001), TBR <3.8 mmol/l (0.9% vs 2.9%; p=0.019) and TBR <3.0 mmol/l (0.6% vs 1.3%, p=0.008). The TIR 3.8-10 mmol/l was higher in the IDegLira group (80.6% vs 69.7%; p=0.008). The findings were consistent regardless of baseline HbA1c.
    CONCLUSIONS/INTERPRETATION: IDegLira proved to be safer and more effective than MDI for individuals with type 2 diabetes who had suboptimal glycaemic control, aiding in their transition from hospital to outpatient care.
    TRIAL REGISTRATION: Clinicaltrials.gov NCT05767255 FUNDING: This research was funded by a grant from the Asociación Colombiana de Endocrinología, Diabetes y Metabolismo (ACE).
    Keywords:  Colombia; Hospital to home transition; IDegLira; Type 2 diabetes mellitus
    DOI:  https://doi.org/10.1007/s00125-025-06446-y
  8. J Med Imaging Radiat Sci. 2025 Aug 07. pii: S1939-8654(25)00212-7. [Epub ahead of print]56(6): 102063
    A case report of continuous glucose monitoring for a radiographer working in a 1.5T MR Linac.
    Benedict Dobby, Claire Nelder, James Tallon, Lisa McDaid, Marcel van Herk, Mairead Daly, Cynthia L Eccles.
       INTRODUCTION: This case report details the first in-vivo use of continuous glucose monitoring (CGM) technology by a therapeutic radiographer working in magnetic resonance image (MRI) guided radiotherapy with type 1 diabetes (T1D) at our institution. As adoption rates of this device increase, understanding how they perform in MR environments is important for staff working in MR specific roles.
    CASE AND OUTCOMES: For a single member of an MRI guided radiotherapy team with type I diabetes, daily CGM readings in mmol/L were recorded for 4 months when working in all areas of an Elekta Unity MR Linac (Elekta AB, Sweden). These measurements were compared to the mean daily self-monitoring blood glucose (SMBG) readings taken at 2-hour intervals whilst in work over a 4-month testing period. A cloud-based diabetes management system demonstrated successful data transmission as 96% of BG readings had been received from the CGM across all areas of working. A Pearson correlation coefficient of CGM and SMBG readings showed a positive correlation (r = 0.70) and a paired T-Test indicated no significant differences (p = 0.63), indicating CGM reliability in this MR Linac environments across 122 days of testing.
    CONCLUSION: This case highlights the feasibility and safety of using the Freestyle Libre 2 CGM (FreeStyle Libre 2, Abbott Diabetes Care) for an individual with T1D working in an MR Linac. The data presented here is specific to this scenario and serves as informative guidance for healthcare professionals. Further research and standardisation efforts are needed to enhance the compatibility of non-invasive CGMs in MRI environments.
    Keywords:  Continuous glucose monitor (CGM) & Diabetes; MR Linac
    DOI:  https://doi.org/10.1016/j.jmir.2025.102063
  9. Diabetes Res Clin Pract. 2025 Aug 02. pii: S0168-8227(25)00414-0. [Epub ahead of print]227 112400
    Mediterranean diet adherence among adolescents with type 1 diabetes: Insights into dietary patterns, glycemic control, and gender differences.
    Michal Gillon-Keren, Tamar Propper-Lewinsohn, Maayan David, Gila Fayman, Moshe Phillip, Tal Oron.
       AIMS: To assess Mediterranean Diet (MD) adherence in adolescents with type 1 diabetes)T1D(, explore its associations with glycemic control and cardiometabolic risk factors, and examine gender-specific dietary patterns.
    METHODS: This cross-sectional study included 283 adolescents (45 % female) aged 15-19 years. MD adherence was evaluated using the KIDMED questionnaire. Clinical and demographic data were extracted from medical records.
    RESULTS: Overall MD adherence was moderate (median KIDMED score 5.0). Only 19.1 % had high adherence, while 26.9 % had low adherence. Higher adherence was independently associated with continuous glucose monitoring (CGM) use (β = 0.195, 95 % CI 0.13-2.18; p = 0.027). Adolescents with HbA1c ≤ 7.0 % (≤53 mmol/mol) were more likely to use CGM (OR 2.49, 95 % CI 1.26-4.93; p = 0.009) and consume fast food infrequently (OR 2.03, 95 % CI 1.03-4.00; p = 0.042). Compared to males, females demonstrated higher MD adherence, characterized by higher vegetable consumption (OR 2.17, 95 % CI 1.26-3.72; p = 0.005) and lower frequency of fast-food restaurant visits (OR 0.56, 95 % CI 0.32-0.99; p = 0.047); yet, they also had higher BMI z-scores (OR 1.49, 95 % CI 1.12-1.98; p = 0.007).
    CONCLUSIONS: CGM use is associated with healthier dietary patterns, and reduced fast-food consumption is associated with better glycemic control. Gender disparities in diet and metabolic outcomes highlight the need for personalized, gender-sensitive nutritional strategies.
    Keywords:  Adolescents; Dietary patterns; Mediterranean diet; Nutrition; Type 1 diabetes
    DOI:  https://doi.org/10.1016/j.diabres.2025.112400
  10. Diabetes Metab Syndr Obes. 2025 ;18 2585-2596
    A Prospective Study of the Correlation Between Time in Range and Incidence of Diabetic Cardiovascular Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus.
    Xiangxiang Shan, Shenhang Yao, Ben Hu, Chi Xu, Yonghong Cao, Wu Dai.
       Purpose: To investigate the correlation between time in range (TIR) and the risk of cardiovascular autonomic neuropathy (CAN) development in patients with Type 2 diabetes mellitus (T2DM).
    Patients and Methods: This prospective cohort study enrolled patients with type 2 diabetes mellitus (T2DM) hospitalized and followed at the Department of Endocrinology, Hefei Hospital of Anhui Medical University, between September 2020 and July 2024. All participants underwent standardized cardiovascular autonomic neuropathy (CAN) assessment via the Ewing test, and time in range (TIR) was derived from baseline continuous glucose monitoring (CGM) data. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CAN incidence, adjusted for relevant covariates.
    Results: Over a median follow-up of 25.0 months, 123 of 196 participants (62.8%) were diagnosed with CAN. The CAN group exhibited longer diabetes duration, lower time in range (TIR) and body mass index (BMI), higher time above range (TAR), mean glucose (MG), urinary albumin-to-creatinine ratio (UACR), and higher insulin use rates. Participants with low TIR were older, had longer diabetes duration, and displayed: 1. Higher fasting plasma glucose (FPG), HbA1c, and LDL-C levels; 2. Elevated glycemic variability (MAGE, CV, LAGE, SD, MG, TAR) via continuous glucose monitoring (CGM); 3. Greater likelihood of insulin therapy. All differences were statistically significant (P < 0.05). Multivariable Cox regression analyses, adjusted for key covariates (eg, age, HbA1c, insulin use), demonstrated an inverse association between TIR and CAN incidence.
    Conclusion: Lower TIR is an independent risk factor for CAN in T2DM patients, with higher TIR levels associated with reduced CAN risk (P < 0.05).
    Keywords:  cardiovascular autonomic neuropathy; cohort study; time in range; type 2 diabetes
    DOI:  https://doi.org/10.2147/DMSO.S526784
  11. Diabet Med. 2025 Aug 06. e70116
    Type 1 diabetes technology gap between high-income and developing countries: Continuous glucose monitoring access remains a challenge in Brazil.
    Ana Victoria Santos Castro, Karina O Caneca, Paula M Garcia, Veridiana Tischer, Luciana C Theodoro, Isabella S Leão, Letícia B Cunha, Julia B Vieira, Ludmila N R Campos, Jorge L Luescher, Joana R Dantas, Lenita Zajdenverg, Melanie Rodacki.
      
    DOI:  https://doi.org/10.1111/dme.70116
  12. Adv Ther. 2025 Aug 06.
    Evaluation of Glycemia Risk Index and Continuous Glucose Monitoring Outcomes Following the Transition to an Advanced Hybrid Closed-Loop System in Type 1 Diabetes.
    Ayman Al Hayek, Wael M Alzahrani, Abdulghani H Al Saeed, Malak Al Mashali, David C Klonoff, Mohamed A Al Dawish.
       INTRODUCTION: Advanced hybrid closed-loop (AHCL) systems have shown promise in improving glycemic control in adults with type 1 diabetes (T1D), yet real-world evidence remains limited. This study evaluated the impact of transitioning from multiple daily injections (MDI) or conventional continuous subcutaneous insulin infusion (CSII) to the Tandem t:slim X2™ Control-IQ® AHCL system on glycemic outcomes in adults with T1D.
    METHODS: In this retrospective study, 56 non-pregnant adults with T1D were followed for 6 months. Primary outcomes were changes in the Glycemia Risk Index (GRI) and percentage time in the tight range (%TiTR70-140). Secondary outcomes included other standardized ambulatory glucose profile metrics as well as additional glycemic, anthropometric, and insulin dosing measures.
    RESULTS: Transition to the Control-IQ system increased %TiTR70-140 by 11.5 percentage points and reduced GRI by 23.5 points. Both components of the GRI, hypoglycemia risk (%Chypo) and hyperglycemia risk (%Chyper), improved significantly. Hemoglobin A1c decreased by 1.0%, time in range (%TIR70-180) improved by 13.6 percentage points, and glycemic variability (CV%) showed marked improvement. Total daily insulin dose decreased by 34%, accompanied by modest weight loss. No diabetic ketoacidosis episodes were reported throughout the study period.
    CONCLUSION: Transitioning to the Tandem t:slim X2 Control-IQ AHCL system led to significant improvements in tight glycemic control, glycemic risk reduction, and insulin efficiency, with a favorable safety profile. These findings support broader adoption of AHCL technology and underscore the need for prospective multicenter studies.
    Keywords:  Artificial pancreas; Continuous glucose monitoring; Diabetes mellitus; Glycemic control; Insulin infusion systems; Insulin pumps; Type 1
    DOI:  https://doi.org/10.1007/s12325-025-03326-0
  13. Endocr Pract. 2025 Aug 05. pii: S1530-891X(25)00994-2. [Epub ahead of print]
    Clinical and Economic Impact of Hybrid Closed-Loop Systems for T1 Diabetes Management in Spain.
    Aesha Khan Mirón, Maria-Eleni Syleouni, Giovanni Brusaferri, Myriel Nyffeler, Ana Chico, Jesús Moreno-Fernández, Pilar I Beato-Víbora.
       OBJECTIVES: The main challenge in type 1 diabetes mellitus (T1D) management is achieving and maintaining glycaemic control. Hybrid closed-loop (HCL) systems offer patients the potential to safely achieve tight glycaemic targets. This study analyzed the clinical and economic impact of HCL systems compared to intermittently-scanned continuous glucose monitoring (is-CGM) and continuous subcutaneous insulin infusion (CSII) therapy from the Spanish healthcare system perspective.
    METHODS: IQVIA Core Diabetes Model v10.0 was used to simulate a cohort of 1,000 individuals assigned to either the HCL or is-CGM+CSII therapy. Different time horizons were analyzed: 5, 15, 30 and 50-years. Cohort characteristics were extracted from published literature and a 1.5% HbA1c reduction was considered for the HCL group over is-CGM+CSII.
    RESULTS: in the HCL group, complications were averted or delayed across all time horizons while survival, quality of life and cost savings were increased. At 50 years, HCL group survival was double than the comparator and 1.15 incremental QALYs were gained. Cost savings were the highest at 50-years (28,704,922€/1,000 individuals) mostly attributable to lower amputation, ulcer, and nephrological event rates. The current study is based on real-world evidence data with a median follow-up of 5.1 months. Thus, the long-term projections of clinical and economic outcomes may be affected by uncertainty. Additionally, the study did not include any hypoglycaemia or diabetic ketoacidosis rates, which may lead to underestimation of the real impact of HCL systems.
    CONCLUSIONS: HCL systems should be considered the primary treatment option compared to is-CGM+CSII therapy for people with T1D in Spain.
    Keywords:  Automated insulin delivery; Hybrid closed-loop; Spain; clinical impact; economic impact; type 1 diabetes mellitus
    DOI:  https://doi.org/10.1016/j.eprac.2025.08.002
  14. Stud Health Technol Inform. 2025 Aug 07. 329 189-193
    FHIR-Based Information System for Type 1 Diabetes Consultations Based on Patient-Generated Health Data.
    Pietro Randine, Eirik Årsand.
      This paper presents "Dia-Continua", a FHIR-based information system for Type 1 Diabetes consultations that utilizes patient-generated health data (PGHD). The system integrates information from medical devices like continuous glucose monitors, insulin pumps, and wearable devices like smartwatches and their associated cloud platforms to support a new model of diabetes consultation. It offers features such as summaries of insulin usage, insights into sleep and physical activity patterns, and the integration of health and fitness metrics into daily overviews. Testing the system with patients and conducting semi-structured interviews with clinicians highlighted the need for new metrics in medical consultations. From a technological perspective, we face the challenge of managing data from various vendors in an automated and standardized manner. The article examined the value of data and the system's relevance for both primary uses (e.g., medical applications) and secondary uses (e.g., research). Future work should focus on optimizing data storage and integrating the system with existing electronic health records while ensuring compliance with data regulations.
    Keywords:  Digital Health data utilization; FHIR; Interoperability
    DOI:  https://doi.org/10.3233/SHTI250827
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