bims-glumda Biomed News
on CGM data in management of diabetes
Issue of 2026–01–11
twelve papers selected by
Mott Given
  1. Effect of switching from intermittently scanned continuous glucose monitoring to FreeStyle Libre 2 with real-time continuous glucose monitoring and alert functionality.
  2. Comments on the International Federation of Clinical Chemistry and Laboratory Medicine Continuous Glucose Monitoring Accuracy Requirements.
  3. Continuous glucose monitoring in gestational diabetes mellitus: a tool, not a treatment.
  4. Continuous glucose monitoring for glycemic control in non-insulin-treated patients with type 2 diabetes.
  5. Exploratory study of selected stakeholder insights into continuous glucose monitoring in T2D with risk-sharing agreements.
  6. Continuous Glucose Monitoring Use in Rural Area: An Evidence-Based Case Report.
  7. Continuous Glucose Monitoring in Non-ICU Hospitalized Adults with Type 2 Diabetes: A Systematic Review.
  8. The effect of education in obese type 2 diabetes adolescents and young adults based on continuous glucose monitoring and smartwatch-derived lifelog data.
  9. DHAN: A deep hierarchical attention network for multisource biomedical data fusion in precision diabetic retinopathy diagnosis.
  10. Association Between Hypnotics and Glycemic Variability Assessed by Continuous Glucose Monitoring Under Real-Life Conditions in Patients With Type 2 Diabetes: A Cross-Sectional Study.
  11. Pharmacist's role in addressing barriers to continuous glucose monitoring within underserved communities.
  12. Defining Clinically Interpretable Glycemic Profiles Using Continuous Glucose Monitoring in Type 2 Diabetes.
  1. J Diabetes Investig. 2026 Jan 09.
    Effect of switching from intermittently scanned continuous glucose monitoring to FreeStyle Libre 2 with real-time continuous glucose monitoring and alert functionality.
    Keiji Sugai, Junko Sasaki, Gakuyuki Tomizawa, Ryo Suzuki.
       AIMS/INTRODUCTION: This study aimed to assess the impact of switching from FreeStyle Libre (FSL) to FreeStyle Libre 2 (FSL2) with real-time continuous glucose monitoring (rtCGM) functionality.
    MATERIALS AND METHODS: We retrospectively assessed 58 patients who transitioned from FSL to FSL2 with rtCGM functionality.
    RESULTS: Switching from FSL to FSL2 significantly increased the valid data acquisition rate (76.8% ± 21.6% vs 90.4% ± 18.0%, P < 0.001). Time in range (TIR) improved from 57.7% ± 18.1% to 61.7% ± 17.1% (P = 0.023); time in tight range improved from 33.3% ± 15.4% to 38.6% ± 16.9% (P = 0.006), and glycated hemoglobin decreased from 7.6% ± 1.1% to 7.4% ± 1.0% (P = 0.009). TIR improvement was immediate in Type 1 diabetes but gradual after an initial decline in Type 2 diabetes. Logistic regression identified younger age as a predictor of TIR improvement (odds ratio: 0.95, 95% confidence interval: 0.90-0.99, P = 0.034).
    CONCLUSIONS: Transitioning from FSL to FSL2 with rtCGM functionality improved valid data acquisition rate and glycemic control, particularly in patients with Type 1 diabetes. The duration required for improvement in continuous glucose monitoring-related parameters varied by diabetes type, with early improvements observed in Type 1 diabetes and gradual improvements in Type 2 diabetes.
    Keywords:  Continuous glucose monitoring; Diabetes mellitus; Time in tight range
    DOI:  https://doi.org/10.1111/jdi.70233
  2. J Diabetes Sci Technol. 2026 Jan 06. 19322968251410229
    Comments on the International Federation of Clinical Chemistry and Laboratory Medicine Continuous Glucose Monitoring Accuracy Requirements.
    Jan Krouwer.
      
    Keywords:  CGM; IFCC; accuracy; error grid
    DOI:  https://doi.org/10.1177/19322968251410229
  3. Am J Obstet Gynecol MFM. 2026 Jan 07. pii: S2589-9333(25)00275-7. [Epub ahead of print]8(2): 101877
    Continuous glucose monitoring in gestational diabetes mellitus: a tool, not a treatment.
    Ashley N Battarbee.
      
    DOI:  https://doi.org/10.1016/j.ajogmf.2025.101877
  4. J Am Assoc Nurse Pract. 2026 Jan 07.
    Continuous glucose monitoring for glycemic control in non-insulin-treated patients with type 2 diabetes.
    Nahid Karimi, Sarah E Choi, Yeonsu Song, Dante Anthony Tolentino.
       BACKGROUND: Continuous glucose monitoring (CGM) has been associated with improved glycemic control in individuals with non-insulin-treated type 2 diabetes (T2D), but adoption in endocrinology clinics remains limited.
    LOCAL PROBLEM: This quality improvement (QI) project aimed to explore the use of CGM for non-insulin-treated patients with T2D within an endocrinology clinic in Los Angeles County and to evaluate feasibility of its adoption in this practice setting.
    METHODS: It was a retrospective chart review.
    INTERVENTIONS: Eligible patients were adults (≥18 years) with T2D and hemoglobin A1c (HbA1c) >7% who had not been treated with insulin. Ten patients met inclusion criteria. Descriptive statistics summarized HbA1c and time-in-range (TIR) over 6 months. An interrupted time series was also conducted on two patients with sufficient longitudinal data to assess HbA1c changes before and after CGM use.
    RESULTS: After 6 months of initial CGM use, 8 of 9 patients achieved HbA1c reductions of ≥0.3%. One patient demonstrated a ≥8% increase in TIR with adequate device use. Interrupted time series analyses illustrated individual HbA1c trajectories, showing immediate reductions after CGM initiation and nonsignificant downward trends over time.
    CONCLUSION: This QI project showed that patients with T2D treated with noninsulin medications successfully initiated and used CGM. Early improvements in HbA1c were observed; however, sustained glycemic outcomes varied depending on consistent CGM wear and adherence to follow-up, underscoring the need for individualized support. Nurse practitioners can play a key role in promoting sustained CGM use through structured diabetes education, integration of CGM data into lifestyle counseling, and regular follow-up.
    Keywords:  CGM; Continuous glucose monitoring; T2D; non–insulin-treated type 2 diabetes
    DOI:  https://doi.org/10.1097/JXX.0000000000001237
  5. Am J Manag Care. 2025 Dec;31(Spec. No. 15): SP1090-SP1095
    Exploratory study of selected stakeholder insights into continuous glucose monitoring in T2D with risk-sharing agreements.
    Michael Pangrace, Joseph Albright, Sam Basta, Tori Bratcher, Shannon Gadd, Roy Gandolfi, Michael S Kobernick, Dana McCormick, Hiva Pourarsalan, Arshad K Rahim, Doron Schneider, Michael H Shannon, Roy Thomas.
      Recent trends toward payment reform in the care of chronic conditions seek to mitigate quality-related barriers to optimal diabetes management. In type 2 diabetes (T2D) management, these risk-sharing agreements are intended to improve clinical outcomes by facilitating care coordination, data reporting, and the implementation of interventions to address social determinants of health. Outside a need for systems reform, optimal diabetes management may be impeded by the underutilization of advances in care interventions, including continuous glucose monitoring (CGM). An influx of recent evidence and expert recommendations has expanded the utilization of CGM in the population with insulin-treated T2D. Considering recent evidence and guideline recommendations, a small expert panel of payer and provider stakeholders-with specific knowledge in diabetes disease management and risk-based agreements-was selected for this exploratory study to discuss opportunities for CGM-based care management in risk-sharing agreements between payers and providers. The panelists were surveyed before 2 virtual roundtable meetings in which pertinent clinical and trend data were shared. A moderated discussion allowed the expert panelists to outline key elements of potential risk-sharing agreements from the perspective of agreement design, realistic outcomes measures, and strategies to facilitate payer and provider participation.
    DOI:  https://doi.org/10.37765/ajmc.2025.89859
  6. Acta Med Indones. 2025 Oct;57(4): 541-551
    Continuous Glucose Monitoring Use in Rural Area: An Evidence-Based Case Report.
    Ekvan Danang Setya Pramudito, Fergie Marie Joe Grizella Runtu, Agung Anugerah, Ardy Wildan.
      Continuous Glucose Monitoring (CGM) provides real-time glycemic variability data, surpassing traditional methods like HbA1c. CGM data, also known as glucometrics, provide a comprehensive assessment of glycemic variability rather than a single point estimate like HbA1c, CGM data, or glucometrics. It provides a comprehensive assessment of glycemic variability rather than a single point estimate like HbA1c. CGM enables clinicians to understand dysglycemia patterns better by continuously tracking the patient's glucose levels, therefore allowing for individualized adjustments to antidiabetic therapy. By continuously tracking glucose levels, a CGM enables clinicians to understand dysglycemia patterns better, allowing for individualized adjustments to antidiabetic therapy. While costly, CGM enables long-distance monitoring, addressing healthcare inaccessibility in remote rural areas. This case reportstudy examines a 24-year-old Indonesian female patient diagnosed with young-onset diabetes with limited access to specialized care, a history of macrosomia at birth, high blood glucose, and a body mass index (BMI) of 27.7. The patient's abdominal circumference was 86 cm, which is above normal for women and within the range of obesity. In this patient, CGM recorded a mean glucose level of 145 mg/dL. Studies indicate that when at least 70% of CGM data is available over a 10-14-day period, an estimated HbA1c can be calculated. CGM is vital for diabetes management in rural settings. Further, integrating telemedicine can help bridge healthcare gaps. Expanding access to CGM and genetic testing is crucial for improving outcomes in underserved communities.
    Keywords:  CGM; South Papua; continuous glucose monitoring; diabetes young; remote area; technology adoption
  7. J Clin Med. 2025 Dec 20. pii: 34. [Epub ahead of print]15(1):
    Continuous Glucose Monitoring in Non-ICU Hospitalized Adults with Type 2 Diabetes: A Systematic Review.
    Darío Lara-Gálvez, Matilde Rubio-Almanza, Yolanda Aparicio-Ródenas, David Sanchis-Pascual, Pilar Masdeu-López-Cerón, Victor Pérez-Cervantes, Juan Francisco Merino-Torres.
      Background: Continuous glucose monitoring (CGM) may overcome the limitations of intermittent point-of-care (POC) testing by providing real-time glucose trends and reducing treatment delays. This study aimed to evaluate the efficacy of CGM versus POC capillary testing in improving glycemic control among hospitalized non-Intensive Care Unit (non-ICU) adults with type 2 diabetes mellitus (T2DM). Methods: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. We searched PubMed for randomized controlled trials published in English or Spanish that compared CGM with POC testing in hospitalized non-ICU adults ≥ 18 years old with T2DM and assessed risk of bias using the Cochrane RoB2 tool. The primary outcome was time in range (TIR). Secondary outcomes included time below range (TBR), time above range (TAR), mean glucose (MG), and glycemic variability (GV). Results: Seven randomized controlled trials (RCTs) including 1106 patients were analyzed. CGM significantly improved TIR (mean difference [MD] +8.15%; 95% confidence interval [CI]: +5.76, +10.55; p < 0.001) and reduced TAR > 180 mg/dL (MD -7.11%; 95% CI: -9.43, -4.78; p < 0.001) and TAR > 250 mg/dL (MD -3.96%; 95% CI: -5.29, -2.62; p < 0.001) compared with POC testing. MG also decreased with CGM (MD -11.27 mg/dL; 95% CI: -14.74, -7.81; p < 0.001). A modest reduction in TBR <70 mg/dL was observed (MD -0.29%; p < 0.001), whereas no significant differences were found for TBR < 54 mg/dL or GV. Conclusions: CGM improves inpatient glycemic control in non-ICU adults with type 2 diabetes, demonstrating advantages over POC testing across multiple randomized trials. However, further multicenter research is needed to clarify workflow implications, cost-effectiveness, and optimal implementation strategies.
    Keywords:  continuous glucose monitoring; diabetes mellitus; glycemic control; hospitalization; inpatients; meta-analysis; type 2
    DOI:  https://doi.org/10.3390/jcm15010034
  8. Ann Pediatr Endocrinol Metab. 2025 Dec;30(6): 305-312
    The effect of education in obese type 2 diabetes adolescents and young adults based on continuous glucose monitoring and smartwatch-derived lifelog data.
    Hyun Ah Woo, Ja Hyang Cho, Kye Shik Shim, Do Hyun Kim, Hae Woon Jung, Mi Young Han.
       PURPOSE: The increasing prevalence of type 2 diabetes (T2D) among adolescents and young adults (AYAs) is a major public health concern worldwide. This pilot study evaluated the effectiveness of lifestyle education in managing T2D in obese AYAs using continuous glucose monitoring (CGM) and smartwatch-derived lifelog data.
    METHODS: Seven obese AYAs and T2D aged 12-19 years were enrolled in this prospective interventional study. Patients continued to take their previously prescribed T2D medication. CGM data were collected for 10 days, followed by lifestyle education using CGM and smartwatch data. Outcomes, including anthropometrics, glycemic control, dietary intake, physical activity, and self-management skills, were reassessed after an additional 10 days.
    RESULTS: The median time in range increased from 58.1% (53.2%-75%) to 72% (64%-88%) (p=0.043) and time above range (&gt;250 mg/dL) decreased from 10% (2.9%-18.6%) to 3.0% (1.0%-11.0%) (p=0.028). Median peak total caloric intake decreased from 2,854 (2,465-3,040) kcal/day to 2,091 (1,751-2,283) kcal/day and walking calorie expenditure increased from 163.9 (116.7-321.3) kcal/day to 180.2 (165.3-492.4) kcal/day (p=0.018 for both). The Summary of Diabetes Self-Care Activities score improved from 0.29 (0.05-0.43) to 0.33 (0.32-0.68) (p=0.043).
    CONCLUSION: This integrated approach combining CGM and smartwatch-based education exhibited short-term effects on glycemic control, dietary habits, physical activity, and self-management skills in obese AYAs and T2D. Further studies are needed to confirm the long-term effectiveness of this strategy in this challenging population.
    Keywords:  Adolescents and young adults; Continuous glucose monitoring; Lifestyle modification; Obesity; Pediatrics; Smart watch; Type 2 diabetes
    DOI:  https://doi.org/10.6065/apem.2550026.013
  9. Digit Health. 2026 Jan-Dec;12:12 20552076251408517
    DHAN: A deep hierarchical attention network for multisource biomedical data fusion in precision diabetic retinopathy diagnosis.
    Rui Tao, Hongru Li, Jingyi Lu, Yaxin Wang, Jian Zhou, Xia Yu.
       Objectives: To establish a robust and clinically applicable approach for integrating heterogeneous multisource biomedical data, particularly continuous glucose monitoring (CGM) profiles and structured electronic health records (EHRs), in order to enhance the diagnostic accuracy and clinical utility of diabetic retinopathy (DR) detection.
    Methods: This study proposed a deep hierarchical attention network (DHAN) for multisource biomedical data fusion. First, to address the heterogeneous forms of different data sources, two specific subencoders were designed, a hybrid architecture for time-series CGM sensors and a structured encoder for EHRs. Second, an entity-embedding mechanism was added to the EHR subencoder to fuse heterogeneous feature types within EHRs. Finally, a deep hierarchical attention mechanism was proposed to dynamically capture inner-source saliency and inter-source correlations.
    Results: Using the dataset provided by Shanghai Sixth People's Hospital, 559 patients were included, comprising 157 with DR and 402 without. DHAN achieved the best performance across multiple experiments, with a diagnostic accuracy of 0.89. Its comprehensive performance, including an F1-score of 0.80 and a G-mean of 0.89, further demonstrates its robustness.
    Conclusions: The results indicate that DHAN is a viable approach for diagnosing DR in patients with type 2 diabetes. By effectively fusing multisource heterogeneous data, DHAN can be embedded within CGM sensors to enable remote concurrent diagnosis of DR. Moreover, it provides a generalizable paradigm for multisensor systems requiring fusion of data from multiple sources.
    Keywords:  Continuous glucose monitoring sensors; hierarchical attention; medical signal processing; multisource biomedical data; personalized medicine
    DOI:  https://doi.org/10.1177/20552076251408517
  10. J Diabetes Res. 2025 ;2025 1748628
    Association Between Hypnotics and Glycemic Variability Assessed by Continuous Glucose Monitoring Under Real-Life Conditions in Patients With Type 2 Diabetes: A Cross-Sectional Study.
    Taichi Muramatsu, Miku Otsuka, Daisuke Yamamuro, Mikan Yamanouchi, Saaya Fujisaka, Akifumi Kushiyama, Takako Kikuchi, Lvks Bhaskar.
       Background: Insomnia is common in patients with Type 2 diabetes and can negatively affect glycemic control. However, the effect of hypnotic use on glycemic variability remains unclear. Therefore, we investigated the association between hypnotic use and glycemic variability in patients with Type 2 diabetes.
    Methods: This cross-sectional study enrolled patients with Type 2 diabetes who underwent continuous glucose monitoring (CGM) between June 1, 2017, and February 28, 2022. Patients were classified into six groups based on their insomnia status and hypnotic use: noninsomnia, hypnotic nonusers, benzodiazepine (BZD) users, nonbenzodiazepine (non-BZD) users, orexin receptor antagonist (ORA) users, and melatonin receptor agonist (MRA) users. We used the standard deviation (SD) of glucose, the coefficient of variation (CV) of glucose, and the mean of daily difference (MODD) as indicators of glycemic variability. The independent association between hypnotic use and glycemic variability was assessed using a multiple linear regression model.
    Results: A total of 534 patients were included in the analysis (mean age: 67.7 ± 10.1 years old; mean diabetes duration: 14.5 ± 8.4 years). Thirty-seven patients (6.9%) used hypnotics, including BZD (n = 13), non-BZD (n = 10), ORA (n = 11), and MRA (n = 3). The SD was significantly higher in non-BZD users (53.6 mg/dL, 95% confidence interval [CI]: 42.9-64.3) than in the noninsomnia group (40.5 mg/dL, 95% CI: 39.5-41.5). MODD was also significantly higher in non-BZD users (50.1 mg/dL, 95% CI: 38.0-62.1) than in the noninsomnia group (35.6 mg/dL, 95% CI: 34.5-36.7). In contrast, the CV was not significantly different between non-BZD users and the noninsomnia group. When analyzed separately for different times of the day, the nocturnal CV was significantly higher in non-BZD users than in the noninsomnia group.
    Conclusions: The use of non-BZDs was associated with within-day and between-day glycemic variability measured by CGM in patients with Type 2 diabetes.
    DOI:  https://doi.org/10.1155/jdr/1748628
  11. J Am Pharm Assoc (2003). 2026 Jan 05. pii: S1544-3191(25)00695-8. [Epub ahead of print] 103016
    Pharmacist's role in addressing barriers to continuous glucose monitoring within underserved communities.
    Christ Ange K Cellino, En-Ling Chen, Julia Pawelek, Chris J Daly, David M Jacobs, Gina M Prescott.
      Continuous glucose monitoring (CGM) has transformed diabetes care by enabling real-time tracking of glucose levels, improving glycemic control, reducing hypoglycemia, and enhancing quality of life. Despite their clinical benefits, CGM adoption remains inequitable, with underserved populations facing barriers such as low digital and health literacy, financial hardship, limited provider engagement, and fragmented healthcare system infrastructure. Pharmacists, trusted and accessible providers embedded within communities, have emerged as key collaborators for CGM use through patient education, data interpretation, and treatment optimization. Evidence from community-based settings demonstrates that pharmacist-led CGM interventions are associated with significant reductions in HbA1c, improvements in time-in-range, and enhanced patient engagement, although studies focusing specifically on underserved populations remain limited. Persistent barriers at patient, provider, and system levels must be addressed to achieve equitable CGM system access, including challenges related to cost, digital access or literacy, language barriers, healthcare professional training and patient education. By advancing pharmacist-led CGM initiatives tailored to the social and cultural needs of underserved populations, there is an opportunity to reduce disparities in CGM utilization and improve diabetes outcomes. This commentary highlights current evidence, identifies gaps, and issues a call to action for expanding pharmacist-led CGM programs in high need populations as a critical step toward promoting health equity in diabetes management.
    Keywords:  Continuous Glucose Monitoring (CGM); diabetes management; health disparity; health equity; pharmacist-led interventions; underserved community
    DOI:  https://doi.org/10.1016/j.japh.2025.103016
  12. Diabetes Care. 2026 Jan 09. pii: dc252633. [Epub ahead of print]
    Defining Clinically Interpretable Glycemic Profiles Using Continuous Glucose Monitoring in Type 2 Diabetes.
    Jiahuan Helen He, Dan Wang, Mary R Rooney, Amelia S Wallace, R Nisha Aurora, Naresh M Punjabi, Scott L Zeger, Michael Fang, Elizabeth Selvin.
      
    DOI:  https://doi.org/10.2337/dc25-2633
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