bims-glumda Biomed News
on CGM data in management of diabetes
Issue of 2026–07–12
sixteen papers selected by
Mott Given
  1. Promoting Access to Continuous Glucose Monitoring among Patients with Type 2 Diabetes in Rural Areas: A Report from the Field.
  2. A Spanish-language educational intervention to enhance diabetes outcomes among existing continuous glucose monitor users in a federally qualified health care center.
  3. Home Care Nurses' Experiences With Connected Continuous Glucose Monitoring Systems in Older Adults With Type 2 Diabetes: A Qualitative Study in France.
  4. The Correlation Between Fear and Perceived Frequency of Hypoglycemia and Continuous Glucose Monitoring Metrics in Adults With Type 1 Diabetes Using Diabetes Technology: A One-Year Analysis.
  5. Primary Care-Initiated Continuous Glucose Monitoring in Adults With Insulin-Treated Diabetes.
  6. Continuous glucose monitoring use is associated with higher physical activity in adults with type 1 diabetes: a nationwide cross-sectional study.
  7. Diversity of Daily Glycemic Phenotypes Is Independently Associated With HbA1c: A Time-Resolved CGM Clustering Analysis.
  8. App-Based Digital Therapeutics Integrating Continuous Glucose Monitoring for Glycemic Control in Type 2 Diabetes: Prospective Observational Cohort Study.
  9. Continuous Glucose Monitoring and Hypoglycaemia Risk During Paediatric DKA Treatment in the PICU: A Retrospective Cohort Study.
  10. CGM Accuracy in a Fragmented Regulatory Landscape: A Commentary on Harmonisation and Recent Evidence.
  11. Habituation to Elevated Glucose Levels in Type 1 Diabetes: Function and Well-Being in Guideline-Based Versus Typical Glycemic Range.
  12. A Diabetes Management Protocol with Subcutaneous Insulin During Induced Labor and Delivery in Women with Type 1 or Type 2 Diabetes.
  13. Digital Management of Early-Onset Type 2 Diabetes: Empowerment, Challenges, and Future Outlook.
  14. Continuous glucose monitor device-associated cutaneous Mycobacterium abscessus infection: a novel source of primary inoculation.
  15. Editorial: Advancing pediatric type 1 diabetes management: metrics, technologies, and prevention of complications.
  16. Time-restricted eating in adults with type 2 diabetes mellitus on concomitant glucagon-like peptide-1 receptor agonists: case report.
  1. J Health Care Poor Underserved. 2026 ;37(3S): 194-206
    Promoting Access to Continuous Glucose Monitoring among Patients with Type 2 Diabetes in Rural Areas: A Report from the Field.
    Emily A Schmied, Shiloh Williams, Emmeline Chuang, Yaritza Benitez, Shih-Fan Lin, Julie S Pickrel, Caroline Trujillo, Jordy Lizaola, Xitlali Ortega, Sara Sanders, Yvonne Bell, Guadalupe X Ayala.
      Continuous glucose monitoring (CGM) is an underused tool for diabetes management among patients from underserved communities. This report describes a training designed to increase CGM referrals among health care professionals treating patients with type 2 diabetes in primary care at a federally qualified health center in a rural region in California.
    DOI:  https://doi.org/10.1353/hpu.2026.a994070
  2. J Am Assoc Nurse Pract. 2026 Jul 08.
    A Spanish-language educational intervention to enhance diabetes outcomes among existing continuous glucose monitor users in a federally qualified health care center.
    Marielle Tavares, Katayoun Khoshbin, Walter Solorzano, Ligaya Scarlett, Cynthia Santana, Rebecca Lopez, Giuliana Perini Villanueva, Bryan Escobar, Kathyana Santiago Mangual, Carol Pavlish, Nancy Jo Bush, Tannaz Moin, Estelle Everett.
       ABSTRACT: Latinx adults with type 2 diabetes (T2D) experience worse glycemic outcomes. Although continuous glucose monitors (CGMs) improve glycemic control, benefits often plateau after early adoption, and evidence is limited regarding post-initiation CGM-focused interventions. We conducted a single-arm pilot study among Spanish-speaking adults with T2D who were established CGM users at a federally qualified health center. Participants completed a one-time, culturally tailored CGM-focused educational session delivered in Spanish, with brief post-session follow-up support. Primary outcomes included glycemic control at 3 months. Secondary outcomes included CGM-derived metrics and patient-reported measures of glucose monitoring satisfaction, diabetes distress, and empowerment. Twenty participants (mean CGM use 16.5 months) completed the intervention. HbA1c declined but not significantly (-0.33%, p = .17). Significant improvements were observed in time in range (+11.4%, p = .03) and time in hyperglycemia (-8.7%, p < .001), without increases in hypoglycemia. Participants reported improved glucose monitoring satisfaction and reduced diabetes distress. Empowerment improved immediately post-intervention but was not sustained at 3 months. In conclusion, a culturally informed CGM-focused educational intervention was associated with clinically meaningful improvements in glycemic patterns and psychosocial outcomes among Spanish-speaking Latinx adults with long-standing CGM use, supporting its potential role in enhancing post-initiation CGM engagement and addressing disparities in diabetes.
    Keywords:  CGM; Latinx; continuous glucose monitor; diabetes; diabetes distress; diabetes empowerment; educational intervention; glucose monitoring satisfaction; type 2 diabetes
    DOI:  https://doi.org/10.1097/JXX.0000000000001322
  3. J Gerontol Nurs. 2026 Jul 06. 1-8
    Home Care Nurses' Experiences With Connected Continuous Glucose Monitoring Systems in Older Adults With Type 2 Diabetes: A Qualitative Study in France.
    Basma Berrag, Paul Quindroit.
       PURPOSE: Connected continuous glucose monitoring (CGM) systems are increasingly used in managing older adults with diabetes. Although CGM systems offer clinical benefits, their implementation in home care remains challenging, especially for digitally excluded individuals. The current study sought to explore the experiences, perceptions, and support needs of French home care nurses in the use of connected CGM systems in the home-based care of older adults with type 2 diabetes.
    METHOD: A qualitative descriptive study was conducted with 11 home care nurses in northern France. Semi-structured interviews were analyzed using reflexive thematic analysis.
    RESULTS: Four themes emerged: (1) A Promising Tool With Unresolved Practical Challenges, (2) Variable Digital Autonomy and the Role of Family Support, (3) The Evolving Role of the Home Care Nurse, and (4) Structural Gaps in Training and Support.
    CONCLUSION: CGM use among older adults relies heavily on nurses' ability to address technological and social barriers. Supporting their role is essential for equitable digital health adoption in aging care.
    DOI:  https://doi.org/10.3928/00989134-20260626-01
  4. Diabetes Care. 2026 Jul 06. pii: dc260763. [Epub ahead of print]
    The Correlation Between Fear and Perceived Frequency of Hypoglycemia and Continuous Glucose Monitoring Metrics in Adults With Type 1 Diabetes Using Diabetes Technology: A One-Year Analysis.
    Laura Valgaerts, Jolien De Meulemeester, Margaretha M Visser, Sara Charleer, Steffen Fieuws, Bart Keymeulen, Christophe De Block, Chantal Mathieu, Kristina Casteels, Pieter Gillard.
       OBJECTIVE: To evaluate the association between fear and perceived frequency of hypoglycemia and continuous glucose monitoring (CGM) metrics in adults with type 1 diabetes using diabetes technology over 12 months.
    RESEARCH DESIGN AND METHODS: This retrospective explorative analysis evaluated correlations between hypoglycemia fear, perceived hypoglycemia frequency, and CGM metrics in 1,370 adults with type 1 diabetes using real-time CGM (Comparing Continuous With Flash Glucose Monitoring in Adults With Type 1 Diabetes [ALERTT1] study, n = 254) or hybrid closed-loop (The Impact Of Hybrid Closed-loop Insulin Delivery in Type 1 Diabetes On Glycemic Control And PROMs [INRANGE] studies, n = 1,116) for 12 months. Hypoglycemia fear was assessed with the Hypoglycemia Fear Survey II worry (HFS-worry) and behavior (HFS-behavior) subscales, and perceived hypoglycemia frequency with the hypoglycemia subscale of the Diabetes Treatment Satisfaction Questionnaire-status (DTSQs-hypo). Data are reported as mean ± SD.
    RESULTS: At baseline (before the start of technology), mean age was 41.0 ± 13.7 years, 55.9% were women, diabetes duration was 21.6 ± 12.7 years, HbA1c was 7.6 ± 1.0% (59.0 ± 10.8 mmol/mol), and time in 3.9-10.0 mmol/L was 61.1 ± 15.5%. Over 12 months, time <3.9/<3.0 mmol/L decreased from 3.4 ± 3.5%/0.8 ± 1.4% to 2.3 ± 2.2%/0.5 ± 0.7%, while HFS-worry (21.0 ± 12.9 to 16.8 ± 12.1) and DTSQs-hypo (3.3 ± 1.5 to 2.7 ± 1.4) also decreased. HFS-worry, HFS-behavior, and DTSQs-hypo showed no clear correlations with time in hypoglycemia or other CGM metrics at baseline, at 12 months, or over 12-month change.
    CONCLUSIONS: In adults using diabetes technology over 12 months, fear and perceived frequency of hypoglycemia showed no clear correlations with CGM metrics, suggesting both are influenced by more than glycemic profiles alone.
    DOI:  https://doi.org/10.2337/dc26-0763
  5. JAMA Netw Open. 2026 Jul 01. 9(7): e2621713
    Primary Care-Initiated Continuous Glucose Monitoring in Adults With Insulin-Treated Diabetes.
    Jovan Milosavljevic, Lorena Rasquin Leon, Sharon Rikin, Clyde Schechter, Sybil Hodgson, Shivani Agarwal.
       Importance: Most diabetes care is managed in primary care settings, which represent a critical yet underutilized site for continuous glucose monitoring (CGM) adoption. Whether CGM initiation by primary care clinicians improves glycemic outcomes and reduces acute health care utilization remains understudied.
    Objective: To evaluate the association of primary care-initiated CGM with changes in hemoglobin A1c (HbA1c) levels and rates of hospitalizations and emergency department (ED) visits among adults with insulin-treated diabetes.
    Design, Setting, and Participants: This cohort study was performed at 18 primary care clinics within Montefiore Medical Center, a large safety-net health system in the Bronx, New York. Adults 18 years or older with any insulin-treated diabetes who had at least 1 primary care visit between August 1, 2022, and August 1, 2025, were included. Patients were excluded if they were uninsured, if they had a CGM prescription in the prior 2 years, or if their first CGM during follow-up was prescribed outside primary care.
    Exposure: First CGM prescription by a primary care clinician.
    Main Outcomes and Measures: The primary outcomes were HbA1c level trajectories, which were analyzed using mixed-effects models, and hospitalizations and ED visits, which were analyzed using recurrent event frailty models.
    Results: The study included 8502 insulin-treated CGM-naive adult patients with diabetes (mean [SD] age, 62.3 [14.6] years; 4764 [56.0%] female; 3618 [42.6%] with Medicare and 2854 [33.6%] with Medicaid coverage). Of these, 2392 patients (28.1%) were prescribed CGM by primary care clinicians. Patients who initiated CGM were younger, more often English-speaking and commercially insured, and had higher baseline HbA1c levels and more microvascular complications. At 12 months, HbA1c levels decreased by 0.66 (95% CI, 0.57-0.75) percentage points (pp) in patients who initiated CGM vs 0.17 (95% CI, 0.08-0.27) pp in those who did not, with a between-group difference of -0.49 (95% CI -0.62 to -0.35) pp. CGM initiation was associated with lower risk of recurrent hospitalizations (hazard ratio, 0.87 [95% CI, 0.77-0.98]) and ED visits (hazard ratio, 0.82 [95% CI, 0.74-0.91]).
    Conclusions and Relevance: In this cohort study of adults with insulin-treated diabetes, initiation of CGM by primary care clinicians was associated with clinically meaningful improvements in HbA1c and significant reductions in recurrent hospitalizations and ED visits. These findings support expanding CGM implementation in primary care settings as a scalable strategy to improve diabetes outcomes and reduce acute care utilization, particularly in underserved populations.
    DOI:  https://doi.org/10.1001/jamanetworkopen.2026.21713
  6. Diabetol Metab Syndr. 2026 Jul 10.
    Continuous glucose monitoring use is associated with higher physical activity in adults with type 1 diabetes: a nationwide cross-sectional study.
    Jurga Šuminienė, Rimantas Stukas, Virginija Gaigalaite, Natalja Istomina.
       BACKGROUND: Physical activity is a key component of type 1 diabetes (T1D) management, yet many adults do not achieve recommended activity levels. Continuous glucose monitoring (CGM) may reduce glycemic uncertainty during exercise; however, its association with real-world physical activity remains unclear.
    OBJECTIVE: To examine whether CGM use is independently associated with physical activity and to identify psychological factors related to perceived exercise facilitation among CGM users.
    METHODS: In this nationwide cross-sectional study, 368 adults with self-reported T1D in Lithuania (197 CGM users and 171 non-users) completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Multivariable linear and logistic regression models adjusted for demographic and clinical covariates were used to evaluate associations between CGM use and physical activity outcomes. Among CGM users, logistic regression was applied to identify factors associated with perceived facilitation of physical activity.
    RESULTS: CGM users reported higher total physical activity (median 427.5 vs. 270 min/week, p = 0.001) and were more likely to engage in any moderate-to-vigorous physical activity (adjusted OR 4.4, 95% CI 2.2-8.0, p = 0.001) and to achieve ≥ 600 MET-min/week (adjusted OR 2.2, 95% CI 1.2-4.5, p = 0.035). Associations remained significant after adjustment for acute and chronic diabetes-related complications. Among CGM users, trust in CGM accuracy during exercise was strongly associated with perceived facilitation (adjusted OR 9.2, 95% CI 2.2-23.0, p = 0.008), whereas higher emotional diabetes-related distress was inversely associated (adjusted OR 0.65, 95% CI 0.44-0.90, p = 0.04).
    CONCLUSIONS: CGM use was independently associated with higher physical activity levels in adults with T1D. Psychological factors, particularly technology-related trust and emotional distress, may contribute to differences in perceived exercise facilitation among CGM users. These findings should be interpreted as associative rather than causal.
    Keywords:  Continuous glucose monitoring; Diabetes distress; Hypoglycemia confidence; Moderate-to-vigorous physical activity; Physical activity; Type 1 diabetes
    DOI:  https://doi.org/10.1186/s13098-026-02238-5
  7. J Diabetes Sci Technol. 2026 Jul 06. 19322968261436429
    Diversity of Daily Glycemic Phenotypes Is Independently Associated With HbA1c: A Time-Resolved CGM Clustering Analysis.
    Saeko Osawa, Emi Kuroiwa, Naohiko Ito.
       BACKGROUND: Although continuous glucose monitoring (CGM)-derived summary metrics are widely used, they may obscure the intraday temporal organization and potentially overlook clinically relevant differences in daily glucose patterning across time. We aimed to identify distinct daily glycemic phenotypes using time-resolved clustering and to examine whether the diversity of these patterns is independently associated with glycated hemoglobin (HbA1c).
    METHODS: We analyzed 5902 days of CGM data from 103 participants with type 1 (n = 19) and type 2 (n = 84) diabetes. Daily waveforms were clustered using k-means with dynamic time warping (DTW) to capture temporal features independent of phase shifts. A "Phenotype Diversity Score" (Shannon entropy of each individual's cluster-label distribution) quantified the variety of phenotypes expressed per participant. Multivariable regression assessed its association with HbA1c, adjusting for established variability metrics, insulin use, and estimated glomerular filtration rate (eGFR).
    RESULTS: Eight distinct daily glycemic phenotypes were identified. The Phenotype Diversity Score strongly correlated with HbA1c (r = 0.600, P < .0001). In a fully adjusted model, including mean of daily differences, coefficient of variation, insulin use, and eGFR, the Phenotype Diversity Score remained independently associated with HbA1c (β = 0.322, P = .004).
    CONCLUSIONS: Time-resolved CGM clustering reveals clinically meaningful daily glycemic phenotypes and demonstrates that phenotype diversity is independently associated with HbA1c. This pattern-based perspective complements conventional summary metrics and may help explain glycemic heterogeneity among individuals with similar average glucose levels.
    Keywords:  HbA1c; circadian rhythm; continuous glucose monitoring; dynamic time warping; glycemic phenotypes; glycemic variability
    DOI:  https://doi.org/10.1177/19322968261436429
  8. JMIR Diabetes. 2026 Jul 08. 11 e86651
    App-Based Digital Therapeutics Integrating Continuous Glucose Monitoring for Glycemic Control in Type 2 Diabetes: Prospective Observational Cohort Study.
    Banshi Saboo, Mudit Sabharwal, Mihir Gharia, Devina Aswal, Parth Modi, Twinkle Maheshwari, Jaymin Parikh, Simpel Saanyal, Jaikishan Agrawal.
       Background: Digital therapeutics integrating continuous glucose monitoring (CGM) with personalized lifestyle coaching can enhance glycemic control in individuals with type 2 diabetes mellitus (T2DM). However, real-world evidence evaluating such multicomponent interventions-combining CGM with nutrition coaching, physiotherapy, and cognitive behavioral therapy within a unified digital platform-remains limited in South Asian populations.
    Objective: This study aimed to evaluate the effectiveness of an app-based lifestyle-integrated intervention program (Glycemic Lifestyle Intervention in Diabetes Empowerment-CGM; GLIDE-C) on glycemic, anthropometric, lipid profile, quality of life (QoL), and behavioral outcomes, as well as outcomes related to HEOR (health economics and outcomes research), in adults with mildly uncontrolled T2DM.
    Methods: A prospective observational cohort study was conducted among adults aged ≥18 years with confirmed T2DM and baseline hemoglobin A1c (HbA1c) between 7.5% and 9.5%. The intervention was delivered via the Goodflip mobile app, including a 15-day CGM period and a structured analysis of glucose variations, among other clinical assessments, with follow-up on days 15, 30, and 60. The digital intervention combined CGM-guided personalized diet, exercise, and cognitive behavioral therapy plans delivered through the mobile app, supported by multidisciplinary coaching. Primary outcomes were changes in HbA1c, fasting plasma glucose, postprandial glucose, and CGM metrics; secondary outcomes included lipid profile, anthropometric indices, QoL, and behavioral determinants of glycemic improvement.
    Results: Eighteen participants (mean age 49.45, SD 10.91 years; n=11, 61.1% male) completed the program. Mean HbA1c decreased by 0.59% (P=.05), with postprandial glucose decreasing by 25.42 mg/dL (P=.06) and time in range increasing by 9.98%. Modest reductions, consistent with the short intervention duration, occurred in low-density lipoprotein cholesterol (-8.38 mg/dL), body fat (-1.13 kg), and waist circumference (-1.56 cm). QoL improved significantly for sleep quality (P=.04). Improvements were also observed for motivation (P=.06), stress management (P=.08), and mood (P=.12), although these changes were not statistically significant. Behavioral analysis demonstrated strong associations with glycemic outcomes; all participants who reduced their consumption of energy-dense, nutrient-poor foods experienced improvements in HbA1c, whereas those who did not reduce energy-dense, nutrient-poor intake showed less favorable outcomes.
    Conclusions: The novel GLIDE-C program demonstrated clinically meaningful improvements in glycemic control, behavioral outcomes, and QoL in adults with T2DM, without pharmacological modification. These findings strengthen the role of integrated, CGM-guided digital therapeutic platforms as an effective adjunct to the conventional standard of care.
    Keywords:   digital therapeutics; cognitive behavioral therapy; continuous glucose monitoring; lifestyle intervention; type 2 diabetes mellitus
    DOI:  https://doi.org/10.2196/86651
  9. Diabetes Obes Metab. 2026 Jul 08.
    Continuous Glucose Monitoring and Hypoglycaemia Risk During Paediatric DKA Treatment in the PICU: A Retrospective Cohort Study.
    Minsun Kim, Esther Park.
       BACKGROUND: Hypoglycaemia is a frequent complication during diabetic ketoacidosis (DKA) treatment. Continuous glucose monitoring (CGM) provides real-time glucose trend information; however, its clinical utility during paediatric DKA management in the intensive care unit (ICU) remains uncertain. We investigated whether CGM insertion during DKA treatment in the paediatric ICU (PICU) is associated with reduced hypoglycaemia and a lower burden of point-of-care (POC) glucose measurements.
    MATERIALS AND METHODS: We conducted a retrospective single-centre cohort study of paediatric patients (< 20 years) admitted to the PICU with DKA between December 2013 and December 2025 who received continuous intravenous insulin infusion. Patients were categorised based on CGM insertion during their PICU stay. The primary outcome was hypoglycaemia. Secondary outcomes included frequency of POC glucose measurements, ICU length of stay and time to DKA resolution.
    RESULTS: Seventy-three patients were included; 31 (42.5%) underwent CGM insertion. The incidence of hypoglycaemia was significantly lower in the CGM group (glucose < 70 mg/dL: 6.5% vs. 47.6%, p < 0.001; < 60 mg/dL: 0% vs. 21.4%, p = 0.008). In multivariable analysis, CGM insertion was independently associated with lower hypoglycaemia risk (adjusted OR 0.059, 95% CI 0.011-0.323; p = 0.001). The CGM group also had a significantly lower frequency of POC glucose measurements than the control group.
    CONCLUSION: Amongst paediatric patients with DKA treated in the PICU, CGM insertion was independently associated with reduced hypoglycaemia and a lower POC testing burden. Prospective studies are warranted to determine whether CGM-guided DKA management improves clinical outcomes in critically ill children.
    Keywords:  continuous glucose monitoring; diabetic ketoacidosis; paediatric intensive care unit
    DOI:  https://doi.org/10.1111/dom.71078
  10. Diabetes Obes Metab. 2026 Jul 09.
    CGM Accuracy in a Fragmented Regulatory Landscape: A Commentary on Harmonisation and Recent Evidence.
    Tadej Battelino, Katrien Benhalima, Emanuele Bosi, Helene Hanaire, Lutz Heinemann, Sufyan Hussain, Johan Jendle, Olga Kordonouri, Alistair Lumb, Julia K Mader, Kirsten Nørgaard, Charles Thivolet, Amir Tirosh, Francesco Giorgino.
      
    Keywords:  accuracy; continuous glucose monitoring; diabetes
    DOI:  https://doi.org/10.1111/dom.71098
  11. Diabetes Care. 2026 Jul 07. pii: dc260603. [Epub ahead of print]
    Habituation to Elevated Glucose Levels in Type 1 Diabetes: Function and Well-Being in Guideline-Based Versus Typical Glycemic Range.
    Elizabeth A Pyatak, Stefan Schneider, Raymond Hernandez, Claire Hoogendoorn, Meredith Hawkins, Jeffrey S Gonzalez.
       OBJECTIVE: Chronic hyperglycemia may shift physiological and perceptual thresholds upward, such that guideline-defined glucose targets feel aversive. We compared time in range (TIR) (70-180 mg/dL) with time in personal range (TIPR) (mean glucose ± 50 mg/dL) to determine whether daily symptoms, functioning, and diabetes-specific outcomes align more closely with guideline-based versus personal glucose ranges.
    RESEARCH DESIGN AND METHODS: Adults with type 1 diabetes completed 14 days of blinded continuous glucose monitoring (CGM), with ecological momentary assessments (EMAs) and mobile cognitive testing six times daily. For each 3-h interval preceding an EMA prompt, we calculated the percentage of time in guideline-defined and personal ranges. We estimated within-person correlations and regression models evaluating the incremental predictive effects of TIPR over TIR. Analyses were repeated stratified by personal (unblinded) CGM use.
    RESULTS: Analyses included 161 participants (mean ± SD 41.1 ± 14.8 years old; 55% female; 41% Hispanic, 30% non-Hispanic White, 14% non-Hispanic Black). Compared with TIR, TIPR was more consistently associated with improved pain, fatigue, activity demands, and perceptual speed, whereas TIR was more strongly associated with better diabetes-specific self-evaluations (diabetes distress and self-care). Glucose metrics showed minimal associations with stress and negative affect, and TIPR showed modest associations with positive affect. In models including both predictors, TIPR explained unique variance beyond TIR for several outcomes. Associations between glucose metrics and diabetes-specific outcomes were stronger among CGM users than nonusers.
    CONCLUSIONS: Personal glucose ranges capture aspects of lived experience not fully reflected by guideline targets, supporting TIPR as a complementary metric for psychosocially informed, person-centered care.
    DOI:  https://doi.org/10.2337/dc26-0603
  12. Diabetes Technol Ther. 2026 Jul 09. 15209156261466030
    A Diabetes Management Protocol with Subcutaneous Insulin During Induced Labor and Delivery in Women with Type 1 or Type 2 Diabetes.
    Julie C Søholm, Sidse K Nørgaard, Kirsten Nørgaard, Berit W Pedersen, Peter Damm, Elisabeth R Mathiesen, Lene Ringholm.
       AIMS/HYPOTHESIS: To evaluate a diabetes management protocol with subcutaneous insulin during induction of labor and delivery in women with type 1 diabetes (T1D) and insulin-treated type 2 diabetes (T2D).
    MATERIAL AND METHODS: A secondary analysis of the CopenFast trial, including women undergoing induction of labor. According to the diabetes management protocol, usual diet and insulin were initially continued. From the onset of active labor, target glucose was 4.0-7.0 mmol/L, and intravenous glucose infusion (3 g/h) was given. Women using multiple daily injections discontinued routine insulin injections, and nonautomated insulin pump users continued subcutaneous basal insulin via the pump. Supplemental insulin was given if glucose levels exceeded target levels. Continuous glucose monitoring was used in T1D and hourly capillary blood glucose monitoring (BGM) with a glucometer in T2D. Study endpoints were maternal glucose control and neonatal outcomes.
    RESULTS: In total, 113 women (85 T1D and 28 T2D) were included. HbA1c was 42 ± 5 and 41 ± 10 mmol/mol (6.0 ± 2.0% and 5.9 ± 2.0%) [mean ± standard deviation (SD)]) at 35 weeks. Glucose infusion was given for 4.8 (2.0-7.0) and 5.5 (4.0-8.0) (median [interquartile range (IQR)]) hours. During induction and active labor, mean sensor glucose in T1D was 5.9 ± 1.8 and 7.1 ± 1.8 mmol/L (106 ± 32 and 128 ± 32 mg/dL), respectively, and mean BGM in T2D was 5.6 ± 2.8 and 5.8 ± 1.2 mmol/L (101 ± 50 and 104 ± 22 mg/dL). During active labor, maternal hypoglycemia (≤3.9 mmol/L [70 mg/dL]) occurred in 6% and 11%. Supplemental insulin was administered in 35% (4.0 IU [2.0-7.5]) and 18% (2.0 IU [2.0-4.0]). Neonatal hypoglycemia (<2.2 mmol/L [40 mg/dL]) occurred in 12% and 4%.
    CONCLUSIONS/INTERPRETATION: Following a diabetes management protocol with subcutaneous insulin during induction and active labor, glucose control was close to target, with low prevalence of maternal and neonatal hypoglycemia. These findings support the feasibility of subcutaneous insulin during labor and delivery.
    Keywords:  continuous glucose monitoring; diabetes; glycemic control; hypoglycemia; insulin therapy; labor and delivery; neonatal outcomes; pregnancy; subcutaneous insulin
    DOI:  https://doi.org/10.1177/15209156261466030
  13. Curr Diab Rep. 2026 Jul 10. pii: 20. [Epub ahead of print]26(1):
    Digital Management of Early-Onset Type 2 Diabetes: Empowerment, Challenges, and Future Outlook.
    Li-Jun Guo, Kah-Seng Low, Sok-Kun Tae, Lee-Ling Lim.
       PURPOSE OF REVIEW: Early-onset type 2 diabetes (EOT2D), defined as a diabetes diagnosis before 40 years of age, is rising globally and associated with an aggressive disease course and early complications. This review examines the role of digital health technologies (DHT) in addressing the unique clinical and life-course challenges of EOT2D.
    RECENT FINDINGS: DHT, including continuous glucose monitoring, mobile health applications, digital therapeutics, telemedicine, remote patient monitoring, wearable devices, and artificial intelligence-based analytics, have demonstrated modest improvements in glycemic control, weight management, and patient engagement in people with type 2 diabetes. However, evidence in adults with EOT2D remains limited. Compared with usual-onset T2D, people with EOT2D may derive particular benefits due to higher digital literacy, greater lifestyle variability, and longer anticipated disease duration. Although DHT shows promise for improving empowerment and care integration in EOT2D, important gaps persist, including a lack of EOT2D-specific trials, digital divide-related inequities, interoperability challenges, and reimbursement barriers. Future research should prioritize tailored interventions and hybrid care models to optimize long-term outcomes in this high-risk population.
    Keywords:  Artificial Intelligence; Continuous Glucose Monitoring; Digital Health; Digital Therapeutics; Early-Onset Type 2 Diabetes; Empowerment
    DOI:  https://doi.org/10.1007/s11892-026-01633-6
  14. Proc (Bayl Univ Med Cent). 2026 Jul 08. 1-3
    Continuous glucose monitor device-associated cutaneous Mycobacterium abscessus infection: a novel source of primary inoculation.
    Luke Hamilton, Travis S Dowdle, Antonio Jimenez, Janice M Wilson, Brandon P Goodwin.
      Cutaneous infections with Mycobacterium abscessus are increasingly recognized following disruption of the skin barrier. We report a 72-year-old man with an indurated nodule at a continuous glucose monitor (CGM) insertion site that persisted despite multiple courses of antibiotics. Histopathology demonstrated suppurative granulomatous inflammation, and tissue culture confirmed M. abscessus. This case identifies continuous glucose monitor use as a novel and likely underrecognized source of primary inoculation and underscores the importance of early biopsy with histopathologic, microbiologic, and molecular evaluation when appropriate in treatment-refractory lesions.
    Keywords:  Continuous glucose monitor; Mycobacterium abscessus; cutaneous infection; granulomatous inflammation; nontuberculous mycobacteria
    DOI:  https://doi.org/10.1080/08998280.2026.2691623
  15. Front Endocrinol (Lausanne). 2026 ;17 1910094
    Editorial: Advancing pediatric type 1 diabetes management: metrics, technologies, and prevention of complications.
    Bruno Bombaci, Marta Bassi.
      
    Keywords:  adolescence; automated insulin delivery; children; continuous glucose monitoring; exogenous insulin antibody syndrome; telemedicine; time in range
    DOI:  https://doi.org/10.3389/fendo.2026.1910094
  16. Front Clin Diabetes Healthc. 2026 ;7 1725278
    Time-restricted eating in adults with type 2 diabetes mellitus on concomitant glucagon-like peptide-1 receptor agonists: case report.
    Kyla L Laing, Jordan L Levy, Michael J Wilkinson, Shweta Varshney, Satchidananda Panda, Pam R Taub, Emily N C Manoogian.
      Type 2 diabetes mellitus (T2DM), marked by insulin resistance and impaired blood glucose regulation, can lead to serious complications when poorly controlled. Recent studies highlight interactions between diet, sleep, and metabolic disorders, showing that elevated nighttime glucose levels are associated with a higher risk of cardiometabolic disorders. Time-restricted eating (TRE) is a lifestyle strategy that aligns dietary intake with the circadian system with a consistent 8- to 10-hour eating window during the day. TRE is a safe and effective lifestyle intervention that improves cardiovascular health and glycemic control, and may provide additional benefits beyond stable use of a glucagon-like peptide-1 receptor agonist (GLP-1RA). The three patients presented here participated in a clinical trial for adults with T2DM in which they were instructed to follow a consistent 8 to 10-hour TRE intervention for 3 months (NCT05365529). Assessments, including fasted blood draws, 10-day continuous glucose monitor (CGM) use, and 14-day actigraphy to measure sleep-wake cycles, were conducted at baseline and 3 months. At baseline, all 3 patients were on stable GLP-1RA and exhibited high mean glucose levels (>130mg/dL) during their nightly sleep. Following the 3-month TRE intervention, all 3 patients experienced reductions in hemoglobin A1c (HbA1c) and nighttime glucose, along with improved time in range (TIR) during sleep. This case series highlights the potential benefits of TRE, alongside GLP-1RA use, on nighttime glucose levels, while also underscoring the potential of CGM to identify glycemic phenotypes that may predict specific responses to TRE, demonstrating the importance of a personalized approach.
    Keywords:  case report; continuous glucose monitor; glucagon-like peptide-1 receptor agonist; lifestyle intervention; time-restricted eating; type 2 diabetes mellitus
    DOI:  https://doi.org/10.3389/fcdhc.2026.1725278
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