A.Giaccari1 · G. Gliozzo1 · G. Ciccarelli1 · G. Di Giuseppe1 · C. Castellano2 · S. Cum3 · L. Delle Monache4,13 · M. Gallo5 ·M.Lastretti6 · G. Medea7 · M. Monesi8 · R. Napoli9 · B. Pintaudi10 · E. Succurro11 · G. Turchetti
Received: 9 January 2026 / Accepted: 17 March 2026 © The Author(s) 2026
Abstract
Background and aims Although continuous glucose monitoring (CGM) devices are now standard of care among Type 1 diabetes patients, they are still relatively underutilized in Type 2 diabetes (T2D), particularly in those patients not treated with insulin. Widespread adoption continues to be hindered by a combination of factors. Chief among these is the scarcity of long-term, large-scale clinical trials demonstrating the benefits of the use of CGM in T2D. This meta-analysis aimed to address this gap by comparing CGM with self-blood glucose monitoring (SBMG), with primary outcomes of HbA1c and time in range (TIR) in insulin-treated and non-insulin-treated TD2 patients.
Methods and results Following the stringent rules mandated by our National Health Service (which requires a panel com-posed of all stakeholders involved in diabetes treatment, and includes PICO, GRADE, AGREE, and meta-analyses), we performed a systematic review of RCTs that enrolled two groups of individuals with T2D, those treated with insulin (includ-ing basal and basal-bolus regimens), and those receiving treatments other than insulin. All included trials compared CGM with structured blood glucose monitoring (SBGM) with glycated hemoglobin (HbA1c) as the main endpoint. Based on the strength and consistency of the evidence, the panel issued a strong recommendation in favor of CGM for individuals with T2D treated with insulin (including those on basal insulin alone) and for individuals with T2D not treated with insulin, par-ticularly for those with glycated hemoglobin levels≥7%. From a pharmacoeconomic perspective, outcomes were positive in both patient groups.
Conclusion CGM represents a clinically effective and cost-efficient approach to optimizing glycemic control in T2D, becom-ing mandatory among individuals on insulin therapy. Our findings support a shift in clinical practice toward the more widespread use of CGM in T2D, with regulatory frameworks and reimbursement policies needing to adapt accordingly.
Keywords CGM · Type 2 Diabetes · Metanalysis · PICO · GRADE · Guidelines
Communicated by Massimo Federici, M.D.
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1 Center for Endocrine and Metabolic Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
2 Azienda USL of Modena, Sassuolo Hospital, Sassuolo, Italy
3 Diabetes and Diabetic Foot Care Unit, ASUGI, Monfalcone, Italy
4 National Board Member of FAND (Italian Association for the Rights of Diabetic People), Roma, Italy
5 Department of Endocrinology and Metabolic Diseases, AO SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
6 Order of Psychologists of Lazio, Rome, Italy
7 Italian Society of General Medicine (SIMG), Florence, Italy
8 Territorial Diabetology Unit, AUSL Ferrara, Ferrara, Italy
9 Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
10 Diabetes Unit, Niguarda Cà Granda Hospital, Milan, Italy
11 Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
12 Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
13 Patient Advocacy Lab, ALTEMS – Università Cattolica del Sacro Cuore, Rome, Italy
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引用本文:简喜超, 简扬, 邓呈亮. 2025版《中国糖尿病足防治实践指南》解读[J]. 中华医学美学美容杂志, 2026, 32(2): 99-103. DOI: 10.3760/cma.j.cn114657-20251215-00266.
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Yuancheng Lu1, Benedikt Brommer2,3,11, Xiao Tian1,11, Anitha Krishnan3,4,11, Margarita Meer5,6,11, Chen Wang2,3, Daniel L. Vera1, Qiurui Zeng1, Doudou Yu1, Michael S. Bonkowski1, Jae-Hyun Yang1, Songlin Zhou2,3, Emma M. Hoffmann3,4, Margarete M. Karg3,4, Michael B. Schultz1, Alice E. Kane1, Noah Davidsohn7, Ekaterina Korobkina3,4, Karolina Chwalek1, Luis A. Rajman1, George M. Church7, Konrad Hochedlinger8, Vadim N. Gladyshev5, Steve Horvath9, Morgan E. Levine6, Meredith S. Gregory-Ksander3,4,* , Bruce R. Ksander3,4,* , Zhigang He2,3,* , David A. Sinclair1,10,*,#
1. Department of Genetics, Blavatnik Institute, Paul F. Glenn Center for Biology of Aging Research, Harvard Medical School, MA, USA;
2. Department of Neurology, Boston Children’s Hospital, Harvard Medical School, MA, USA;
3. Department of Ophthalmology, Harvard Medical School, Boston, MA, USA;
4. Schepens Eye Research Institute of Mass Eye & Ear, Harvard Medical School, MA, USA;
5. Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, MA, USA;
6. Department of Pathology, Yale School of Medicine, New Haven, CT, USA;
7. Department of Genetics, Wyss Institute for Biologically Inspired Engineering, Harvard University, MA, USA;
8. Department of Molecular Biology, Cancer Center and Center for Regenerative Medicine, Massachusetts General Hospital, MA, USA;
9. Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, CA, USA;
10. Laboratory for Aging Research, Department of Pharmacology, School of Medical Sciences, The University of New South Wales, Sydney, Australia;
11. These authors contributed equally: B. B., X. T., A. K., M. M.;
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Senior authors;
Contributions
Y.L. and D.A.S. conceived the project. Y.L., X.T., and D.A.S. wrote the manuscript with input from all co-authors. Y.L. was involved in all experiments and analyses. M.S.B. and J.-H.Y. provided early training to Y.L.. B.B., C.W., Q.Z., D.Y., S.Z., and Z.H. contributed to the optic nerve crush studies and imaging. A.K., D.Y., Q.Z., E.M.H., E.K., M.S.G.-K., and B.R.K. contributed to the glaucoma and ageing studies. M.M.K. and B.R.K. performed OCT imaging and analysis. M.M. and V.N.G. conducted ribosomal DNAm age analysis for mouse RGCs. M.E.L. developed DNAm ageing signature. D.L.V. performed the RNA-seq and gene association analysis. X.T. conducted human neuron experiments. S.H. conducted human methylation clock analysis. X.T., J.-H.Y., and K.H. helped with transgenic mouse fibroblasts work. M.S.B., X.T., M.B.S., A.E.K., L.A.R., helped with systemic AAV9 experiments. N.D., and G.M.C. helped with plasmid constructs and AAV9 production. K.C. helped with grant applications and project management. M.S.G.-K., B.R.K., Z.H., and D.A.S. jointly supervised this work.
Conflict of interest
D.A.S. is a consultant to, inventor of patents licensed to, board member of and equity owner of Iduna Therapeutics, a Life Biosciences company developing epigenetic reprograming therapies. D.A.S. is an advisor to Zymo Research, an epigenetics tools company. Additional disclosures are at https://genetics.med.harvard.edu/sinclair/people/sinclair-other.php. Y.L., L.A.R. and S.H. are equity owners of Iduna Therapeutics, a Life Biosciences company. D.L.V. is an advisor to Liberty Biosecurity. M.S.B. is a shareholder in MetroBiotech. K.C. is an equity owner in Life Biosciences and affiliates. N.D. and G.M.C. are co-founders of Rejuvenate Bio. Disclosures for G.M.C. can be found at http://arep.med.harvard.edu/gmc/tech.html. M.E.L. is a bioinformatics advisor to Elysium Health. Y.L., N.D. and D.A.S. are inventors on patents arising from this work (WO/2020/069373 and WO/2020/069339), filed by the President and Fellows of Harvard College. The other authors declare no competing interests.
This article is excerpted from the Nature. 2020 December ; 588(7836): 124–129. by Wound World.
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
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