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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Ciska Janssens‑Böcker · Claudia Doberenz · Marta Monteiro · Marta de Oliveira Ferreira
C. Janssens‑Böcker (*) · C. Doberenz MedSkin Solutions Dr. Suwelack AG, Billerbeck, Germany e-mail: ciska.janssens-boecker@medskin-suwelack. com M. Monteiro · M. de Oliveira Ferreira Inovapotek, Pharmaceutical Research & Development, Porto, Portugal
Received: September 10, 2024 / Accepted: November 27, 2024 / Published online: December 21, 2024 © The Author(s) 2024
Supplementary Information
The online version contains supplementary material available at https://doi.org/10.1007/s13555-024-01321-x.
ABSTRACT
Introduction:
The human skin acts as a pro‑ tective barrier against external pathogens and hosts a diverse microbiome consisting of bacte‑ ria, fungi, viruses, and archaea. Disruptions to the skin microbiome can impact immune func‑ tion, leading to inflammatory and autoimmune conditions. The importance of pH for the micro‑ biome is paramount. Cosmetic skincare prod‑ ucts interact with the skin microbiome and skin pH, playing a key role in maintaining microbial balance. Research suggests that products with non-physiological pH levels may disrupt the skin microbiota. Our clinical study aimed to evaluate the effects of low-pH cosmetic products (pH<5) on the skin microbiome, contributing to improved skin health.
Methods: The clinical study focused on evalu‑
ating the skin microbiome diversity following
the application for 28 days of four different low
pH cosmetic products (vitamin C, resveratrol, a
collagen mask, and a native algae mask) on the
forearms of post-menopausal women with skin
pH>5.5.
Results:
The diversity of the natural skin microbiome increased consistently through‑ out the study, evident in both the untreated area and after the application of the Vitamin C Concentrate, Resveratrol Concentrate, Colla‑ gen Mask, and Native Algae Mask, as indicated by Shannon’s diversity index. The native algae mask notably reduced the Corynebacterium genus and significantly lowered the pH. The skin pH changes corresponded with microbiota stability.
Conclusions:
In conclusion, enhanced diver‑ sity of the natural skin microbiome was observed over the study duration. None of the investi‑ gational products caused significant disruption to the skin microbiome diversity, as evidenced by the stable Shannon’s diversity index and relative abundance of specific genera. Notably, the native algae mask significantly decreased the presence of the opportunistic pathogenic Corynebacterium genus, which is likely attribut‑ able to a minor reduction in skin pH following extended product use. The findings suggest that the use of low-pH skincare products, like the native algae mask, do not disrupt skin micro‑ biome diversity and may have the potential to positively impact skin microbiome diversity and health by reducing certain pathogenic microbial
Keywords: Human skin; Microbiome; Skincare; Cosmetics; pH
Key Summary Points
Why carry out this study?
This study investigated the intricate relation‑ ship between cosmetic skincare products, the skin microbiome, and skin health. It evaluated the impact of low-pH skincare products on skin microbiome diversity and skin barrier function.
What was learned from this study?
The diversity of the skin microbiome increased following the application of vita‑ min C concentrate, resveratrol concentrate, a collagen mask, and a native algae mask, as demonstrated by Shannon’s diversity index. The native algae mask notably decreased the genus Corynebacterium and lowered the pH, with the pH changes aligning with micro‑ biota stability. Low-pH skincare products maintain skin microbiome diversity and health by reducing pathogenic microbial populations, promot‑ ing a positive impact on skin microbiome health.
INTRODUCTION
The skin serves as the outermost boundary between the human body and the environment and functions as a protective shield prevent‑ ing the entry of external pathogens [1–5]. At the same time, it accommodates the resident commensal microbiota, also called the micro‑ biome [2, 6, 7]. This microbial community that inhabits human skin is highly complex and consists of highly diverse microorganisms, including bacteria, fungi, viruses, and archaea [6–8]. Disruptions to the skin’s microbial consor‑ tium may influence the functioning of the skin’s immune system. Dysregulation of the skin microbiome has been associated with numerous inflammatory and autoimmune con‑ ditions such as atopic dermatitis and vitiligo, which is indicative of the pivotal role of the skin microbiome in maintaining skin health [9–13]. Cosmetic skincare products are widely used to modify or improve the appearance of the skin. These formulations typically incorporate antimicrobial preservatives, scents, and diverse constituents that engage not only with the skin but also with its resident microbiome [14–16]. Over the past decade, there has been a signifi‑ cant rise in interest in elucidating the complex interactions between cosmetic products and the skin microbiome, with a key emphasis on for‑ mulating products that maintain a healthy skin microflora [17, 18]. The pH of the skin plays a pivotal role in influencing the profile of resident microbial populations. The skin preserves a slightly acidic pH, approximately 5.0, facilitating the forma‑ tion of the ‘acid mantle’ [19–22]. This protec‑ tive layer is responsible for defending against external pathogens whilst mitigating excessive moisture loss [22–25]. Numerous studies have illustrated a link between variations in skin pH and shifts in microbiome composition. A rise in skin pH is associated with the proliferation of harmful bacteria and concurrently causes disrup‑ tion to beneficial resident microflora [1, 26]. Most cosmetic skincare products in the mar‑ ket, in particular cleansers, soaps, and textur‑ izers, tend to have an alkaline pH ranging from 7.0 to 8.0. This is due to the presence of surfactants, emulsifiers, and humectants that function optimally at a higher pH [20]. This pH greatly exceeds the inherent pH of the skin, causing a temporary yet pronounced elevation of the skin’s pH following the application of the product. This deviation from the natural acidic state of the skin could potentially disturb the microbial balance of the skin, leading to a shift
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。
2019广东省医疗行业协会伤口管理分会年会
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