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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Athina Stamati1 · Athanasios Christoforidis2
Received: 7 October 2024 / Accepted: 31 December 2024 / Published online: 10 January 2025 © The Author(s) 2025
Aims To assess the efficacy and safety of automated insulin delivery (AID) systems compared to standard care in managing glycaemic control during pregnancy in women with Type 1 Diabetes Mellitus (T1DM).
Methods We searched MEDLINE, Cochrane Library, registries and conference abstracts up to June 2024 for randomized controlled trials (RCTs) and observational studies comparing AID to standard care in pregnant women with T1DM. We con-ducted random effects meta-analyses for % of 24-h time in range of 63–140 mg/dL (TIR), time in hyperglycaemia (>140 mg/ dl and>180 mg/dL), hypoglycaemia (<63 mg/dl and<54 mg/dL), total insulin dose (units/kg/day), glycemic variability (%), changes in HbA1c (%), maternal and fetal outcomes.
Results Thirteen studies (450 participants) were included. AID significantly increased TIR (Mean difference, MD 7.01%, 95% CI 3.72–10.30) and reduced time in hyperglycaemia>140 mg/dL and>180 mg/dL (MD – 5.09%, 95% CI – 9.41 to – 0.78 and MD – 2.44%, 95% CI – 4.69 to – 0.20, respectively). Additionally, glycaemic variability was significantly reduced (MD – 1.66%, 95% CI – 2.73 to – 0.58). Other outcomes did not differ significantly.
Conclusion AID systems effectively improve glycaemic control during pregnancy in women with T1DM by increasing TIR and reducing hyperglycaemia without any observed adverse short-term effects on maternal and fetal outcomes.
Keywords Automated insulin delivery · Pregnancy · Type 1 diabetes mellitus · Systematic review · Meta-analysis
Nikoline Nygaard1 · Anne Kirstine Eriksen2 · Lars Ängquist3 · Daniel Belstrøm1 · Evelina Stankevic3 · Torben Hansen3 · Anja Olsen2 · Merete Markvart1
Received: 15 August 2024 / Accepted: 22 December 2024 / Published online: 13 January 2025 © The Author(s) 2025
Background Evidence suggests a bidirectional relationship between oral health status and type 2 diabetes (T2D) in adults. Studies on associations between childhood oral health and T2D in adulthood are lacking.
Methods This is a nationwide Danish registry-based cohort study of individuals born between 1963 and 1972, having at least one registration in the National Child Odontology Registry between 1972 and 1987 (n=627,758). Follow-up lasted from 1995 to 2018. Main exposure variables were the highest achieved levels of dental caries and gingivitis between 1972 and 1987. The outcome was T2D diagnosis during follow-up. Data was analyzed using Cox-regression, stratified on sex, with age as the underlying timescale and highest achieved level of education between age 25–30 years as Cox-strata. Main analyses were conducted with and without age-restrictions (T2D diagnosis before/after age 40).
Results Compared to lowest-level references, high levels of gingivitis associated with increased hazard ratios (HRs) of T2D in both males (HR [95% confidence interval]: 1.59 [1.47; 1.72]) and females (1.87 [1.68; 2.08]), as did severe dental caries (males: (1.15 [1.04; 1.27], in females: 1.19 [1.06; 1.35]). Below age 40, gingivitis associated with increased HRs in males (1.84 ([1.58; 2.15]) and females (1.94 [1.63; 2.30]). Above age 40, both exposures displayed higher HRs in males (high gin-givitis: 1.52 [1.39; 1.66] vs. severe caries: 1.23 [1.09; 1.38]) and females (1.83 [1.59; 2.10] vs. 1.37 [1.17; 1.59]).
Conclusions Data suggest an association between childhood dental caries and gingivitis with risk of receiving a T2D diag-nosis in adulthood. However, results are affected by residual confounding warranting further studies.
Keywords Cohort studies · Dental caries · Diabetes mellitus · Type 2 · Gingivitis
Sunita M. C. De Sousa1,2,3 · Jennifer M. N. Phan4,5 · Amanda Wells4 · Kathy H. C. Wu6,7,8,9 · Hamish S. Scott1,4,10
Received: 12 December 2024 / Accepted: 3 January 2025 / Published online: 16 January 2025 © The Author(s) 2025, corrected publication 2025
Aims To assess the utility of reanalysing GCK variants of uncertain significance (VUS) as an intervention to improve the detection of monogenic diabetes.
Methods We examined GCK VUS in a local cohort of individuals with suspected monogenic diabetes and re-curated each variant against the recent ClinGen GCK-specific variant classification guidelines.
Results Variant reanalysis achieved a new ‘likely pathogenic’ classification (i.e., positive results) in 4/8 identified VUS.The single most common newly applied criterion indicating variant pathogenicity was a confirmed phenotype of GCK-hyperglycaemia. RNA sequencing and segregation studies were performed in two cases but not additive to reclassification.
Conclusions This is the first VUS reclassification study in monogenic diabetes using gene-specific guidelines. Within the limits of this small study, we observed a high rate (50%) of VUS upgrades to a positive result, thereby confirming the util-ity of VUS reanalysis– particularly with biochemical phenotyping– in increasing the detection of monogenic diabetes. We recommend HbA1c, fasting blood glucose and either pancreatic autoantibody negativity or a small oral glucose tolerance test increment as a feasible minimum dataset to inform variant classification at the individual patient level, noting the ongoing work of the ClinGen Monogenic Diabetes Expert Panel in systematically reviewing GCK variants at the international level.
Keywords Glucokinase · Monogenic diabetes · DNA sequencing · Genetics
Abbreviations
PVS Pathogenic very strong
PS Pathogenic strong
PM Pathogenic moderate
PP Pathogenic supporting
FHx Family history
AR Autosomal recessive
del/ins Deletion/insertion
IFG Impaired fasting glucose
OGTT Oral glucose tolerance test
Sunita M. C. De Sousa
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1 Adelaide Medical School, University of Adelaide, Adelaide, Australia
2 Endocrine & Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia
3 Adult Genetics Unit, Royal Adelaide Hospital, Adelaide, Australia
4 Department of Genetics & Molecular Pathology, SA Pathology, Adelaide, Australia
5 Flinders Medical School, Flinders University, Adelaide, Australia
6 Clinical Genomics, St Vincent’s Hospital, Darlinghurst, Australia
7 School of Medicine, University of New South Wales, Sydney, Australia
8 Discipline of Genomic Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
9 School of Medicine, University of Notre Dame, Sydney, Australia
10 Centre for Cancer Biology, an alliance between SA Pathology, University of South Australia, Adelaide, Australia
Tim Mori1,2 · Katsiaryna Prystupa2,3 · Klaus Straßburger1,2 · Marc Bonn2,4 · Oana Patricia Zaharia2,3,5 · Olaf Spörkel2,4 · Oliver Kuß1,2,6 · Michael Roden2,3,5 · Robert Wagner2,3,5
Received: 10 December 2024 / Accepted: 13 December 2024 / Published online: 17 January 2025 © The Author(s) 2025
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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