The edition · Diabetes & Endocrinology
CGM lowers HbA1c in type 2 diabetes even without insulin
A primary care trial finds a 0.9-point HbA1c gain from sensors in people on tablets alone, while automated insulin delivery extends to type 2 and an amylin analogue posts phase 2 weight data.
The edition in brief
The lead today is a 26-week randomised trial from 22 US primary care practices: adults with type 2 diabetes not on insulin, starting from an HbA1c near 8.8%, reached 7.2% with continuous glucose monitoring against 8.0% with routine care, an adjusted difference of 0.9 points, with 21 percentage points more time in range and no rise in hypoglycaemia. The trial was industry funded and short, and it did not measure complications. A single-arm study of an automated insulin delivery system in 307 adults with insulin-treated type 2 diabetes reported HbA1c falling 0.7 points over 13 weeks, largest in those starting above 9%, with one episode of ketoacidosis. In obesity, the phase 2 ZUPREME 1 trial of petrelintide, a once-weekly amylin analogue, reported placebo-adjusted weight loss of 6 to 8% at 28 weeks with nausea in one in five. An international position statement sets out how to keep sensors and pumps running safely on general wards. A meta-analysis of 29 trials links antenatal nutrition education to a modest fall in gestational diabetes, about one case fewer per 100 women. The pearl covers what a sensor reading can and cannot replace.
Automated insulin delivery in insulin-treated type 2 diabetes
AID is a reasonable option to discuss for insulin-treated type 2 patients far from target, with ketone and pump-failure training.
Petrelintide, a once-weekly amylin analogue: phase 2 weight data
Petrelintide is a phase 2 drug with moderate weight loss and mild nausea; it changes nothing in clinic yet.
Keeping sensors and pumps running on the ward
Where a patient can manage their own device, a written continuation plan is usually better than removing it on admission.
Antenatal nutrition education and gestational diabetes
Structured antenatal nutrition advice is associated with slightly fewer gestational diabetes cases and is worth offering at booking.
What a sensor reading does not replace
Treat the patient, not the number: confirm discordant sensor readings with a fingerstick.
Continuous glucose monitoring helps type 2 diabetes without insulin
For people with type 2 diabetes not on insulin who are above target, a sensor with structured review is now an evidence-based option to discuss.
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