Sensors earn a place in non-insulin type 2 diabetes care

The edition in brief

The edition closes on a 283-person randomised trial in 22 US primary care practices: adults with type 2 diabetes not on insulin who used continuous glucose monitoring (CGM) for 26 weeks lowered HbA1c by 0.9 percentage points more than routine care (95% CI -1.1 to -0.6), with 21 points more time in range and no severe hypoglycaemia. It was open-label and device-maker funded, but the effect is large and the population is the one most clinics see. A single-arm 13-week study of automated insulin delivery in 307 adults with insulin-treated type 2 diabetes reported HbA1c falling from 8.1% to 7.4% and time in range rising from 57% to 73%, with one episode of ketoacidosis; there was no control group. The phase 2 ZUPREME 1 trial of petrelintide, a once-weekly amylin analogue, gave 6 to 8 percentage points more weight loss than placebo at 28 weeks, with nausea in a fifth of patients. FDA lists Class II recalls of compounded tirzepatide and semaglutide syringes from one US pharmacy for lack of sterility assurance, a reminder to ask where a patient's injection comes from. A meta-analysis of 23 trials suggests telemedicine may help some glucose and perinatal outcomes in gestational diabetes, but certainty was low to very low and heterogeneity extreme. The pearl covers reading a CGM report in under a minute.