T2D

Spotlight article

Exercise, Hemodialysis, and Continuous Glucose Monitoring Accuracy: What the Evidence Shows

Authors of a systematic review examined factors that may influence the accuracy and clinical usefulness of continuous glucose monitoring (CGM). CGM provides round-the-clock glucose data from interstitial fluid and is widely valued for helping patients and clinicians track glucose trends and manage diabetes more effectively. To evaluate possible sources of inaccuracy, the authors reviewed observational studies published through March 2025 and included 11 studies in the final analysis. Across the pooled data, they found no significant overall differences in CGM performance related to the main factors studied. Subgroup analyses likewise suggested that product performance differences, hemodialysis, and exercise did not significantly impair CGM accuracy overall.

 

The discussion emphasizes that improvements in CGM technology, calibration, and algorithms have made these systems more precise and clinically useful, including in some complex care settings. The authors note that CGM may still offer meaningful benefits in patients on hemodialysis and during exercise, helping support safer glucose management without clear evidence that these settings meaningfully distort readings. At the same time, the review points out important limitations: the evidence base was small, study quality was mixed, and heterogeneity was very high. The authors conclude that more robust research is still needed, especially for situations such as peritoneal dialysis, surgery, radiofrequency ablation, and high-altitude environments, where evidence remains limited and less certain.

 

Reference: Liao W, Mo C, Lian G, Liang H. Factors Affecting Continuous Glucose Monitoring Results: A Meta-Analysis. J Diabetes Mellitus. 2025;15(3):107-120. doi: 10.4236/jdm.2025.153008.

Nicole Martinez de Andino

DNP, APRN, AGNP-C, RD

Director of Clinical Operations, Weight Management, MUSC Health and Wellness Institute

Featured article

Could Common Food Preservatives Raise Cancer and Type 2 Diabetes Risk?

The author of this article reports on two French studies that suggest some commonly used food preservatives may be linked to a higher risk of certain cancers and type 2 diabetes. Using data from the NutriNet-Santé cohort, researchers examined detailed dietary records and health outcomes over many years. In the cancer analysis, several preservatives classified as generally recognized as safe were associated with higher risks of specific cancers, including sodium nitrite, potassium nitrate, sorbates, potassium metabisulfite, acetates, acetic acid, and some erythorbates. The strongest findings included higher risks of prostate cancer, breast cancer, and overall cancer among people with the highest exposures. The authors stressed that these are the first studies of their kind and that the findings should be interpreted cautiously until replicated.

 

The second study found that higher intake of multiple preservatives was associated with a substantially greater risk of developing type 2 diabetes. Five preservatives linked to cancer were also tied to diabetes risk. Several additional additives, including calcium propionate, alpha-tocopherol, sodium ascorbate, rosemary extracts, phosphoric acid, and citric acid, were also implicated. Experts quoted in the article said the findings do not prove causation, but they add to growing concern about the health effects of ultra-processed foods and support a broader emphasis on fresh, minimally processed foods. Overall, the article suggests these studies may prompt closer scientific scrutiny and possible regulatory reassessment of how widely certain food additives are used.

 

Reference: LaMotte S. Common food preservatives linked to cancer and type 2 diabetes. CNN. Published January 7, 2026. Accessed April 7, 2026. https://www.cnn.com/2026/01/07/health/food-preservatives-cancer-diabetes-wellness

Tina Copple

DNP, APRN, FNP-BC, ADM-BC, CDCES

Could At-Home HbA1c Screening Help Catch Type 2 Diabetes Earlier?

Researchers of a recent study evaluated whether type 2 diabetes screening using at-home self-sampling HbA1c kits is feasible and cost-effective in Denmark for adults aged 50 to 75 who had not had an HbA1c test in the prior 2 years. In a 9-month pilot, 8000 people were invited and 36% successfully completed testing. Among those tested, 1.7% were newly identified with HbA1c levels in the diabetes range and another 10.2% had prediabetes-range HbA1c values. Participation was fairly consistent across age groups and slightly higher among women, while men had a somewhat higher detection rate. The findings suggest that mailing self-sampling kits can identify previously undiagnosed diabetes in an under-screened population and may complement more traditional clinic-based screening approaches.

 

The economic analysis suggested that this screening approach could be worthwhile at a population level. Assuming screening advances diagnosis by about 3 years, the authors estimated an average societal gain of €1514 per screen-detected individual. That was compared with a projected screening cost of €1183 per screen detected, for a return ratio of 1.28. In other words, each euro invested in the program was estimated to save about €1.28 through lower treatment costs and reduced lost income tied to diabetes complications. The authors note, however, that the model depends on several assumptions and a long-time horizon, so the cost-effectiveness results should be interpreted cautiously. Overall, the study concludes that at-home HbA1c self-sampling appears both feasible and potentially cost-effective, and it could serve as a useful complement to other diabetes screening strategies aimed at earlier detection.

 

Reference: Mateu NC, Rossing P, Neergaard KP, Thybo T. Feasibility and cost-effectiveness of at-home self-sampling screening for type 2 diabetes: a pilot screening study in Denmark. BMJ Open Diabetes Res Care. 2026 Feb 11;14(1):e005539. doi: 10.1136/bmjdrc-2025-005539.

Avital Lehmann

PA-C

Weekend Catch-Up Sleep and Metabolic Health: What New Data Suggest

In a recent study, researchers examined how weekday sleep duration relates to estimated glucose disposal rate (eGDR), a marker of insulin sensitivity. They also explored whether weekend catch-up sleep (WCS) changes that relationship. Using NHANES data, the authors found an inverted U-shaped association between weekday sleep and eGDR, with the most favorable eGDR occurring at about 7.32 hours of weekday sleep. When weekday sleep was less than 7.32 hours, each additional hour of sleep was associated with higher eGDR, suggesting better metabolic status. But when weekday sleep was 7.32 hours or more, longer sleep was linked to lower eGDR, suggesting worse metabolic regulation. The relationship was especially notable in certain groups, including women, adults aged 40–59, and individuals with obesity.

 

Authors also explored whether sleeping more on weekends could offset short weekday sleep. Among people who slept less than 7.32 hours on weekdays, modest weekend catch-up sleep of up to 2 hours was associated with higher eGDR, suggesting a possible metabolic benefit. However, more than 2 hours of weekend catch-up sleep appeared to worsen the association between weekday sleep and eGDR, indicating that excessive catch-up sleep may be counterproductive. Overall, the authors suggest that both too little and too much weekday sleep may be linked to poorer metabolic health, and that moderate—rather than excessive—weekend recovery sleep may be the better strategy. They also note important limits, including the study’s cross-sectional design and reliance on self-reported sleep, meaning the findings show association rather than proof of cause and effect.

 

Reference: Fan Z, Wei R, Chen T, et al. Association of weekday sleep duration and estimated glucose disposal rate: the role of weekend catch-up sleep. BMJ Open Diabetes Res Care. 2026 Mar 3;14(2):e005692. doi: 10.1136/bmjdrc-2025-005692.

Avital Lehmann

PA-C

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