Continuous glucose monitor metrics from five studies identify participants at risk for type 1 diabetes development – 11/02/2025

Peter Calhoun, Charles Spanbauer, Andrea K. Steck, Brigitte I. Frohnert, Mark A. Herman, Bart Keymeulen, Riitta Veijola, Jorma Toppari, Aster Desouter, Frans Gorus, Mark Atkinson, Darrell M. Wilson, Susan Pietropaolo, Roy W. Beck

Several studies have shown continuous glucose monitor (CGM) metrics are associated with a future diagnosis of stage 3 type 1 diabetes, but these studies included relatively small sample sizes, making it difficult to adequately evaluate the predictive performance of CGM metrics. In this issue, Calhoun et al (https://doi.org/10.1007/s00125-025-06362-1) combined data from five studies to enhance the sample size and assess the ability of CGM metrics to accurately predict stage 3 type 1 diabetes in individuals with islet autoantibodies. The authors demonstrate that CGM metrics improved predictive performance when combined with participant characteristics and achieved high precision in predicting an imminent diagnosis of type 1 diabetes. The authors conclude that this study highlights the benefits of using CGM to identify an individual’s risk of stage 3 type 1 diabetes, and that using CGM metrics as an eligibility requirement and/or endpoint in clinical trials may expand access and improve generalisability.