A-Z Diabetes Boot Camp 2026

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Diabetes and Eating Disorders: Prevalence, Risks, and Clinical Implications

Research consistently shows a strong association between diabetes—especially type 1 diabetes (T1D)—and an increased risk of eating disorders (EDs) and disordered eating behaviors (DEBs). This comorbidity presents significant challenges for both metabolic control and psychological well-being.

Prevalence and Types of Eating Disorders in Diabetes

• Adolescents and adults with T1D have a two- to three-fold higher prevalence of EDs and DEBs compared to peers without diabetes, with rates ranging from 7% to over 20% in various studies (Yahia et al., 2025; Hirvelä et al., 2025; Babayeva et al., 2025; Harris et al., 2020; Toni et al., 2017; Hanlan et al., 2013; Colton et al., 2015; Tate et al., 2020).
• Common EDs in diabetes include binge eating disorder, bulimia nervosa, and insulin omission for weight control (sometimes termed "diabulimia") (Winston, 2020; Harris et al., 2020; Toni et al., 2017; Hanlan et al., 2013; Goebel-Fabbri, 2009).
• In type 2 diabetes (T2D), binge eating disorder is most prevalent, with point prevalence estimates for BED and night eating syndrome (NES) ranging from 1.2% to 8% (Harris et al., 2020; Abbott et al., 2018).

Risk Factors and Predictors

• Longer diabetes duration, higher HbA1c, female sex, adolescence, higher BMI, and psychosocial stressors (e.g., family conflict, low self-esteem, depression) are significant risk factors for EDs in diabetes (Yahia et al., 2025; Babayeva et al., 2025; Toni et al., 2017; Goebel-Fabbri, 2009; Tate et al., 2020).
• Diabetes-specific factors such as insulin-related weight gain, dietary restrictions, and the psychological burden of disease management contribute to the risk (Toni et al., 2017; Priesterroth et al., 2022; Goebel-Fabbri, 2009).

Clinical Consequences

• The coexistence of diabetes and EDs is linked to poor glycemic control, increased risk of acute (e.g., diabetic ketoacidosis) and chronic complications, higher comorbidity burden, and elevated mortality rates (Yahia et al., 2025; Hirvelä et al., 2025; Bagsic et al., 2025; Harris et al., 2020; Colton et al., 2015; Goebel-Fabbri, 2009; Gibbings et al., 2021).
• Adolescents and young adults with T1D and EDs have more than triple the risk of diabetic ketoacidosis and nearly sixfold increased risk of death compared to those without EDs (Gibbings et al., 2021).

Screening and Management

• Early and regular screening for EDs is recommended, starting in pre-adolescence and continuing through adulthood, using diabetes-specific tools like the DEPS-R (Yahia et al., 2025; Harris et al., 2020; Hanlan et al., 2013; Goebel-Fabbri, 2009).
• Integrated, multidisciplinary care—including psychological support and diabetes management—is essential for effective treatment (Winston, 2020; Toni et al., 2017; Dziewa et al., 2023; Wagner & Karwautz, 2020; Hanlan et al., 2013; Salvia et al., 2022).
• Insulin pump therapy may be safe and effective for T1D patients at high risk for EDs, but careful monitoring is required (Şaşmazer et al., 2024).

Prevalence and Impact of Eating Disorders in Diabetes

Figure 1: Prevalence and risks of eating disorders in diabetes populations.

Summary

People with diabetes, especially T1D, are at significantly higher risk for eating disorders, which worsen metabolic and psychological outcomes. Early detection, diabetes-specific screening, and integrated care are critical to improving prognosis and quality of life.

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

References

Yahia, S., Salem, N., Tobar, S., Abdelmoneim, Z., Mahmoud, A., & Laimon, W. (2025). Shedding light on eating disorders in adolescents with type 1 diabetes: insights and implications. European Journal of Pediatrics, 184. https://doi.org/10.1007/s00431-025-06081-0

Winston, A. (2020). Eating Disorders and Diabetes. Current Diabetes Reports, 20, 1-6. https://doi.org/10.1007/s11892-020-01320-0

Hirvelä, L., Haukka, J., Keski-Rahkonen, A., & Sipilä, P. (2025). Eating disorders among people with and without type 1 diabetes: incidence and treatment in a nationwide population-based cohort. Diabetologia, 68, 766 - 777. https://doi.org/10.1007/s00125-024-06346-7

Bagsic, S., Soriano, E., Fortmann, A., & Philis-Tsimikas, A. (2025). 644-P: Eating Disorders among Adults with Diabetes. Diabetes. https://doi.org/10.2337/db25-644-p

Babayeva, A., Alishova, S., Mammadova, G., Coşkun, M., Cerit, E., Altinova, A., Akturk, M., Toruner, F., Karakoç, M., & Yalçın, M. (2025). Assessment of diabetes-specific eating disorder risk in adult patients with diabetes. Journal of Eating Disorders, 13. https://doi.org/10.1186/s40337-025-01188-z

Harris, S., Carrillo, M., & Fujioka, K. (2020). Binge-Eating Disorder and Type 2 Diabetes: A Review.. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. https://doi.org/10.1016/j.eprac.2020.10.005

Toni, G., Berioli, M., Cerquiglini, L., Ceccarini, G., Grohmann, U., Principi, N., & Esposito, S. (2017). Eating Disorders and Disordered Eating Symptoms in Adolescents with Type 1 Diabetes. Nutrients, 9. https://doi.org/10.3390/nu9080906

Dziewa, M., Bańka, B., Herbet, M., & Piątkowska-Chmiel, I. (2023). Eating Disorders and Diabetes: Facing the Dual Challenge. Nutrients, 15. https://doi.org/10.3390/nu15183955

Wagner, G., & Karwautz, A. (2020). Eating disorders in adolescents with type 1 diabetes mellitus. Current Opinion in Psychiatry, 33, 602 - 610. https://doi.org/10.1097/yco.0000000000000650

Hanlan, M., Griffith, J., Patel, N., & Jaser, S. (2013). Eating Disorders and Disordered Eating in Type 1 Diabetes: Prevalence, Screening, and Treatment Options. Current Diabetes Reports, 13, 909-916. https://doi.org/10.1007/s11892-013-0418-4

Salvia, M., Ritholz, M., Craigen, K., & Quatromoni, P. (2022). Managing type 2 diabetes or prediabetes and binge eating disorder: a qualitative study of patients’ perceptions and lived experiences. Journal of Eating Disorders, 10. https://doi.org/10.1186/s40337-022-00666-y

Colton, P., Olmsted, M., Daneman,, D., Farquhar, J., Wong, H., Muskat, S., & Rodin, G. (2015). Eating Disorders in Girls and Women With Type 1 Diabetes: A Longitudinal Study of Prevalence, Onset, Remission, and Recurrence. Diabetes Care, 38, 1212 - 1217. https://doi.org/10.2337/dc14-2646

Abbott, S., Dindol, N., Tahrani, A., & Piya, M. (2018). Binge eating disorder and night eating syndrome in adults with type 2 diabetes: a systematic review. Journal of Eating Disorders, 6. https://doi.org/10.1186/s40337-018-0223-1

Priesterroth, L., Grammes, J., Strohm, E., & Kubiak, T. (2022). Disordered eating behaviours and eating disorders in adults with type 1 diabetes (DEBBI): rational and design of an observational longitudinal online study. BMJ Open, 12. https://doi.org/10.1136/bmjopen-2022-064863

Goebel-Fabbri, A. (2009). Disturbed eating behaviors and eating disorders in type 1 diabetes: Clinical significance and treatment recommendations. Current Diabetes Reports, 9, 133-139. https://doi.org/10.1007/s11892-009-0023-8

Şaşmazer, B., Yildiz, M., Keleş, Ş., Oğuz, S., Sendur, S., Ünlütürk, U., Gürlek, A., Erbaş, T., & Dağdelen, S. (2024). 1899-LB: The Predictors and Management of Eating Disorders in Adult Patients with Type 1 Diabetes Mellitus. Diabetes. https://doi.org/10.2337/db24-1899-lb

Tate, A., Liu, S., Zhang, R., Yilmaz, Z., Larsen, J., Petersen, L., Bulik, C., Svensson, A., Gudbjörnsdottir, S., Larsson, H., Butwicka, A., & Kuja-Halkola, R. (2020). Association and Familial Coaggregation of Type 1 Diabetes and Eating Disorders: A Register-Based Cohort Study in Denmark and Sweden. Diabetes Care, 44, 1143 - 1150. https://doi.org/10.2337/dc20-2989

Gibbings, N., Kurdyak, P., Colton, P., & Shah, B. (2021). Diabetic Ketoacidosis and Mortality in People With Type 1 Diabetes and Eating Disorders. Diabetes Care, 44, 1783 - 1787. https://doi.org/10.2337/dc21-0517

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

Diabetic Eye Pathologies: Mechanisms, Prevalence, and Management

Diabetes significantly increases the risk of several eye diseases, most notably diabetic retinopathy (DR), diabetic macular edema (DME), cataracts, and glaucoma. DR is the most common and vision-threatening complication, but diabetes also impacts other ocular structures.

Major Diabetic Eye Pathologies

Diabetic Retinopathy (DR)

• DR affects about one-third of people with diabetes and is a leading cause of blindness in working-age adults (Wong et al., 2016; Lee et al., 2015; Solomon et al., 2017; Duh et al., 2017).
• It progresses from non-proliferative (NPDR) to proliferative (PDR) stages, with PDR marked by abnormal new blood vessel growth and a high risk of vision loss (Wang & Lo, 2018; Wong et al., 2016; Duh et al., 2017).
• Diabetic macular edema (DME), which can occur at any stage, is the main cause of vision loss in DR and results from fluid accumulation in the macula (Wang & Lo, 2018; Wong et al., 2016; Duh et al., 2017; Tatsumi, 2023).
• Pathogenesis involves microvascular damage, chronic inflammation, oxidative stress, and neurodegeneration (Wang & Lo, 2018; Lim et al., 2020; Wong et al., 2016; Roy et al., 2017; Mesquida et al., 2019; Duh et al., 2017; Amorim et al., 2023).

Other Diabetic Eye Diseases

• Cataracts: Diabetes accelerates cataract formation, leading to earlier and more frequent surgery needs (Lee et al., 2015; Lin & Jivraj, 2025).
• Glaucoma: Diabetics have an increased risk of glaucoma, possibly due to microvascular and metabolic changes (Lin & Jivraj, 2025).
• Ocular Surface Disease: Diabetes can cause corneal complications, including delayed healing, neuropathy, and tear film changes, affecting up to 70% of patients (Amorim et al., 2023).

Risk Factors and Epidemiology

• Duration of diabetes, poor glycemic control, hypertension, and dyslipidemia are major risk factors for DR and DME (Wong et al., 2016; Lee et al., 2015; Solomon et al., 2017; Ding & Wong, 2012; Tan et al., 2017).
• Ethnic differences exist, with some populations (e.g., Indian Singaporeans) showing higher DR prevalence (Tan et al., 2017).
• DR is also a predictor of other diabetic complications, such as nephropathy, stroke, and cardiovascular disease (Kropp et al., 2023; Pearce et al., 2018).

Screening and Management

• Early detection through regular screening is critical, as vision loss is often preventable with timely intervention (Wong et al., 2018; Solomon et al., 2017).
• Treatments include anti-VEGF injections, laser photocoagulation, corticosteroids, and, in advanced cases, surgery (Wang & Lo, 2018; Wong et al., 2016; Duh et al., 2017; Gonzalez-Cortes et al., 2022; Kim et al., 2019; Tatsumi, 2023).
• Control of blood glucose, blood pressure, and lipids is essential for prevention and slowing progression (Wong et al., 2016; Solomon et al., 2017; Gonzalez-Cortes et al., 2022; Lin & Jivraj, 2025).

Key Diabetic Eye Pathologies and Features

Figure 1: Summary of major diabetic eye pathologies, risks, and management strategies.

Summary

Diabetic eye pathologies, especially DR and DME, are major causes of vision loss. Early detection, risk factor management, and advances in therapy are key to reducing the burden of these complications.

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

References

Kropp, M., Golubnitschaja, O., Mazurakova, A., Koklesová, L., Sargheini, N., Vo, T., De Clerck, E., Polívka, J., Potužník, P., Polívka, J., Štětkářová, I., Kubatka, P., & Thumann, G. (2023). Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation. The EPMA Journal, 14, 21 - 42. https://doi.org/10.1007/s13167-023-00314-8

Wang, W., & Lo, A. (2018). Diabetic Retinopathy: Pathophysiology and Treatments. International Journal of Molecular Sciences, 19. https://doi.org/10.3390/ijms19061816

Wong, T., Sun, J., Kawasaki, R., Ruamviboonsuk, P., Gupta, N., Lansingh, V., Maia, M., Mathenge, W., Moreker, S., Muqit, M., Resnikoff, S., Verdaguer, J., Zhao, P., Ferris, F., Aiello, L., & Taylor, H. (2018). Guidelines on Diabetic Eye Care: The International Council of Ophthalmology Recommendations for Screening, Follow-up, Referral, and Treatment Based on Resource Settings.. Ophthalmology, 125 10, 1608-1622. https://doi.org/10.1016/j.ophtha.2018.04.007

Lim, R., Wieser, M., Ganga, R., Barathi, V., Lakshminarayanan, R., Mohan, R., Hainsworth, D., & Chaurasia, S. (2020). NOD-like Receptors in the Eye: Uncovering Its Role in Diabetic Retinopathy. International Journal of Molecular Sciences, 21. https://doi.org/10.3390/ijms21030899

Wong, T., Cheung, C., Larsen, M., Sharma, S., & Simó, R. (2016). Diabetic retinopathy. Nature Reviews Disease Primers, 2. https://doi.org/10.1038/nrdp.2016.12

Lee, R., Wong, T., & Sabanayagam, C. (2015). Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye and Vision, 2. https://doi.org/10.1186/s40662-015-0026-2

Pearce, I., Simó, R., Lövestam-Adrian, M., Wong, D., & Evans, M. (2018). Association between diabetic eye disease and other complications of diabetes: Implications for care. A systematic review. Diabetes, Obesity & Metabolism, 21, 467 - 478. https://doi.org/10.1111/dom.13550

Solomon, S., Chew, E., Duh, E., Sobrin, L., Sun, J., Vanderbeek, B., Wykoff, C., & Gardner, T. (2017). Diabetic Retinopathy: A Position Statement by the American Diabetes Association. Diabetes Care, 40, 412 - 418. https://doi.org/10.2337/dc16-2641

Roy, S., Kern, T., Song, B., & Stuebe, C. (2017). Mechanistic Insights into Pathological Changes in the Diabetic Retina: Implications for Targeting Diabetic Retinopathy.. The American journal of pathology, 187 1, 9-19. https://doi.org/10.1016/j.ajpath.2016.08.022

Ding, J., & Wong, T. (2012). Current Epidemiology of Diabetic Retinopathy and Diabetic Macular Edema. Current Diabetes Reports, 12, 346-354. https://doi.org/10.1007/s11892-012-0283-6

Mesquida, M., Drawnel, F., & Fauser, S. (2019). The role of inflammation in diabetic eye disease. Seminars in Immunopathology, 41, 427 - 445. https://doi.org/10.1007/s00281-019-00750-7

Duh, E., Sun, J., & Stitt, A. (2017). Diabetic retinopathy: current understanding, mechanisms, and treatment strategies.. JCI insight, 2 14. https://doi.org/10.1172/jci.insight.93751

Gonzalez-Cortes, J., Martinez-Pacheco, V., Gonzalez-Cantu, J., Bilgic, A., De Ribot, F., Sudhalkar, A., Mohamed-Hamsho, J., Kodjikian, L., & Mathis, T. (2022). Current Treatments and Innovations in Diabetic Retinopathy and Diabetic Macular Edema. Pharmaceutics, 15. https://doi.org/10.3390/pharmaceutics15010122

Kim, E., Lin, W., Rodriguez, S., Chen, A., Loya, A., & Weng, C. (2019). Treatment of Diabetic Macular Edema. Current Diabetes Reports, 19. https://doi.org/10.1007/s11892-019-1188-4

Tatsumi, T. (2023). Current Treatments for Diabetic Macular Edema. International Journal of Molecular Sciences, 24. https://doi.org/10.3390/ijms24119591

Tan, G., Gan, A., Sabanayagam, C., Tham, Y., Neelam, K., Mitchell, P., Wang, J., Lamoureux, E., Cheng, C., & Wong, T. (2017). Ethnic Differences in the Prevalence and Risk Factors of Diabetic Retinopathy: The Singapore Epidemiology of Eye Diseases Study.. Ophthalmology, 125 4, 529-536. https://doi.org/10.1016/j.ophtha.2017.10.026

Amorim, M., Martins, B., & Fernandes, R. (2023). Immune Fingerprint in Diabetes: Ocular Surface and Retinal Inflammation. International Journal of Molecular Sciences, 24. https://doi.org/10.3390/ijms24129821

Lin, C., & Jivraj, S. (2025). Are diabetes and blood sugar control associated with the diagnosis of eye diseases? An English prospective observational study of glaucoma, diabetic eye disease, macular degeneration and cataract diagnosis trajectories in older age. BMJ Open, 15. https://doi.org/10.1136/bmjopen-2024-091816

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

Pediatric Diabetes: Type 1 & Type 2—Epidemiology, Progression, and Clinical Challenges

Both type 1 diabetes (T1D) and type 2 diabetes (T2D) are rising in children and adolescents, but they differ in pathophysiology, risk factors, and clinical course. Recent research highlights the aggressive nature of youth-onset T2D, the unique management needs of pediatric T1D, and the influence of social, genetic, and environmental factors.

Epidemiology and Trends

• The incidence and prevalence of both T1D and T2D are increasing globally among youth, with T2D showing particularly rapid growth in minority and disadvantaged populations (Perng et al., 2023; Bjornstad et al., 2022; Shah et al., 2022; Lascar et al., 2018).
• In some non-White groups, adolescent T2D incidence now exceeds that of T1D (Perng et al., 2023; Bjornstad et al., 2022).
• T2D remains less common than T1D in most pediatric populations but is rising due to increasing obesity and sedentary lifestyles (Perng et al., 2023; Bjornstad et al., 2022; Shah et al., 2022; Lascar et al., 2018).

Pathophysiology and Disease Course

• T1D is an autoimmune disease leading to insulin deficiency, while T2D in youth is characterized by severe insulin resistance and rapid β-cell decline (Chiang et al., 2018; Bacha et al., 2024; Nadeau et al., 2016; D’Adamo & Caprio, 2011).
• Youth-onset T2D progresses more rapidly than adult-onset T2D or pediatric T1D, with faster β-cell deterioration (20–35% per year in youth vs. 7–11% in adults) and earlier onset of complications (Barrett et al., 2019; Bjornstad et al., 2022; Bacha et al., 2024; Nadeau et al., 2016).
• T2D in youth is associated with a higher risk of nephropathy, neuropathy, hypertension, and cardiovascular disease compared to T1D (Barrett et al., 2019; Bjornstad et al., 2022; Bacha et al., 2024).

Risk Factors and Disparities

• Obesity, family history, ethnicity, and social determinants of health are major risk factors for T2D in youth (Perng et al., 2023; Bjornstad et al., 2022; Bacha et al., 2024; Shah et al., 2022).
• Minority and low-income youth are disproportionately affected by T2D and experience more severe disease and complications (Bjornstad et al., 2022; Shah et al., 2022; Lascar et al., 2018).
• T1D can present at any age in childhood, with some evidence for age-related endotypes and differences in presentation and progression (Chiang et al., 2018; Parviainen et al., 2022).

Management and Outcomes

• T1D management in children requires individualized care, attention to developmental stages, and family support (Chiang et al., 2018; Shah et al., 2022).
• Treatment options for pediatric T2D are limited compared to adults, with metformin and insulin being the mainstays; newer therapies are emerging (Barrett et al., 2019; Bacha et al., 2024; Shah et al., 2022).
• Early diagnosis and intervention in both T1D and T2D improve metabolic control and reduce complications (Chiang et al., 2018; Hummel et al., 2023; Hammersen et al., 2024).
• Screening for prediabetes and early-stage T1D can lead to milder disease at onset and better outcomes (Hummel et al., 2023; Sundheim et al., 2025; Hammersen et al., 2024).

Key Differences Between Pediatric Type 1 and Type 2 Diabetes

Figure 1: Comparison of pediatric type 1 and type 2 diabetes features and risks.

Summary

Pediatric diabetes is a growing public health concern, with T2D showing a particularly aggressive course in youth. Early detection, tailored management, and addressing social determinants are critical to improving outcomes for both T1D and T2D in children and adolescents.

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

References

Perng, W., Conway, R., Mayer-Davis, E., & Dabelea, D. (2023). Youth-Onset Type 2 Diabetes: The Epidemiology of an Awakening Epidemic.. Diabetes care, 46 3, 490-499. https://doi.org/10.2337/dci22-0046

Barrett, T., Jalaludin, M., Turan, S., Hafez, M., & Shehadeh, N. (2019). Rapid progression of type 2 diabetes and related complications in children and young people—A literature review. Pediatric Diabetes, 21, 158 - 172. https://doi.org/10.1111/pedi.12953

Chiang, J., Maahs, D., Garvey, K., Hood, K., Laffel, L., Weinzimer, S., Wolfsdorf, J., & Schatz, D. (2018). Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association. Diabetes Care, 41, 2026 - 2044. https://doi.org/10.2337/dci18-0023

Bjornstad, P., Chao, L., Cree‐Green, M., Dart, A., King, M., Looker, H., Magliano, D., Nadeau, K., Pinhas‐Hamiel, O., Shah, A., Van Raalte, D., Pavkov, M., & Nelson, R. (2022). Youth-onset type 2 diabetes mellitus: an urgent challenge. Nature Reviews Nephrology, 19, 168-184. https://doi.org/10.1038/s41581-022-00645-1

Bacha, F., Hannon, T., Tosur, M., Pike, J., Butler, A., Tommerdahl, K., & Zeitler, P. (2024). Pathophysiology and Treatment of Prediabetes and Type 2 Diabetes in Youth.. Diabetes care. https://doi.org/10.2337/dci24-0029

Hummel, S., Carl, J., Friedl, N., Winkler, C., Kick, K., Stock, J., Reinmüller, F., Ramminger, C., Schmidt, J., Lwowsky, D., Braig, S., Dunstheimer, D., Ermer, U., Gerstl, E., Weber, L., Nellen-Hellmuth, N., Brämswig, S., Sindichakis, M., Tretter, S., Lorrmann, A., Bonifacio, E., Ziegler, A., & Achenbach, P. (2023). Children diagnosed with presymptomatic type 1 diabetes through public health screening have milder diabetes at clinical manifestation. Diabetologia, 66, 1633 - 1642. https://doi.org/10.1007/s00125-023-05953-0

Nadeau, K., Anderson, B., Berg, E., Chiang, J., Chou, H., Copeland, K., Hannon, T., Huang, T., Lynch, J., Powell, J., Sellers, E., Tamborlane, W., & Zeitler, P. (2016). Youth-Onset Type 2 Diabetes Consensus Report: Current Status, Challenges, and Priorities. Diabetes Care, 39, 1635 - 1642. https://doi.org/10.2337/dc16-1066

Shah, A., Zeitler, P., Wong, J., Pena, A., Wicklow, B., Arslanian, S., Chang, N., Fu, J., Dabadghao, P., Pinhas‐Hamiel, O., Urakami, T., & Craig, M. (2022). ISPAD Clinical Practice Consensus Guidelines 2022: Type 2 diabetes in children and adolescents. Pediatric Diabetes, 23, 872 - 902. https://doi.org/10.1111/pedi.13409

Sundheim, B., Hirani, K., Blaschke, M., Lemos, J., & Mittal, R. (2025). Pre-Type 1 Diabetes in Adolescents and Teens: Screening, Nutritional Interventions, Beta-Cell Preservation, and Psychosocial Impacts. Journal of Clinical Medicine, 14. https://doi.org/10.3390/jcm14020383

Parviainen, A., Härkönen, T., Ilonen, J., But, A., & Knip, M. (2022). Heterogeneity of Type 1 Diabetes at Diagnosis Supports Existence of Age-Related Endotypes.. Diabetes care. https://doi.org/10.2337/dc21-1251

D’Adamo, E., & Caprio, S. (2011). Type 2 Diabetes in Youth: Epidemiology and Pathophysiology. Diabetes Care, 34, S161 - S165. https://doi.org/10.2337/dc11-s212

Hammersen, J., Tittel, S., Kamrath, C., Warncke, K., Galler, A., Menzel, U., Hess, M., Meissner, T., Karges, B., & Holl, R. (2024). Clinical Outcomes in Pediatric Patients With Type 1 Diabetes With Early Versus Late Diagnosis: Analysis From the DPV Registry.. Diabetes care. https://doi.org/10.2337/dc24-0625

Lascar, N., Brown, J., Pattison, H., Barnett, A., Bailey, C., & Bellary, S. (2018). Type 2 diabetes in adolescents and young adults.. The lancet. Diabetes & endocrinology, 6 1, 69-80. https://doi.org/10.1016/s2213-8587(17)30186-9

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

Modern Monitoring and Pattern Management in Diabetes: Advances and Clinical Impact

Recent research highlights the transformative role of continuous glucose monitoring (CGM) and data-driven pattern management in optimizing diabetes care for both type 1 and type 2 diabetes.

Advances in Glucose Monitoring

• Continuous Glucose Monitoring (CGM): CGM provides real-time, detailed glucose data, enabling patients and clinicians to visualize the effects of diet, exercise, stress, and medication on glycemic control. CGM is now considered standard of care for type 1 diabetes and is increasingly used in type 2 diabetes, especially for those on insulin therapy (Carlson et al., 2017; Ajjan, 2017; Teo et al., 2022; Spanakis et al., 2022; Ajjan et al., 2024; Slattery & Choudhary, 2017).
• Professional and Remote Monitoring: Professional CGM (short-term, clinic-based) and remote continuous data monitoring (RCDM) have shown significant improvements in HbA1c, BMI, and cardiovascular risk factors compared to standard care (Di Molfetta et al., 2023; Caccelli et al., 2022).
• Pattern Recognition and Personalization: Advanced analytics, including clustering and machine learning, are being used to identify glycemic patterns and personalize targets, leading to more effective and individualized management (Song et al., 2024; Miller et al., 2019; Eissa et al., 2020).

Clinical Outcomes and Pattern Management

• Improved Glycemic Control: CGM use leads to significant reductions in HbA1c, especially in those with higher baseline levels, and increases time-in-range (TIR) while reducing hyper- and hypoglycemia (Teo et al., 2022; Olsen et al., 2025; Spanakis et al., 2022; Di Molfetta et al., 2023; Slattery & Choudhary, 2017; Caccelli et al., 2022).
• Inpatient and Special Populations: In hospital and long-term care settings, CGM-guided insulin titration improves TIR, reduces glycemic variability, and lowers the risk of hypoglycemia and complications compared to point-of-care (POC) testing (Olsen et al., 2025; Spanakis et al., 2022; Idrees et al., 2024).
• Pattern Management Tools: Standardized reports like the Ambulatory Glucose Profile (AGP) and algorithm-enabled patient prioritization support shared decision-making and population-level management (Carlson et al., 2017; Ferstad et al., 2021; Battelino & Bergenstal, 2020; Miller et al., 2019).

Key Monitoring Strategies and Outcomes in Diabetes Management

Figure 1: Comparison of monitoring strategies and outcomes in diabetes management.

Summary

Continuous glucose monitoring and advanced pattern management tools are revolutionizing diabetes care, enabling more precise, personalized, and effective glycemic control across diverse patient populations.

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

References

Carlson, A., Mullen, D., & Bergenstal, R. (2017). Clinical Use of Continuous Glucose Monitoring in Adults with Type 2 Diabetes. **, 19, S-4 - S-11. https://doi.org/10.1089/dia.2017.0024

Olsen, M., Liarakos, A., Wilmot, E., Dhatariya, K., Thabit, H., Sánchez-García, D., Nørgaard, K., Pedersen-Bjergaard, U., Hansen, K., Vangoitsenhoven, R., Mathieu, C., Kristensen, P., & Mader, J. (2025). Implementation strategies for inpatient continuous glucose monitoring-based diabetes management: a systematic review.. The Journal of clinical endocrinology and metabolism. https://doi.org/10.1210/clinem/dgaf074

Ajjan, R. (2017). How Can We Realize the Clinical Benefits of Continuous Glucose Monitoring?. **, 19, S-27 - S-36. https://doi.org/10.1089/dia.2017.0021

Teo, E., Hassan, N., Tam, W., & Koh, S. (2022). Effectiveness of continuous glucose monitoring in maintaining glycaemic control among people with type 1 diabetes mellitus: a systematic review of randomised controlled trials and meta-analysis. Diabetologia, 65, 604 - 619. https://doi.org/10.1007/s00125-021-05648-4

Olsen, M., Klarskov, C., Jensen, S., Rasmussen, L., Lindegaard, B., Andersen, J., Gottlieb, H., Lunding, S., Pedersen-Bjergaard, U., Hansen, K., & Kristensen, P. (2025). In-Hospital Diabetes Management by a Diabetes Team and Insulin Titration Algorithms Based on Continuous Glucose Monitoring or Point-of-Care Glucose Testing in Patients With Type 2 Diabetes (DIATEC): A Randomized Controlled Trial.. Diabetes care. https://doi.org/10.2337/dc24-2222

Ferstad, J., Vallon, J., Jun, D., Gu, A., Vitko, A., Morales, D., Leverenz, J., Lee, M., Leverenz, B., Vasilakis, C., Osmanlliu, E., Prahalad, P., Maahs, D., Johari, R., & Scheinker, D. (2021). Population‐level management of type 1 diabetes via continuous glucose monitoring and algorithm‐enabled patient prioritization: Precision health meets population health. Pediatric Diabetes, 22, 982 - 991. https://doi.org/10.1111/pedi.13256

Spanakis, E., Urrutia, A., Galindo, R., Vellanki, P., Migdal, A., Davis, G., Idrees, T., Pasquel, F., Coronado, W., Albury, B., Moreno, E., Singh, L., Marçano, I., Lizama, S., Gothong, C., Munir, K., Chesney, C., Maguire, R., Scott, W., Perez-Guzman, M., Cardona, S., Peng, L., & Umpierrez, G. (2022). Continuous Glucose Monitoring-Guided Insulin Administration in Hospitalized Patients With Diabetes: A Randomized Clinical Trial.. Diabetes care. https://doi.org/10.2337/dc22-0716

Di Molfetta, S., Caruso, I., Cignarelli, A., Natalicchio, A., Perrini, S., Laviola, L., & Giorgino, F. (2023). Professional continuous glucose monitoring in patients with diabetes mellitus: A systematic review and meta‐analysis. Diabetes, 25, 1301 - 1310. https://doi.org/10.1111/dom.14981

Ajjan, R., Battelino, T., Cos, X., Del Prato, S., Philips, J., Meyer, L., Seufert, J., & Seidu, S. (2024). Continuous glucose monitoring for the routine care of type 2 diabetes mellitus.. Nature reviews. Endocrinology. https://doi.org/10.1038/s41574-024-00973-1

Song, J., McNeany, J., Wang, Y., Daley, T., Stecenko, A., & Kamaleswaran, R. (2024). Riemannian manifold-based geometric clustering of continuous glucose monitoring to improve personalized diabetes management. Computers in biology and medicine, 183, 109255. https://doi.org/10.1016/j.compbiomed.2024.109255

Slattery, D., & Choudhary, P. (2017). Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes. **, 19, S-55 - S-61. https://doi.org/10.1089/dia.2017.0051

Battelino, T., & Bergenstal, R. (2020). Continuous Glucose Monitoring–Derived Data Report—Simply a Better Management Tool. Diabetes Care, 43, 2327 - 2329. https://doi.org/10.2337/dci20-0032

Idrees, T., Castro, I., Oh, H., Gavaller, M., Zabala, Z., Moreno, E., Moazzami, B., Galindo, R., Vellanki, P., Cabb, E., Johnson, T., Peng, L., & Umpierrez, G. (2024). Continuous Glucose Monitoring-Guided Insulin Administration in Long-Term Care Facilities: A Randomized Clinical Trial.. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2024.01.031

Miller, D., Ward, A., Maahs, D., & Scheinker, D. (2019). 960-P: Personalized Diabetes Management Using Data from Continuous Glucose Monitors. Diabetes. https://doi.org/10.2337/db19-960-p

Eissa, M., Good, T., Elliott, J., & Benaissa, M. (2020). Intelligent Data-Driven Model for Diabetes Diurnal Patterns Analysis. IEEE Journal of Biomedical and Health Informatics, 24, 2984-2992. https://doi.org/10.1109/jbhi.2020.2975927

Caccelli, M., Said, Y., Mojado, J., Palsky, C., Colodetti, R., Almarzooqi, I., & Hashemi, A. (2022). 974-P: Implementation of Remote Continuous Data Monitoring within a Clinical Setting for the Management of Type 2 Diabetes Mellitus. Diabetes. https://doi.org/10.2337/db22-974-p

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

Dietary Supplements and Fad Diets: Efficacy, Risks, and Public Health Concerns

Dietary supplements and fad diets are widely used for health, weight loss, and disease prevention, but research reveals mixed evidence regarding their benefits and highlights significant safety and regulatory concerns.

Efficacy and Health Outcomes

• Dietary Supplements: Most large-scale studies and meta-analyses show little to no benefit of dietary supplements for reducing all-cause mortality, cardiovascular disease, or cancer in the general population. Some supplements, such as vitamin E and folic acid, may offer small benefits for specific outcomes, but others (e.g., high-dose vitamin A, β-carotene) have been linked to increased cancer risk, especially in certain populations (Chen et al., 2019; Schwingshackl et al., 2017; Jabbari et al., 2024; Hua et al., 2023).
• Fad Diets: Popular diets like the ketogenic diet and intermittent fasting may improve some cardiovascular risk factors in the short term, but long-term safety and efficacy remain uncertain. Low-carbohydrate diets can lead to short-term weight loss and metabolic improvements, but benefits often diminish after six months, and there are concerns about nutritional imbalances and sustainability (D’Souza et al., 2020; Barber et al., 2021).

Safety and Adverse Effects

• Supplements: Adverse effects are well-documented, including toxicity at high doses, contamination, and drug-supplement interactions. Supplements marketed for weight loss, muscle building, and energy are associated with higher risks of severe medical events, especially in children and young adults (Ronis et al., 2018; Or et al., 2019; Knapik et al., 2022; White, 2020; Hua et al., 2023).
• Fad Diets: High-protein and low-carbohydrate diets may increase the risk of kidney stones and other metabolic complications if not properly balanced. Vegan and vegetarian diets require careful planning to avoid nutrient deficiencies (Barghouthy et al., 2021; Barber et al., 2021).

Regulation and Quality Control

• Dietary supplements are poorly regulated in many countries, with inconsistent quality, potential contamination, and inaccurate labeling. Regulatory agencies often act only after harm is reported, and many products are not tested for safety or efficacy before reaching consumers (Ronis et al., 2018; Binns et al., 2018; White, 2020; Starr, 2015).

Health Effects and Risks of Supplements and Fad Diets

Figure 1: Summary of benefits and risks of supplements and fad diets.

Summary

Most dietary supplements and fad diets offer limited proven long-term health benefits and may pose significant risks, especially when used unsupervised or at high doses. Regulatory oversight is limited, and consumers should seek evidence-based guidance before adopting these products or diets.

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

References

D’Souza, M., Dong, T., Ragazzo, G., Dhindsa, D., Mehta, A., Sandesara, P., Freeman, A., Taub, P., & Sperling, L. (2020). From Fad to Fact: Evaluating the Impact of Emerging Diets on the Prevention of Cardiovascular Disease.. The American journal of medicine. https://doi.org/10.1016/j.amjmed.2020.05.017

Chen, F., Du, M., Blumberg, J., Chui, K., Ruan, M., Rogers, G., Shan, Z., Zeng, L., & Zhang, F. (2019). Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults. Annals of Internal Medicine, 170, 604-613. https://doi.org/10.7326/m18-2478

Ronis, M., Pedersen, K., & Watt, J. (2018). Adverse Effects of Nutraceuticals and Dietary Supplements.. Annual review of pharmacology and toxicology, 58, 583-601. https://doi.org/10.1146/annurev-pharmtox-010617-052844

Schwingshackl, L., Boeing, H., Stelmach-Mardas, M., Gottschald, M., Dietrich, S., Hoffmann, G., & Chaimani, A. (2017). Dietary Supplements and Risk of Cause-Specific Death, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis of Primary Prevention Trials123. Advances in Nutrition, 8, 27 - 39. https://doi.org/10.3945/an.116.013516

Barghouthy, Y., Corrales, M., & Somani, B. (2021). The Relationship between Modern Fad Diets and Kidney Stone Disease: A Systematic Review of Literature. Nutrients, 13. https://doi.org/10.3390/nu13124270

Or, F., Kim, Y., Simms, J., & Austin, S. (2019). Taking Stock of Dietary Supplements' Harmful Effects on Children, Adolescents, and Young Adults. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. https://doi.org/10.1016/j.jadohealth.2019.03.005

Binns, C., Lee, M., & Lee, A. (2018). Problems and Prospects: Public Health Regulation of Dietary Supplements. Annual review of public health, 39, 403-420. https://doi.org/10.1146/annurev-publhealth-040617-013638

Jabbari, P., Yazdanpanah, O., Benjamin, D., & Kalebasty, A. (2024). Supplement Use and Increased Risks of Cancer: Unveiling the Other Side of the Coin. Cancers, 16. https://doi.org/10.3390/cancers16050880

Knapik, J., Trone, D., Steelman, R., Farina, E., & Lieberman, H. (2022). Adverse Effects Associated with Multiple Classes of Dietary Supplements: The Military Dietary Supplement Use Study.. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2022.01.014

White, M. (2020). Dietary Supplements Pose Real Dangers to Patients. Annals of Pharmacotherapy, 54, 815 - 819. https://doi.org/10.1177/1060028019900504

Hua, R., Lam, C., Chu, N., Yang, A., Chow, E., & Cheung, Y. (2023). Association between dietary supplement use and mortality among US adults with diabetes: a longitudinal cohort study. Nutrition & Metabolism, 20. https://doi.org/10.1186/s12986-023-00753-0

Barber, T., Hanson, P., Kabisch, S., Pfeiffer, A., & Weickert, M. (2021). The Low-Carbohydrate Diet: Short-Term Metabolic Efficacy Versus Longer-Term Limitations. Nutrients, 13. https://doi.org/10.3390/nu13041187

Starr, R. (2015). Too little, too late: ineffective regulation of dietary supplements in the United States. American journal of public health, 105 3, 478-85. https://doi.org/10.2105/ajph.2014.302348

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

Medical Nutrition Therapy for Patients with Diabetes: Evidence, Effectiveness, and Best Practices

Medical Nutrition Therapy (MNT) is a cornerstone of diabetes management, with strong evidence supporting its effectiveness in improving glycemic control, weight management, and cardiovascular risk factors for both type 1 and type 2 diabetes, as well as prediabetes.

Effectiveness and Clinical Outcomes

• Glycemic Control: MNT, especially when delivered by a registered dietitian, leads to significant reductions in HbA1c, fasting blood glucose, and improvements in lipid profiles and blood pressure in both diabetes and prediabetes populations (Evert et al., 2019; Møller et al., 2017; Dudzik et al., 2023; Siopis et al., 2020; García-Molina et al., 2019; Evert et al., 2013; Parker et al., 2014).
• Weight and Cardiometabolic Risk: MNT is associated with modest but clinically meaningful reductions in weight, BMI, and LDL cholesterol, and helps improve overall cardiometabolic risk (Møller et al., 2017; Dudzik et al., 2023; Siopis et al., 2020; Sun et al., 2017; García-Molina et al., 2019; Evert et al., 2013).
• Cost-Effectiveness: MNT is cost-effective, reducing healthcare costs by improving outcomes and potentially delaying or preventing diabetes complications (Evert et al., 2019; Pastors et al., 2002; Sun et al., 2017; Hess-Fischl, 2025).

Individualization and Delivery

• No One-Size-Fits-All: There is no universal eating plan for diabetes; nutrition therapy must be individualized based on health goals, cultural preferences, comorbidities, and socioeconomic context (Evert et al., 2019; Evert et al., 2013; Diabetes, 2023; Salis et al., 2020).
• Role of Dietitians: Interventions led by registered dietitians are more effective than general dietary advice from other healthcare professionals, resulting in greater improvements in glycemic and metabolic outcomes (Møller et al., 2017; Dudzik et al., 2023; Siopis et al., 2020; Sun et al., 2017).
• Behavioral Support: Incorporating behavior change techniques and ongoing support enhances adherence and long-term success (Wen et al., 2025; Glasgow et al., 1996).

Special Populations and Settings

• Prediabetes: MNT can delay or prevent progression to type 2 diabetes and improve glycemic and cardiometabolic outcomes in prediabetes (Evert et al., 2019; Dudzik et al., 2023; Parker et al., 2014).
• Hospitalized Patients: MNT is essential for glycemic control and nutritional adequacy in hospitalized patients, reducing complications and length of stay (Gosmanov & Umpierrez, 2012).
• Pediatrics and Gestational Diabetes: MNT should be tailored to age, cultural, and family needs, with evidence supporting both universal and risk-prioritized approaches (Handu & Piotrowski, 2021; Salis et al., 2020; Smith et al., 2025).

Key Outcomes of Medical Nutrition Therapy in Diabetes

Figure 1: Summary of clinical outcomes and benefits of MNT in diabetes.

Summary

Medical Nutrition Therapy, especially when individualized and delivered by dietitians, is highly effective for improving glycemic control, weight, and cardiometabolic health in diabetes and prediabetes. Ongoing support and tailored interventions are essential for long-term success.

These papers were sourced and synthesized using Consensus, an AI-powered search engine for research. Try it at https://consensus.app

References

Evert, A., Dennison, M., Gardner, C., Garvey, W., Lau, K., MacLeod, J., Mitri, J., Pereira, R., Rawlings, K., Robinson, S., Saslow, L., Uelmen, S., Urbanski, P., Yancy, W., & Yancy, W. (2019). Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care, 42, 731 - 754. https://doi.org/10.2337/dci19-0014

Pastors, J., Warshaw, H., Daly, A., Franz, M., & Kulkarni, K. (2002). The evidence for the effectiveness of medical nutrition therapy in diabetes management.. Diabetes care, 25 3, 608-13. https://doi.org/10.2337/diacare.25.3.608

Møller, G., Andersen, H., & Snorgaard, O. (2017). A systematic review and meta-analysis of nutrition therapy compared with dietary advice in patients with type 2 diabetes.. The American journal of clinical nutrition, 106 6, 1394-1400. https://doi.org/10.3945/ajcn.116.139626

Dudzik, J., Senkus, K., Evert, A., Raynor, H., Rozga, M., Handu, D., & Moloney, L. (2023). The Effectiveness of Medical Nutrition Therapy Provided by a Dietitian in Adults with Prediabetes: A Systematic Review and Meta-Analysis.. The American journal of clinical nutrition. https://doi.org/10.1016/j.ajcnut.2023.08.022

Handu, D., & Piotrowski, M. (2021). Nutrition Interventions in Pediatric Patients with Type 1 Diabetes: An Evidence Analysis Center Scoping Review.. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2021.02.020

Siopis, G., Colagiuri, S., & Allman-Farinelli, M. (2020). Effectiveness of dietetic intervention for people with type 2 diabetes: A meta-analysis.. Clinical nutrition. https://doi.org/10.21203/rs.3.rs-59641/v1

Evert, A., Boucher, J., Cypress, M., Dunbar, S., Franz, M., Mayer‐Davis, E., Neumiller, J., Nwankwo, R., Verdi, C., Urbanski, P., & Yancy, W. (2013). Nutrition Therapy Recommendations for the Management of Adults With Diabetes. Diabetes Care, 36, 3821 - 3842. https://doi.org/10.2337/dc13-2042

Wen, A., Wu, K., & Ji, M. (2025). Behaviour Change Techniques Used in the Dietary Management of Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis.. Journal of clinical nursing. https://doi.org/10.1111/jocn.17782

Sun, Y., You, W., Almeida, F., Estabrooks, P., & Davy, B. (2017). The Effectiveness and Cost of Lifestyle Interventions Including Nutrition Education for Diabetes Prevention: A Systematic Review and Meta-Analysis.. Journal of the Academy of Nutrition and Dietetics, 117 3, 404-421.e36. https://doi.org/10.1016/j.jand.2016.11.016

Hess-Fischl, A. (2025). The Value of Medical Nutrition Therapy and Diabetes Self-Management Education and Support in Diabetes Care and Education: A Call to Action to Increase Referrals and Recognize Insurance Coverage Variation.. Current diabetes reports, 25 1, 18. https://doi.org/10.1007/s11892-024-01573-z

Gosmanov, A., & Umpierrez, G. (2012). Medical Nutrition Therapy in Hospitalized Patients with Diabetes. Current Diabetes Reports, 12, 93-100. https://doi.org/10.1007/s11892-011-0236-5

García-Molina, L., Lewis-Mikhael, A., Riquelme-Gallego, B., Cano-Ibáñez, N., Oliveras-López, M., & Bueno-Cavanillas, A. (2019). Improving type 2 diabetes mellitus glycaemic control through lifestyle modification implementing diet intervention: a systematic review and meta-analysis. European Journal of Nutrition, 59, 1313-1328. https://doi.org/10.1007/s00394-019-02147-6

Evert, A., Boucher, J., Cypress, M., Dunbar, S., Franz, M., Mayer‐Davis, E., Neumiller, J., Nwankwo, R., Verdi, C., Urbanski, P., & Yancy, W. (2013). Nutrition Therapy Recommendations for the Management of Adults With Diabetes. Diabetes Care, 37, S120 - S143. https://doi.org/10.2337/dc14-s120

Diabetes, T. (2023). Evidence-based European recommendations for the dietary management of diabetes. Diabetologia, 66, 965-985. https://doi.org/10.1007/s00125-023-05894-8

Parker, A., Byham-Gray, L., Denmark, R., & Winkle, P. (2014). The effect of medical nutrition therapy by a registered dietitian nutritionist in patients with prediabetes participating in a randomized controlled clinical research trial.. Journal of the Academy of Nutrition and Dietetics, 114 11, 1739-48. https://doi.org/10.1016/j.jand.2014.07.020

Glasgow, R., Toobert, D., & Hampson, S. (1996). Effects of a Brief Office-Based Intervention to Facilitate Diabetes Dietary Self-Management. Diabetes Care, 19, 835 - 842. https://doi.org/10.2337/diacare.19.8.835

Salis, S., Joseph, M., Agarwala, A., Sharma, R., Kapoor, N., & Irani, A. (2020). Medical nutrition therapy of pediatric type 1 diabetes mellitus in India: Unique aspects and challenges. Pediatric Diabetes, 22, 100 - 93. https://doi.org/10.1111/pedi.13080

Smith, R., Boaro, M., Mak, K., & Wong, V. (2025). Risk-Prioritised Versus Universal Medical Nutrition Therapy for Gestational Diabetes: A Retrospective Observational Study. Nutrients, 17. https://doi.org/10.3390/nu17020294