BACKGROUND:Progress in type 1 diabetes (T1D) algorithm development is limited by the fragmentation and lack of standardization across existing T1D management data sets. Current data sets differ substantially in structure and are time-consuming to access and process, which impedes data integration and reduces the comparability and generalizability of algorithmic developments. This work aims to establish a unified and accessible data resource for T1D algorithm development. METHOD:Multiple publicly available T1D data sets were harmonized into a unified resource, termed the MetaboNet data set. Inclusion required the availability of both continuous glucose monitoring (CGM) data and corresponding insulin pump dosing records. In addition, auxiliary information such as reported carbohydrate intake and physical activity was retained when present. RESULTS:The MetaboNet data set comprises 3135 subjects and 1228 patient-years of overlapping CGM and insulin data, making it substantially larger than existing standalone benchmark data sets. The resource is distributed as a fully public subset available for immediate download at https://metabo-net.org/, and with a data use agreement (DUA)-restricted subset accessible through their respective application processes. For the data sets in the latter subset, processing pipelines are provided to automatically convert the data into the standardized MetaboNet format. CONCLUSIONS:A harmonized public data set for T1D research is presented, and the access pathways for both its unrestricted and DUA-governed components are described. The resulting data set covers a broad range of glycemic profiles and demographics and thus can yield more generalizable algorithmic performance than individual data sets.
Purpose:To quantify the value of using prior changes in spherical equivalent refractive error (SER) and axial length (AL) to predict future myopia progression. Methods:For this post hoc analysis of a randomized controlled trial, we used data from children ages 5 to 12 years with SER -1.00 to -6.00 D who had been randomized 2:1 to 0.01% atropine or placebo eye drops for 24 months. Multivariable linear regression evaluated the association of baseline-to-12-month change in SER and AL versus 12-to-24-month change while controlling for age and SER or AL at 12 months. Treatment groups were pooled for analyses; sensitivity analyses were conducted using only the placebo group. Results:Among 187 children, 136 (73%) with complete data were included. For predicting a 0.50-D-or-more SER increase of myopia in the second 12 months based on observing a 0.50-D-or-more increase of myopia in the first 12 months, the positive predictive value was 42% (19 of 45; 95% confidence interval [CI], 29%-57%). Greater baseline-to-12-month SER change was weakly associated with greater 12-to-24-month SER change (0.20 D per additional 1.00 D; 95% CI, 0.02 to 0.39; P = 0.03; partial R2 = 0.03). The 95% prediction interval half-width for 12-to-24-month change was ±0.66 D with prior change versus ±0.67 D without (difference = 0.01 D; 95% CI, -0.05 to 0.07). Analyses of AL and sensitivity analyses limited to the placebo group were qualitatively similar. Conclusions:Changes in SER and AL of children in the prior 12 months were poor predictors of future myopia progression, limiting their usefulness for clinical decision-making or selecting participants for clinical trials.
Innovations in diabetes medications and technologies have revolutionized our approach to the management of diabetes. Automated insulin delivery (AID) systems have substantially improved overall glycemia and time-in-range; however, AID systems do not eliminate postprandial hyperglycemia or correct hyperglycemia quickly, given the glucose-lowering action lag of insulins that are used in AID systems. Inhaled insulin offers a novel approach to prandial insulin delivery, characterized by rapid absorption kinetics and a "rapid on, rapid off" pharmacokinetic profile that closely mimics endogenous insulin secretion and can compensate for the glucose-lowering action delay of subcutaneous insulin delivery. While the integration of inhaled insulin with AID systems presents an opportunity to address the limitations of subcutaneous insulin formulations, challenges remain in harmonizing the pharmacokinetics of inhaled insulin with AID systems. This article reviews the current evidence supporting the potential role of concomitant use of TI with AID and gaps in our current knowledge that need to be filled with future studies.
OBJECTIVE:Intraindividual cognitive variability (IICV) is a promising measure for early identification of dementia risk. Fewer studies have assessed IICV using high-frequency digital cognitive assessment or in populations with medical conditions. We aimed to characterize associations between IICV for reaction time and accuracy with plasma biomarkers of neurodegeneration (phosphorylated tau 181, phosphorylated tau 217, β-amyloid 42/40 ratio, glial fibrillary acidic protein, and neurofilament light chain) in individuals with Type 1 diabetes. METHOD:We analyzed data from 114 participants from the Glycemic Variability and Fluctuations in Cognitive Status in Adults With Type 1 Diabetes study who provided blood samples (M = 48.9 years, range = 19-84). Cognition was assessed digitally at baseline and three times daily for 15 days via ecological momentary assessment. Hierarchical linear regression models examined associations between biomarkers and IICV, adjusting for demographics, glycemic variability, mean cognition, and nephropathy. Multiple testing correction used Benjamini-Hochberg. RESULTS:IICVs for reaction time at baseline and across repeated assessments were correlated and associated with β-amyloid 42/40, glial fibrillary acidic protein, neurofilament light chain, and phosphorylated tau 217 (small to moderate effect size, p < .05), but associations did not remain significant after adjustment. Exploratory analyses indicated interactions with age and sex. IICV for accuracy was not associated with any biomarker. CONCLUSIONS:Although associations between IICV and plasma biomarkers were not robust after full adjustment, exploratory analyses suggested potential interactions with age and sex. The sample was predominantly non-Hispanic White, limiting the generalizability of our findings. These findings support continued investigation of digital IICV as a dynamic marker of early cognitive vulnerability. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
