Future of diabetic foot risk: Unveiling predictive continuous glucose monitoring biomarkers

This study critically analyzes the findings of Geng et al, which investigated the association between continuous glucose monitoring (CGM) metrics and the risk of diabetic foot (DF) in individuals with type 2 diabetes mellitus. The study demonstrated significant associations between lower time in range, higher glycemic risk index, mean blood glucose, and time above range and an increased risk of DF. While acknowledging the study's strengths, such as its large sample size and robust statistical methods, this analysis also highlights its limitations, including its cross-sectional design and reliance on self-reported data. The findings are discussed within the framework of established theories, including the concepts of metabolic memory, the glucocentric paradigm, and the role of inflammation. This analysis emphasizes that a comprehensive approach to glucose management, extending beyond traditional glycated hemoglobin A1c measurements, is crucial for DF risk mitigation. Recognizing the impact of poor adherence and ongoing inflammation, future research should prioritize exploring causal mechanisms, the effectiveness of interventions aimed at improving CGM metrics, and the specific contributions of glucose variability to DF development. In conclusion, these findings strongly support the clinical application of diverse CGM metrics to enhance patient outcomes and effectively manage the risk of DF.