Aims: To compare the efficacy and safety of different hybrid closed loop (HCL) systems in people with diabetes through a network meta‐analysis.Methods: We searched MEDLINE, EMBASE, CENTRAL and PubMed for randomised clinical trials (RCTs) enrolling children, adolescents and/or adults with type 1 or type 2 diabetes, evaluating Minimed 670G, Minimed 780G, Control‐IQ, CamAPS Fx, DBLG‐1, DBLHU, and Omnipod 5 HCL systems against other types of insulin therapy, and reporting time in target range (TIR) as outcome.Results: A total of 28 RCTs, all enrolling people with type 1 diabetes, were included. HCL systems significantly increased TIR compared with subcutaneous insulin therapy without continuous glucose monitoring (SIT). Minimed 780G achieved the highest TIR ahead of Control IQ (mean difference (MD) 5.1%, 95% confidence interval (95% CI) [0.68; 9.52], low certainty), Minimed 670G (MD 7.48%, 95% CI [4.27; 10.7], moderate certainty), CamAPS Fx (MD 8.94%, 95% CI [4.35; 13.54], low certainty), and DBLG1 (MD 10.69%, 95% CI [5.73; 15.65], low certainty). All HCL systems decreased time below target range, with DBLG1 (MD −3.69%, 95% CI [−5.2; −2.19], high certainty), Minimed 670G (MD −2.9%, 95% CI [−3.77; −2.04], moderate certainty) and Minimed 780G (MD −2.79%, 95% CI [−3.94; −1.64], high certainty) exhibiting the largest reductions compared to SIT. The risk of severe hypoglycaemia and diabetic ketoacidosis was similar to other types of insulin therapy.Conclusions: We show a hierarchy of efficacy among the different HCL systems in people with type 1 diabetes, thus providing support to clinical decision‐making.Trial Registration: PROSPERO CRD42023453717

Aim: To evaluate the effect on glucose control of professional continuous glucose monitoring (p‐CGM)‐based care as compared with standard care in the management of patients with type 1 and type 2 diabetes. Materials and methods: The PubMed database was searched comprehensively to identify prospective or retrospective studies evaluating p‐CGM as a diagnostic tool for subsequent implementation of lifestyle and/or medication changes and reporting glycated haemoglobin (HbA1c) as an outcome measure. Results: We found 872 articles, 22 of which were included in the meta‐analysis. Overall, the use of p‐CGM was associated with greater HbA1c reduction from baseline (−0.28%, 95% confidence interval [CI] −0.36% to −0.21%, I ² = 0%, P < 0.00001) than usual care, irrespective of type of diabetes, length of follow‐up, frequency of continuous glucose monitoring (CGM) use and duration of CGM recording. In the few studies describing CGM‐derived glucose metrics, p‐CGM showed a beneficial effect on change in time in range from baseline (5.59%, 95% CI 0.12 to 11.06, I ² = 0%, P = 0.05) and a neutral effect on change in time below the target range from baseline (−0.11%, 95% CI −1.76% to 1.55%, I ² = 33%, P = 0.90). Conclusions: In patients with type 1 and type 2 diabetes, p‐CGM‐driven care is superior to usual care in improving glucose control without increasing hypoglycaemia.

Pheochromocytoma and paraganglioma are neuroendocrine neoplasms, originating in the adrenal medulla and in parasympathetic and sympathetic autonomic nervous system ganglia, respectively. They usually present as localized tumours curable with surgery. However, these tumours may exhibit heterogeneous clinical course, ranging from no/minimal progression to aggressive (progressive/metastatic) behavior. For this setting of patients, current therapies are unsatisfactory. Immune checkpoint inhibitors have shown outstanding results for several types of solid cancers. We therefore aimed to summarize and discuss available data on efficacy and safety of current FDA-approved immune checkpoint inhibitors in patients with pheochromocytoma and paraganglioma. After an extensive search, we found 15 useful data sources (four full-published articles, four supplements of scientific journals, seven ongoing registered clinical trials). The data we detected, even with the limit of the small number of patients treated, make a great expectation on the therapeutic use of immune checkpoint inhibitors. Besides, the newly detected predictors of response will (hopefully) be of great helps in selecting the subset of patients that might benefit the most from this class of drugs. Finally, new trials are in the starting blocks, and they are expected to shed in the next future new light on a therapy, which is considered a milestone in oncology.

Medullary thyroid carcinoma is a rare neuroendocrine neoplasm that originates from thyroid C cells. Surgery, with complete resection of the tumor, is the only curative approach. However, in most cases, the tumor recurs at locoregional or metastatic level. In this setting, the management remains challenging. In recent years, the immune checkpoint inhibitors have provided promise for changing the cancer treatment paradigm through the application of new approaches that enhance the body’s natural antitumor defenses. The aim of this review is to summarize and discuss available data on efficacy and safety of the Food and Drug Administration-approved immune checkpoint inhibitors in patients with medullary thyroid carcinoma. After an extensive search, we found 7 useful data sources (one single-case report, one short article with very preliminary data, five ongoing registered clinical trials). Despite the lack of published evidence regarding the use of immune check point inhibitors, it must be considered that all the ongoing registered clinical trials saw first light in the last three years, thus indicating a growing interest of researchers in this field. Results coming from these trials, and hopefully, in the next future, from additional trials, will help to clarify whether this class of drugs may represent a new weapon in favor of patients with medullary thyroid carcinoma.

Aims: To provide an updated analysis of the performance of different hybrid closed loop (HCL) systems in randomised controlled trials (RCTs) on subjects with type 1 diabetes. Materials and methods: We conducted a systematic review with meta‐analysis. We searched four online databases and performed hand‐searching of conference proceedings to find studies from inception to 18 April 2025. We included RCTs enrolling subjects with type 1 diabetes, evaluating commercial HCL systems against other insulin therapy regimens, with a duration of intervention ≥2 weeks, and reporting time in range (TIR) as an outcome. Studies involving pregnant women were excluded. Results: A total of 37 studies evaluating seven different HCL systems (CamAPS Fx, Control IQ, DBLG1, iLet BP, MiniMed 670G, MiniMed 780G, and Omnipod 5) were included. In studies with a mean age < 18 years, mean TIR was 64.1% (95% CI: 61‐67.2), ranging from 59.3% (95% CI: 49.6‐69.1) with MiniMed 780G to 68% (95% CI: 65.8‐70.3) with Control IQ, and end‐of‐study HbA1c was 7.4% (95% CI: 7‐7.7), ranging from 6.7% (95% CI: 6.6‐6.9) with CamAPS Fx to 7.9% (95% CI: 6.9‐9) with MiniMed 780G. In studies with a mean age ≥ 18 years, mean TIR was 70.8% (95% CI: 68.6‐73), ranging from 63.1% (95% CI: 59.4‐66.8) with Omnipod 5 to 74.4% (95% CI: 69.7‐79.1) with MiniMed 780G, and end‐of‐study HbA1c was 7.1% (95% CI: 7‐7.3), ranging from 7.0% (95% CI: 6.9‐7.1) with Control IQ to 7.2% (95% CI: 7‐7.5) with MiniMed 670G. Conclusions: In RCTs, commercial HCL systems show different achievements of CGM metrics and HbA1c in people with type 1 diabetes.

Optical coherence tomography angiography (OCTA) is an innovative and reliable technique detecting the early preclinical retinal vascular change in patients with diabetes. We have designed our study to evaluate whether an independent relationship exists between continuous glucose monitoring (CGM)-derived glucose metrics and OCTA parameters in young adult patients with type 1 diabetes without diabetic retinopathy (DR). Inclusion criteria were years, diagnosis of type 1 diabetes , stable insulin treatment in the last three months, use of real-time CGM, and CGM wear . Each patient underwent dilated slit lamp fundus biomicroscopy to exclude the presence of DR. A skilled operator performed OCTA scans in the morning to avoid possible diurnal variation. CGM-derived glucose metrics from the last 2 weeks were collected through the dedicated software during OCTA. Forty-nine patients with type 1 diabetes (age 29 [18; 39] years, HbA1c ) and 34 control subjects participated in the study. Vessel density (VD) of the whole image and parafoveal retina in the superficial (SCP) and deep capillary plexus (DCP) was significantly lower in patients with type 1 diabetes compared to controls. The coefficient of variation of average daily glucose, evaluated by CGM, significantly correlated with foveal and parafoveal VD in SCP and with foveal VD in DCP. High glucose variability might be responsible for the early increase of VD in these areas. Prospective studies may help understand if this pattern precedes DR. The difference we detected between patients with and without diabetes confirms that OCTA is a reliable tool for detecting early retinal abnormalities.