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In established type 1 diabetes, CGM-derived measures of glucose management, such as time in range, time above range, time below range and glycaemic variability, have become integral tools to optimise therapy, reduce episodes of hypoglycaemia and guide clinical decision-making. More recently, CGM has emerged as a promising tool to detect early hyperglycaemia and other glucose abnormalities in individuals with early-stage type 1 diabetes, for whom current screening and staging methods, including fasting glucose, HbA\n                    <jats:sub>1c<\/jats:sub>\n                    and the OGTT, remain limited by episodic sampling, participant burden and variable reproducibility. This review examines the rationale, evidence and practical considerations for integrating CGM into early-stage type 1 diabetes research and clinical frameworks. We discuss its potential to complement existing metabolic and immunological markers, as well as the technical, analytical and regulatory challenges that must be addressed for CGM to serve as a reliable tool for screening, staging and monitoring and as a clinical endpoint in early-stage type 1 diabetes.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical Abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s00125-026-06707-4","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T18:11:36Z","timestamp":1773079896000},"page":"1413-1431","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Continuous glucose monitoring as a tool in early-stage type 1 diabetes"],"prefix":"10.1007","volume":"69","author":[{"given":"Alice L. 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Allard Chair in Diabetes Research, the Blanch family, the Alberta Diabetes Institute and the Chan family. REJB, EBon, EBos, PG and JV are supported by European action for the Diagnosis of Early Non-clinical Type 1 diabetes For disease Interception (EDENT1FI). REJB additionally receives support from the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) and a JDRF\/Wellcome Strategic Award (4-SRA-2017-473-A-N; 107212\/A\/15\/Z). RS was supported by the Novo Nordisk UK Research Foundation through a research fellowship. EDENT1FI is supported by the Innovative Health Initiative Joint Undertaking (IHI JU) under grant agreement no 101132379. The JU receives support from the European Union\u2019s Horizon Europe research and innovation programme, the Leona M. and Harry B. Helmsley Charitable Trust, Breakthrough T1D, EFPIA, COCIR, Vaccines Europe EuropaBio and MedTech. Additional funding is provided to associated UK partners through the UK Research and Innovation (UKRI) Guarantee Fund. Views and opinions expressed are those of the author(s) only and do not necessarily reflect those of the European Union, the private members and contributing partners of the IHI JU, the NHS, the NIHR or the Department of Health or other aforementioned parties. The aforementioned parties cannot be held responsible for them.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"REJB reports receiving speaker honoraria from Eli Lilly and Springer Healthcare, sitting on the Novo Nordisk UK Foundation Research Selection Committee on a voluntary basis and acting as an independent advisor for Provent Bio, and has received speaking honoraria from Sanofi and Medscape that were donated to an education research fund. RS has received speaker honoraria for type 1 diabetes-related symposia sponsored by Sanofi. RMA is an employee and shareholder of Novo Nordisk A\/S. PG\u2019s institution has received grants from Novo Nordisk, Sanofi, Dexcom, Tandem, Medtronic, Abbott and Roche. In addition, PG has received consultancy fees from Abbott, Medtronic and Bayer; payments or honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing or educational events from Medtronic, Novo Nordisk, Abbott, Ypsomed, Vitalaire, Dexcom, Bayer and Insulet; support for attending meetings and\/or travel from Sanofi, Novo Nordisk, Medtronic and Roche; and payments for participation on advisory boards from Insulet, Dexcom, Tandem and Ypsomed. Additionally, PG\u2019s institution has received equipment including Dexcom CGMs for the ALERTT1 trial and Medtronic 780G devices for the CRISTAL trial from the respective sponsors. JV presented the EDENT1FI programme at the Medtronic industry symposium at the 61st Annual Meeting of the EASD in 2025. JV is a member of Sanofi\u2019s Advisory Committee for the BR1DGE programme. JV also serves on the Steering Committee of Sanofi\u2019s TH1NK Ahead initiative. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"All authors were responsible for drafting the article and reviewing it critically for important intellectual content. All authors approved the version to be published.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}