{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:10:26Z","timestamp":1789186226403,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditional management of type 2 diabetes mellitus (T2DM) and pre\u2010diabetes centres on HbA1c reduction, yet this single metric fails to capture glycaemic variability (GV)\u2014an independent driver of \u03b2\u2010cell dysfunction, endothelial damage, oxidative stress, inflammation and cardiovascular risk, even in the pre\u2010diabetes stage. Unlike existing reviews that focus predominantly on T2DM or HbA1c\u2010centric approaches, this perspective articulates a unified three\u2010pillar closed\u2010loop framework that integrates continuous glucose monitoring (CGM) across the entire pre\u2010diabetes\u2010to\u2010remission continuum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Perspective<\/jats:title>\n                    <jats:p>We synthesize evidence from prospective cohorts, mechanistic studies, randomized controlled trials and real\u2010world data to demonstrate that GV is a modifiable therapeutic target. CGM uniquely reveals dynamic glucose patterns invisible to HbA1c, enabling precise, real\u2010time interventions that improve time in range (TIR), reduce GV and hypoglycaemia and support the achievement of clinical remission (HbA1c &lt;48\u2009mmol\/mol (&lt;6.5%) without glucose\u2010lowering medication for \u22653\u2009months) in subsets of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CGM\u2010centred management of glycaemic stability offers a clinically actionable paradigm shift from static, average\u2010glucose control to dynamic, precision\u2010guided care. The proposed three\u2010pillar framework\u2014tiered personalized targets, data\u2010driven intelligent decision support and empowered patient\u2013clinician collaboration\u2014provides a structured roadmap grounded in current evidence. Long\u2010term outcomes in pre\u2010diabetes, cost\u2010effectiveness and global accessibility remain important areas for future investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70404","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:03:41Z","timestamp":1782450221000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond\n                    <scp>HbA1c<\/scp>\n                    : A\n                    <scp>CGM<\/scp>\n                    \u2010centred three\u2010pillar framework for glycaemic variability in pre\u2010diabetes and type 2 diabetes"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2141-0373","authenticated-orcid":false,"given":"Taoming","family":"Qian","sequence":"first","affiliation":[{"name":"Graduate School Heilongjiang University of Chinese Medicine  Harbin 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