Diabetes, especially Type 2, is usually monitored with simple lab tests like HbA1c. But new research shows these tests miss much of the story. A recent Nature Medicine study reveals that using multiple tools—like continuous glucose monitors, fitness trackers, food diaries, and even gut microbiome analysis—can give a much clearer view of blood sugar control and health risks (Carletti et al., 2025).
Ordinary diabetes tests only offer a snapshot, often missing important blood sugar spikes that happen after meals or overnight. That means some risks go undetected—especially variations that could help guide more personalized treatment decisions. The research team wanted to go further, capturing real-life data from everyday people to see how all these influences add up.
The study recruited over 1,100 Americans, splitting them into healthy, prediabetic, and Type 2 diabetes groups. Participants provided a wide range of information:
- Continuous glucose readings
- Food logging
- Activity and heart-rate data
- Sleep patterns
- Genetics and gut bacteria samples
Nearly half came from groups often left out of medical studies, making the findings more inclusive (Carletti et al., 2025).
Key Measurements and Main Results for Type 2 Diabetes
| Measurement | What It Shows | Main Results for T2D |
|---|---|---|
| Mean glucose level | Average blood sugar over time | Higher in T2D |
| Expected spike value | How high sugar spikes go after meals | Worse in T2D |
| Spike resolution time | How long it takes to return to normal after a spike | Longer in T2D |
| Time in hyperglycemia | Percentage of time spent above 150 mg/dL | Higher in T2D |
| Nocturnal hypoglycemia | Lowest blood sugars at night | Lower in T2D |
| Gut microbiome diversity | Healthiness of gut bacteria | Lower in T2D |
The results were clear:
- Type 2 diabetes brings longer, more dangerous blood sugar spikes, and more time spent in unhealthy ranges.
- Diverse gut bacteria correlate with better glucose control and fewer dangerous spikes.
- Lifestyle changes—like better sleep, more exercise, and improved nutrition—can really make a difference.
Most importantly, people with identical HbA1c scores could have very different health risks, showing why a “multimodal” approach matters.
Continuous tracking gives more accurate, day-to-day pictures of glucose control than periodic lab tests. This helps doctors and patients spot trouble sooner, tailor treatment, and adjust lifestyle habits for the best outcomes (Carletti et al., 2025).
This multimodal strategy could help catch diabetes and complications earlier, leading to better prevention and early intervention. With more personalized advice and digital tracking tools, the future of diabetes care looks more proactive and less one-size-fits-all.
Carletti, M., Pandit, J., Gadaleta, M., Chiang, D., Delgado, F., Quartuccio, K., Fernandez, B., Garay, J. A. R., Torkamani, A., Miotto, R., Rossman, H., Berk, B., Baca-Motes, K., Kheterpal, V., Segal, E., Topol, E. J., Ramos, E., & Quer, G. (2025). Multimodal AI correlates of glucose spikes in people with normal glucose regulation, pre-diabetes and type 2 diabetes. Nature Medicine. https://doi.org/10.1038/s41591-025-03849-7