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Shams Ali Baig College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Kashish Malhotra Department of Surgery, Rama Medical College Hospital and Research Centre, Hapur, Uttar Pradesh, India
Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Anagh Josh Banerjee College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Mukunth Kowsik College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Khushi Kumar College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Fazna Rahman College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Syeda Sabbah Batul College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Mohammed Faraaz Saiyed College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Vardhan Venkatesh College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Pranav Viswanath Iyer College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Punith Kempegowda Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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. This can be disadvantageous as most patients and healthcare professionals are not experienced in filtering this information. To ensure the dissemination of peer-reviewed, evidence-based medicine on YouTube®, Concise Medical Information Cines (CoMICs

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Henry Zelada Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA

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M Citlalli Perez-Guzman Internal Medicine Division of Endocrinology, Centro Médico ABC, Mexico City, Mexico

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Daniel R Chernavvsky Center for Diabetes Technology, University of Virginia, Charlottesville, Virginia, USA

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Rodolfo J Galindo Division of Endocrinology, Diabetes and Metabolism, University of Miami Miller School of Medicine. Miami, Florida, USA

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the widespread use of insulin sliding scales, a reactive approach to management, waiting for hyperglycemia to occur to correct it ( 1 , 2 ). As new evidence became available, the optimal management of hyperglycemia in the hospital evolved. The

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Xinge Tao Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China

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Yanbin Xue Computer Net Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Rui Niu Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China

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Wenjing Lu Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China

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Huayan Yao Computer Net Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Chunmei He Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China

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Bin Cui Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Changqin Liu Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
Xiamen Key Laboratory for Clinical Efficacy and Evidence-Based Research of Traditional Chinese Medicine, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
Fujian Province Key Laboratory of Diabetes Translational Medicine, The First Affiliated Hospital of Xiamen University, School of medicine, Xiamen University, Xiamen, China

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Database (SHLD) to provide new real-world evidence for the management and therapy of T2DM. Methods Data source Data in this study were extracted from SHLD, which included electronic health records (EHRs) for patients from 37 tertiary hospitals

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Jonathan Hazlehurst Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Bernard Khoo Endocrinology, Division of Medicine, University College London, London, UK

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Carolina Brito Lobato Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Medicine, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark

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Ibiyemi Ilesanmi Section of Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK

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Sally Abbott Department of Dietetics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

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Tin Chan Faculty of Medicine, Chinese University of Hong Kong, Hong Kong

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Sanesh Pillai Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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Kate Maslin School of Nursing and Midwifery, University of Plymouth, Plymouth, UK

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Sanjay Purkayastha Brunel University, London, UK
Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, UK

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Barbara McGowan Endocrinology, Guys’ and St Thomas’s NHS Foundation Trust, London, UK

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Rob Andrews University of Exeter Medical School, Exeter, UK

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Eveleigh Nicholson Portsmouth Hospitals University NHS Trust, Portsmouth, UK

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Katherine McCullough Royal Surrey County Hospital, Guildford, UK

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Lorraine Albon University Hospitals Sussex NHS Foundation Trust, Worthing, UK

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Rachel Batterham Endocrinology, Division of Medicine, University College London, London, UK

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Georgios K Dimitriadis King's College Hospital NHS Foundation Trust, London, UK

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Shareen Forbes BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK

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Gavin Bewick School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK

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Tricia M-M Tan Section of Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK

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events. As a result of this clinical evidence, bariatric surgery is more often considered as an option for the treatment of obesity and diabetes, as well as for other metabolic complications such as non-alcoholic fatty liver disease ( 1 ). Given the

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Rama Lakshman Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK

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Charlotte Boughton Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
Cambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, UK

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Roman Hovorka Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK

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such as Fiasp (Novo Nordisk) and Lyumjev (Eli Lilly) are now available. While these have only shown small overall benefits over standard insulin analogues when applied in HCL systems ( 68 , 69 ), there is evidence of reduced postprandial hyperglycaemia

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Ziting Liang Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Mengge Yang Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Changjuan Xu Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Rong Zeng Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Liang Dong Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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prospective studies showed that COPD appeared to be an important risk factor for the development of type 2 diabetes mellitus (T2DM) after adjusting for possible confounders ( 2 , 30 , 31 ). Recent evidence suggests that hyperglycemia could exacerbate the

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Xiaohui Qi Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Ping He Shanghai Hospital Link Center, Shanghai Hospital Development Center, Shanghai, China

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Huayan Yao Computer Net Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Huanhuan Sun Wonders Information Co. Ltd, Shanghai, China

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Jiying Qi Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Min Cao Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Bin Cui Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Guang Ning Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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because it is structurally modified ( 20 , 21 ). In addition to activating the insulin receptor cascade response, long-acting insulin analogs can also affect the IGF-1 receptor cascade response ( 22 ). And there is evidence from Alvaro’s study that IGF-1

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Zhenyu Liu Department of Clinical Medicine, Beijing Luhe Hospital, Capital Medical University, Tongzhou District, Beijing, China

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Huixi Kong Department of Clinical Medicine, Beijing Shijitan Hospital, Capital Medical University, Haidian District, Beijing, China

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Baoyu Zhang Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Tongzhou District, Beijing, China

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-line therapies worldwide ( 24 , 67 ). A study ( 70 ) ( n  = 29 patients with T2DM) with gliclazide reported no change in SUA levels. Similar results have been reported in another study ( 71 ). At present, the mechanism is unclear, and there is no evidence

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Kathryn Lingen Close Concerns, San Francisco, California, USA

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Talia Pikounis Close Concerns, San Francisco, California, USA

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Natalie Bellini University Hospitals, Cleveland, Ohio, USA

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Diana Isaacs Cleveland Clinic, Cleveland, Ohio, USA

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Insulin administration remains vital to the treatment of diabetes and although there have been advances in insulin delivery, evidence suggests that many people with diabetes on insulin therapy have suboptimal glycemic management. Recent advancements in insulin administration techniques include connected insulin devices, such as connected insulin pens and pen caps. In this review, we provide an overview of the literature on the use of connected insulin pens and pen caps to further elucidate the clinical benefits and drawbacks of these devices. We discuss the development of these devices, outlining the characteristics of insulin pens and pen caps with regulatory approvals. These devices have different features that can ease the burden of diabetes management, including automatic recording of insulin dose information, tracking of insulin-on-board, bolus calculators, and missed dose alerts. Despite the advantages of connected pens and pen caps, a small percentage of insulin users are currently using these devices, due to many factors, including lack of health-care professional awareness, initial training for prescribers, and setup of the device. Overcoming these barriers and publishing more data demonstrating the glycemic outcomes associated with these systems could improve diabetes management for people living with diabetes. As health-care systems become increasingly digital, connected insulin pens have the potential to allow a data-driven approach to diabetes management for people who are not interested in, cannot afford, or do not have intensive insulin regimens that might warrant use of insulin pumps or automated insulin delivery systems.

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Aliyu Tijani Jibril Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

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Ahmad Jayedi Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

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Sakineh Shab-Bidar Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

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supplementations. In addition, the estimates of the effect of ALA supplementation, including the certainty of the evidence for each estimate and the magnitude of the observed impact based on the minimal clinically important difference (MCID), have not been

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