## 4 Treatment Advancements
### Diabetes Treatments
Sensors are becoming more accurate and lasting longer, while minimally invasive options are being explored [112]. The future of CGM technology is looking even brighter with the development of implantable CGM systems. These small, biocompatible devices are inserted under the skin and can continuously monitor blood sugar levels for extended periods, typically ranging from 3 to 6 months [113; 114; 115]. CGM is also becoming more interconnected with other devices and cloud storage, allowing for better data sharing and remote monitoring by healthcare professionals [116; 117]. _Closed-loop insulin delivery systems:_ One of the most exciting advancements in diabetes management is the emergence of closed-loop insulin delivery systems, often referred to as \"artificial pancreas\" systems. These innovative devices integrate seamlessly with CGM technology. This closed-loop system mimics the natural function of a healthy pancreas, offering tighter blood sugar control, lowering the risk of hypoglycemia, and reducing the burden of constant monitoring and medication adjustments for patients [118; 119]. Whilea fully autonomous artificial pancreas remains under development, the achievements in closed-loop systems to date and the swift pace of innovation highlight the immense potential for this technology to revolutionize diabetes treatment. _Stem cell therapy_: Researchers are exploring various stem cell sources, including embryonic stem cells, induced pluripotent stem cells (iPSCs), and adult stem cells. iPSCs, derived from a patient's own skin cells and reprogrammed to an embryonic-like state, hold particular promise, as they can potentially reduce the risk of immune rejection [120, 121]. Despite the immense potential, there are significant challenges to overcome. Ethical considerations surrounding embryonic stem cells and the potential for tumor formation with certain types of stem cells require careful evaluation. Additionally, ensuring the long-term survival and function of transplanted stem cells within the body remains a hurdle [120, 122, 123]. With continued research and development, stem cell therapy has the potential to revolutionize diabetes treatment and ultimately lead to a cure. _Glycemic Variability (GV)_: Beyond absolute blood sugar levels, researchers are increasingly focusing on glycemic variability (GV), which refers to wide swings in blood sugar levels throughout the day. High GV is associated with an increased risk of diabetes complications, even if average blood sugar levels fall within the normal range. New technologies like CGM are facilitating the measurement of GV, allowing healthcare professionals to tailor treatment plans that not only focus on lowering blood sugar but also aim to minimize these harmful fluctuations [124, 125, 126]. _Hydrogels_: These three-dimensional networks of water and polymers are emerging as versatile materials for various diabetes management applications. Their biocompatibility and customizability allow for integration with glucose-sensitive enzymes in CGM sensors, the development of hydrogels responsive to blood sugar fluctuations for smart insulin delivery, the creation of moist wound-healing environments for diabetic foot ulcers, and the encapsulation of insulin-producing cells for cell transplantation therapies [127, 128, 129, 130]. The tailorable properties of hydrogels, including self-healing abilities, along with continuous advancements in incorporating biosensors, drug delivery mechanisms, and closed-loop systems, position them at the forefront of innovative diabetes treatment strategies. _Artificial intelligence (AI) and machine learning (ML)_: These technologies are revolutionizing diabetes management. AI algorithms can analyze CGM data to predict glucose levels and personalize insulin delivery in closed-loop systems. Additionally, ML holds promise for risk stratification, allowing for early intervention [39, 131, 132, 133, 134]. AI-powered virtual assistants and chatbots can further empower patients through education and medication reminders.