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A systematic review found that while some RCTs show benefit, others do not

Some medical professionals studying this matter think that a rapid change in blood sugar levels could be the reason for the vision complications (according to a 2025 study)

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We proposed at 512.725(h)(4)(ii)(A) to consider significant changes or errors regarding instances in which a quality measure score could not be calculated as changes or errors external to the care provided, and that CMS determines may lead to misleading or inaccurate results that negatively impact the measure's ability to reliably assess performance

"I was literally throwing up four, five times a day and I thought, 'I can't do this.' So that's it."