scholarly journals Impact of Lifestyle Behaviors on Postprandial Hyperglycemia during Continuous Glucose Monitoring in Adult Males with Overweight/Obesity but without Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3092
Author(s):  
Ichiro Kishimoto ◽  
Akio Ohashi
Keyword(s):  
Continuous Glucose Monitoring ◽  
Cell Function ◽  
Glucose Monitoring ◽  
Maximum Level ◽  
Postprandial Hyperglycemia ◽  
Disposition Index ◽  
Oral Glucose ◽  
Adult Males ◽  
Characteristic Analysis ◽  
Related Factors

Data regarding hyperglycemia-related factors were scarce in people without diabetes. Fifty males (age 50–65 years) with overweight/obesity but without diagnosis of diabetes were recruited. After excluding participants with the 2 h plasma glucose value during a 75 g oral glucose tolerance test ≥200 mg/dL, continuous glucose monitoring (CGM) was performed for 6 days. Subjects with ≥1800 CGM readings were included (n = 36). The CGM indices of hyperglycemia were significantly associated with disposition index and snacking frequency. In receiver-operating characteristic analysis for predicting the maximal CGM glucose ≥200 mg/dL, the area under curves of disposition index, snacking frequency, and minimal daily step counts during the study were 0.69, 0.63, and 0.68, whereas the cutoff values were 1.57, once daily, and 2499 steps, respectively. After adjustments, the lower disposition index (≤1.57), higher snacking frequency (≥1 per day), and lower minimal step (≤2499 steps per day) categories conferred 14.5, 14.5, and 6.6-fold increased probabilities for having the maximum level ≥ 200 mg/dL, respectively. In addition, the snacking habits were significantly associated with insulin resistance and compensatory hyperinsulinemia. In conclusion, in middle aged males with overweight/obesity but without diabetes, snacking and physical inactivity serve as the major drivers of postprandial hyperglycemia independently of β-cell function.

Full The Relationship between Continuous Glucose Monitoring and OGTT in Youth and Young Adults with Cystic Fibrosis

2021 ◽  
Author(s):  
Christine L Chan ◽  
Laura Pyle ◽  
Tim Vigers ◽  
Philip S Zeitler ◽  
Kristen J Nadeau
Keyword(s):  
Cystic Fibrosis ◽  
Continuous Glucose Monitoring ◽  
Cell Function ◽  
Glucose Monitoring ◽  
Oral Glucose ◽  
Β Cell ◽  
Oral Glucose Tolerance Testing ◽  
C Peptide ◽  
Β Cell Function ◽  
The Relationship

Abstract Context Early glucose abnormalities in people with CF (PwCF) are commonly detected by continuous glucose monitoring (CGM). Relationships between these CGM abnormalities and oral glucose tolerance testing (OGTT) in PwCF have not been fully characterized. Objective(s) 1) To determine the relationship between CGM and common OGTT-derived estimates of β-cell function, including C-peptide index and oral disposition index (oDI) and 2) to explore whether CGM can be used to screen for OGTT-defined prediabetes and cystic fibrosis related diabetes (CFRD). Study Design/Methods PwCF not on insulin and healthy controls ages 6-25 yrs were enrolled in a prospective study collecting OGTT and CGM. A subset underwent frequently-sampled OGTTs (fsOGTT) with 7-point glucose, insulin, and C-peptide measurements. Pearson’s correlation coefficient was used to test the association between select CGM and fsOGTT measures. ROC analysis was applied to CGM variables to determine the cutoff optimizing sensitivity and specificity for detecting prediabetes and CFRD. Results A total of 120 participants (controls=35, CF=85), including 69 with fsOGTTs, were included. CGM coefficient of variation correlated inversely with C-peptide index (Cpeptide30-Cpeptide0/Glucose30-Glucose0) (r=-0.45, p<0.001) and oDIcpeptide (C-peptide index)(1/cpep0) (r=-0.48, p<0.0001). In PwCF, CGM variables had ROC-AUCs ranging from 0.43-0.57 for prediabetes and 0.47-0.6 for CFRD. Conclusions Greater glycemic variability on CGM correlated with reduced β-cell function. However, CGM performed poorly at discriminating individuals with and without OGTT-defined CFRD and prediabetes. Prospective studies are now needed to determine how well the different tests predict clinically-relevant non-glycemic outcomes in PwCF.

scholarly journals Evaluation of Reference Metrics for Continuous Glucose Monitoring in Persons Without Diabetes and Prediabetes

2020 ◽  
pp. 193229682096559
Author(s):  
Sheyda Sofizadeh ◽  
Anders Pehrsson ◽  
Arndís F. Ólafsdóttir ◽  
Marcus Lind
Keyword(s):  
Clinical Practice ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Glucose Lowering ◽  
Glucose Levels ◽  
Deviation Coefficient

Background: Recent guidelines have been developed for continuous glucose monitoring (CGM) metrics in persons with diabetes. To understand what glucose profiles should be judged as normal in clinical practice and glucose-lowering trials, we examined the glucose profile of healthy individuals using CGM. Methods: Persons without diabetes or prediabetes were included after passing a normal oral glucose tolerance test, two-hour value <8.9 mmol/L (160 mg/dL), fasting glucose <6.1 mmol/L (110 mg/dL), and HbA1c <6.0% (<42 mmol/mol). CGM metrics were evaluated using the Dexcom G4 Platinum. Results: In total, 60 persons were included, mean age was 43.0 years, 70.0% were women, mean HbA1c was 5.3% (34 mmol/mol), and mean body mass index was 25.7 kg/m2. Median and mean percent times in hypoglycemia <3.9 mmol/L (70 mg/dL) were 1.6% (IQR 0.6-3.2), and 3.2% (95% CI 2.0; 4.3), respectively. For glucose levels <3.0 mmol/L (54 mg/dL), the corresponding estimates were 0.0% (IQR 0.0-0.4) and 0.5% (95% CI 0.2; 0.8). Median and mean time-in-range (3.9-10.0 mmol/L [70-180 mg/dL]) was 97.3% (IQR 95.4-98.7) and 95.4% (95% CI 94.0; 96.8), respectively. Median and mean standard deviations were 1.04 mmol/L (IQR 0.92-1.29) and 1.15 mmol/L (95% CI 1.05; 1.24), respectively. Measures of glycemic variability (standard deviation, coefficient of variation, mean amplitude of glycemic excursions) were significantly greater during daytime compared with nighttime, whereas others did not differ. Conclusions: People without prediabetes or diabetes show a non-negligible % time in hypoglycemia, median 1.6% and mean 3.2%, which needs to be accounted for in clinical practice and glucose-lowering trials. Glycemic variability measures differ day and night in this population.

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