Are standardized conditions needed for correct CGM data interpretation in subjects at early stages of glucose intolerance?

Abstract

Aim: The present study comparatively evaluated glucose variability (GV) parameters derived from both continuous glucose monitoring (CGM) performed under standard conditions for a 24-h period and under usual everyday conditions for a 14-day period in a high-risk population without diabetes.

Methods and results: Seventy five subjects: 14 with normal glucose tolerance (NGT; mean age 43.6 ± 10.7 years; BMI 30.5 ± 6.9 kg/m²), 19 with high 1-h postload glucose > 8.6 mmol/l (1hrOGTT; mean age 45.6 ± 8.9 years; BMI 33.7 ± 6.9 kg/m²), and 42 with isolated impaired glucose tolerance (iIGT; mean age 47.6 ± 11.8 years; BMI 31.0 ± 6.5 kg/m²), were enrolled. An OGTT was performed. CGM was performed with blinded FreeStyleLibrePro for 24 h under standard conditions and for the rest of the 14-day period under usual everyday conditions. GV parameters derived from both periods were compared. There was a significant increase in GV with worsening of glucose tolerance from NGT, to 1hrOGTT and iIGT, independently of the conditions. Our findings showed moderate to strong correlations among GV indices between the studied periods in the cohort and in the 1hrOGTT and iIGT groups. However, a significant difference was found in some of the GV parameters between the analyzed periods.

Conclusion: The trend in GV is independent of the conditions, under which CGM is performed, in subjects at early stages of glucose intolerance. Although its measurements to some extend differ in standard and everyday conditions, there is no need of standardized conditions for correct interpretation of GV indices in this population.