The effect of continuous glucose monitoring feedback on glycaemic variability in youth with obesity: A within-participant feasibility study.

Abstract

Background: Continuous glucose monitors (CGM) offer real-time biofeedback that might support behavioural changes to reduce obesity in youth. However, the feasibility and acceptability of CGM in this population remain underexplored.

Methods: A 6-week crossover trial was conducted with youth aged 10-18 years with a body mass index above the 95th percentile. Participants experienced two phases in random order: (1) masked CGM (without data access) and (2) unmasked CGM (with real-time data access). The primary objective was to assess feasibility through recruitment, retention and adherence rates. Secondary measures included CGM-derived glucose metrics, sleep patterns, dietary intake, physical activity, eating behaviours and weight change. Descriptive analyses and mixed-effects regression models were used to examine between-condition differences on an intention-to-treat basis.

Results: Of 30 eligible participants, 27 were enrolled (90% recruitment rate; age: 14.5 ± 2.2 years, HbA1c: 5.5 ± 0.24%, 15/27 [55%] Hispanic, 16/27 [59%] female). Of the enrolled participants, 24 completed the protocol. Adherence averaged 35.1 days over 42 days (87% of days). The CGM was well tolerated, with no adverse effects reported. There was no significant difference in glycaemic variability metrics between masked and unmasked conditions over the 6-week period.

Conclusions: This trial supports the feasibility and acceptability of CGM use in youth with obesity. Given the exploratory nature of this study, longer-term research is needed to evaluate its effectiveness in modifying health behaviours and metabolic outcomes in this population.