Beyond Scalar Metrics: Functional Data Analysis of Postprandial Continuous Glucose Monitoring in the AEGIS Study.

Postprandial glucose collected through continuous glucose monitoring (CGM) provides critical information for assessing metabolic capacity and guiding dietary recommendations. Traditional approaches summarize these data into scalar measures, such as 2-hour AUC or peak glucose, potentially overlooking temporal dynamics. We propose analyzing entire CGM trajectories using multilevel functional data analysis (FDA), which accounts for the smooth, hierarchical nature of glucose responses. Applying these methods to AEGIS study participants without diabetes, we illustrate how FDA characterizes variability in postprandial responses and links dietary/patient characteristics to glucose dynamics. We further extend the R² metric to hierarchical functional models to quantify explanatory power. Our results show that dietary effects vary across the 6-hour postprandial window-for example, fiber blunts responses after 90 minutes, while fats reduce early rises within 50 minutes. Moreover, metabolic responses differ between normoglycemic and prediabetic individuals. These findings demonstrate that functional approaches reveal temporal and stratified insights into postprandial glucose regulation that scalar methods cannot capture.