Introduction and Objective: Over-the-counter continuous glucose monitors (CGMs) help users understand how food impacts glucose, supporting behavior change to improve glycemia. This study assessed the relationship between food tracking behavior and clinically meaningful glycemic improvements among individuals with hyperglycemia using real-world data. Methods: People with hyperglycemia who wore six Lingo CGMs over 65-135 days were grouped by frequency of food tracking (50% vs ≤50% sensor days). Clinically meaningful improvement was defined as ≥14 mg/dL reduction in mean glucose or ≥ 5% reduction in time above 140 mg/dL (TA140) between the first and sixth sensor. Relationships between logging frequency and glycemic improvements were assessed with logistic regression odds ratios (OR) adjusting for demographics for those with first sensor mean glucose 117-140 mg/dL and, separately, 140 mg/dL. Results: More frequent food trackers (50% sensor days) with first sensor mean glucose 117-140 mg/dL (n=115 of 992) were nearly twice as likely to see meaningful reductions in mean glucose (30 vs 19%, OR=1.9 1.2, 3.0) and TA140 (55 vs 42%, OR=1.7 1.2, 2.6). In more and less frequent trackers, respectively, mean glucose reduced by 7 (14) and 1 (20) mg/dL (p 0.001) and TA140 decreased by 6 (13) and increased by 2 (19) % (p 0.001). Among those with first sensor mean glucose 140 mg/dL, more frequent trackers (n=30 of 662) had no statistical difference in odds of improvement or reduction of mean glucose (53 vs 41%, OR=1.7 0.8,3.5; 23 (36) vs 11 (40) mg/dL, p = 0.097), but had significantly greater reductions in TA140 (70 vs 54%, OR=2.0 0.9, 4.3; 23 (30) vs 12 (26)%, p = 0.028). Conclusion: These data are among the first to demonstrate a relationship between food tracking and improved CGM metrics of glycemia in real-world users with hyperglycemia. These findings suggest people may be encouraged to track foods while wearing a CGM, as this may facilitate better understanding of the relative impact of different foods on glucose to inform future decisions. Disclosure A. McKenzie: Employee; Current; Abbott. Stock/Shareholder; Current; Abbott, Virta Health Corp. A.J. Wilk: Employee; Current; Abbott Diagnostics.
McKenzie et al. (Fri,) studied this question.