Key result
Higher BMI links to worse glucose metrics versus normal BMI in CGM users.
Why the study?
Effective weight management and metabolic control prevent hyperglycemia complications, but real-world data on glucose metrics stratified by BMI are limited.
Is increasing BMI associated with worse continuous glucose monitoring metrics in participants of a weight loss program?
Cross-Sectional (n=3,019)
Is increasing BMI associated with worse continuous glucose monitoring metrics in participants of a weight loss program?
Continuous glucose monitoring metrics worsen with increasing BMI, suggesting CGM may detect early metabolic dysregulation before severe obesity develops.
Worsening CGM metrics with rising BMI may aid early detection; leaves open prospective validation before clinical adoption.
Introduction and Objective: Effective weight management and early metabolic control are important to prevent complications of hyperglycemia. There is limited real-world data on glucose metrics stratified by BMI. This cross-sectional analysis evaluates the relationship between BMI and glucose control in FreeStyle Libre (FSL) participants enrolled in Weight Watchers (WW). Methods: De-identified data from participants who connected FSL to WW were analyzed. The diabetes diagnosis status and medication usage of participants were unknown. Mean glucose (mg/dL), uGMI (%), TITR (%), TIR (%), TA120 (%), TA140 (%), and TA180 (%) were calculated from the first 14 days of glucose data for each user. Glucose metrics were stratified by BMI categories: Normal (18.5 - 24), Overweight (25 - 29), Obesity class 1 (30 - 34), class 2 (35 - 39), and class 3 (≥40). Group differences were evaluated by the Wilcoxon rank-sum test. Results: Participants (n = 3,019) from the United States were analyzed: 3.5% normal, 16.4% overweight, 27.6% obesity class 1, 24.5% class 2, and 28.1% class 3. Compared to the normal BMI group, obesity classes 1-3 showed statistically significant differences in mean glucose, GMI, TITR, TA120, and TA140 (Table 1). Conclusion: Glucose metrics worsened with increasing BMI, suggesting that CGM may detect early metabolic dysregulation before BMI ≥ 30, supporting its role in earlier risk stratification and personalized weight management interventions. Disclosure F.S. Quadri: Employee; Current; Abbott Diabetes. K. Boyd: Employee; Current; Weight Watchers. Consultant; Ended; Calibrate. C. Wysham: Advisory Panel; Current; Abbott Diabetes. Speaker's Bureau; Current; Abbott Diabetes. Research Support; Ended; AbbVie Inc., Bayer AG, Novo Nordisk. Speaker's Bureau; Current; Novo Nordisk. Advisory Panel; Current; Eli Lilly and Company. Research Support; Ended; Eli Lilly and Company. Speaker's Bureau; Current; Eli Lilly and Company. Stock/Shareholder; Current; Pendulum. Speaker's Bureau; Ended; MannKind Corporation. E. Silver: Employee; Current; WW International, Inc. Employee; Ended; Calibrate Health. J.B. Alkhaddo: Speaker's Bureau; Current; Lilly. Employee; Current; WW International, Inc. Stock/Shareholder; Current; Novo Nordisk. Consultant; Current; Maximus Appeal services. M.A. Frazzitta: Employee; Current; Abbott Diabetes. S. Rahman: Employee; Current; Abbott Diabetes.
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QUADRI et al. (2026) conducted a cross-sectional in Obesity and Glucose Control (n=3,019). Increasing BMI (Obesity classes 1-3) vs. Normal BMI (18.5 - 24) was evaluated on Differences in mean glucose, GMI, TITR, TA120, and TA140. Increasing BMI (obesity classes 1-3) was associated with statistically significant worsening in mean glucose, GMI, TITR, TA120, and TA140 compared to normal BMI among CGM users.
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