Key result
Prediabetes linked to higher glycemic variability and 12% time above range versus normal glucose tolerance.
Why the study?
Glycemic variability assessed by continuous glucose monitoring is linked to cardiovascular disease in diabetes, but CGM indicators have been less well studied in prediabetes.
Does continuous glucose monitoring identify differences in glycemic variability between prediabetes subtypes and normal glucose tolerance?
Cross-Sectional (n=49)
Does continuous glucose monitoring identify differences in glycemic variability between prediabetes subtypes and normal glucose tolerance?
Continuous glucose monitoring reveals that individuals with prediabetes have significantly higher glycemic variability than those with normal glucose tolerance, despite similar mean glucose levels.
Answers are grounded in this paper and cite their sources.
Higher glycemic variability in prediabetes on CGM may identify at-risk individuals; leaves open prospective validation for cardiovascular outcomes.
Introduction and Objective: Continuous glucose monitoring (CGM) yields information on glycemic variability (GV) which is linked to cardiovascular disease (CVD) in diabetes. However, CGM indicators have been less well studied in prediabetes. Methods: 49 participants underwent a 2-hour oral glucose tolerance test (OGTT) and euglycemic insulin clamp and were subsequently divided into four groups based on their OGTT glucose profile: Normal Glucose Tolerance (NGT, n=6), Isolated Impaired Fasting Glucose (IFG, n=9), Isolated Impaired Glucose Tolerance (IGT, n=4), and Combined IFG and IGT (CGI, n=30). For 5 days, subjects wore a CGM device. Matsuda insulin sensitivity index and Beta-cell function (BCF) (ΔI/ΔG and ΔI/ΔG x Matsuda Index=Disposition Index) were calculated from OGTT. Results: From CGM, mean glucose was similar in prediabetes and NGT (98±16 vs 98±8 mg/dL). Peak glucose, standard deviation (SD), coefficient of variation (CV), and time above 140 mg/dL (TAR) were all significantly higher in prediabetes than NGT (151 vs 126 mg/dL; 16 vs 10 mg/dL; 0.16 vs 0.10; and 12 vs 0.2% respectively, all p<0.05). Glucose Infusion Rate during the insulin clamp and Disposition Index from OGTT progressively declined in a stepwise fashion from NGT to IFG to IGT to CGI (p<0.01). In the CGI subgroup, the mean CGM glucose correlated negatively with Disposition Index (r= -0.381, p<0.05). Conclusion: Glycemic variability indices can identify individuals with prediabetes even when mean glucose levels with CGM are normal. Higher CV may provide a metric that these individuals are at higher risk of progression to diabetes. The present findings may inform the design of future studies examining this relationship. Disclosure P. Mahapol: None. A. Merovci: None. S.V. Rosembarque: None. A.A. Hansis-Diarte: None. J.M. Adams: None. E. Cersosimo: None. M. Abdul-Ghani: None. R. Belfort DeAguiar: None. R.A. DeFronzo: Advisory Panel; Ended; AstraZeneca. Research Support; Current; AstraZeneca. Advisory Panel; Current; Novo Nordisk. Research Support; Current; Eli Lilly and Company. Advisory Panel; Current; Corcept Therapeutics. Speaker's Bureau; Current; Corcept Therapeutics. Consultant; Current; Alnylam Pharmaceuticals, Inc. Advisory Panel; Current; Regeneron Pharmaceuticals Inc., Aardvark. A.O. Chavez-Velazquez: Advisory Panel; Ended; Crinetics Pharmaceuticals, Inc.
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Mahapol et al. (2026) conducted a cross-sectional in Prediabetes (n=49). Prediabetes vs. Normal Glucose Tolerance was evaluated on Time above 140 mg/dL (TAR) (p=<0.05). Prediabetes was associated with significantly higher glycemic variability on continuous glucose monitoring compared to normal glucose tolerance, including a higher time above 140 mg/dL (12% vs 0.2%, p<0.05).
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