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June 7, 2026Diabetes

Prediabetes linked to higher glycemic variability and 12% time above range versus normal glucose tolerance.

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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?

Population

49 participants classified into NGT, IFG, IGT, and CGI groups

Comparison

Prediabetes subtypes (IFG, IGT, and CGI) vs Normal Glucose Tolerance

Follow-up

5 days

Key result

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).

Authors

PMPapanun MahapolAMAurora MerovciSRSAVIA V. ROSEMBARQUE

Discussion

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Overview

Higher glycemic variability in prediabetes on CGM may identify at-risk individuals; leaves open prospective validation for cardiovascular outcomes.

Key Points

  • The study aims to investigate glycemic variability in different prediabetes subtypes using continuous glucose monitoring.
  • 49 participants underwent a 2-hour oral glucose tolerance test and euglycemic insulin clamp.
  • Subjects were categorized into four groups based on OGTT glucose profiles: NGT, IFG, IGT, CGI.
  • Five days of continuous glucose monitoring were performed to assess glycemic variability indices.
  • CGM indicated that mean glucose levels were similar between prediabetes and NGT (98±16 vs 98±8 mg/dL).
  • Significantly higher peak glucose, SD, CV, and time above 140 mg/dL were found in prediabetes compared to NGT, all p<0.05.
  • In CGI, CGM mean glucose showed a negative correlation with Disposition Index (r= -0.381, p<0.05).

Study Design

Type

Cross-Sectional (n=49)

Structured PICO

Does continuous glucose monitoring identify differences in glycemic variability between prediabetes subtypes and normal glucose tolerance?

P
Population
49 participants with normal glucose tolerance or prediabetes who underwent a 2-hour oral glucose tolerance test, euglycemic insulin clamp, and 5 days of continuous glucose monitoring.
E
Exposure
Continuous glucose monitoring (CGM) for 5 days
C
Comparator
Normal Glucose Tolerance (NGT)
O
Outcome
Glycemic variability indices (mean glucose, peak glucose, standard deviation, coefficient of variation, and time above 140 mg/dL)surrogate

Main Result

Absolute Event Rate: 12% vs 0.2%

p-value: p=<0.05

Continuous glucose monitoring reveals that individuals with prediabetes have significantly higher glycemic variability than those with normal glucose tolerance, despite similar mean glucose levels.

Cite This Study

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).

synapsesocial.com/papers/6a250b2d7def13d035e1b361https://doi.org/10.2337/db26-1929-p
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 12184-P: CGM-Derived Measures in Relation to 10-Year CVD Risk in Adults without Diabetes2026
  2. 2Limited Discriminatory Capacity of Continuous Glucose Monitoring in Prediabetes and Increased Diabetes Risk: A Cross-Sectional Study2026
  3. 31138-P: Continuous Glucose Monitor (CGM)–Based Glycemic Variability Is Associated with Beta-Cell Function in Youth at Risk for Type 2 Diabetes2024
  4. 474-OR: ADA Presidents' Select Abstract: CGM Metrics from Five Studies Identify Participants at High Risk of Imminent Type 1 Diabetes (T1D) Development2024 · 1 citations
  5. 51952-P: Real-World Continuous Glucose Monitoring Profiles Individuals with Prediabetes2026