Temporal Changes in Continuous Glucose Monitoring Profiles in Health Care Workers Participating in a Digitally Delivered Metabolic Wellness Program

Background: Health care workers face elevated cardiometabolic risks due to irregular hours and chronic stress, yet targeted interventions are limited. This study evaluated an 8-week digital Metabolic Wellness Program (MWP), combining lifestyle education with real-time continuous glucose monitoring (CGM). Methods: One hundred health care workers and dependents within a California health care system completed the MWP and were stratified by baseline time in tight range (TITR) 70 to 140 mg/dL. Continuous glucose monitoring (CGM)-derived metrics (average glucose [AG], glycemia risk index [GRI], time in range [TIR] 70-180 mg/dL, TITR, coefficient of variation [CV]) were evaluated via static pre-post comparison. These were supplemented by novel temporal change metrics: mean change index (MCI, average daily change relative to baseline) and improvement consistency index (ICI, % days with improvement). Engagement and behavioral changes were also assessed. Results: Static pre-post comparisons of CGM-derived metrics showed no significant glycemic changes cohort-wide or within TITR strata. However, temporal change metrics revealed improvements across participants. The low TITR (<70%) Group showed comprehensive improvements: AG (MCI −17.2 mg/dL), GRI (MCI −15.3), CV (MCI −3.2%), TIR (MCI 8.5%), and TITR (MCI 8.8%), with consistent improvements in GRI (ICI 72.1%), TIR (ICI 70.5%), and CV (ICI 73.3%), all P < .05. The high TITR (≥90%) group improved CV (MCI −1.6%, ICI 69.5%, P < .001). Metabolic Wellness Program engagement was associated with positive behavioral changes ( P < .001), which were correlated with improved temporal change metrics (eg, TIR MCI: r = 0.31, P < .05). Conclusions: While static CGM metrics remained unchanged, MWP participation was associated with significant behavioral and temporal glycemic improvements, particularly among those with lower baseline TITR. Long-term sustainability warrants further investigation.