Cargando…

Glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes

BACKGROUND: Continuous glucose monitors (CGMs) provide high-frequency information regarding daily glucose variation and are recognised as effective for improving glycaemic control in individuals living with diabetes. Despite increased use in individuals with non-diabetic blood glucose concentrations...

Descripción completa

Detalles Bibliográficos
Autores principales: Bermingham, Kate M., Smith, Harry A., Gonzalez, Javier T., Duncan, Emma L, Valdes, Ana M., Franks, Paul W., Delahanty, Linda, Dashti, Hassan S., Davies, Richard, Hadjigeorgiou, George, Wolf, Jonathan, Chan, Andrew T., Spector, Tim D., Berry, Sarah E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Journal Experts 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635370/
https://www.ncbi.nlm.nih.gov/pubmed/37961419
http://dx.doi.org/10.21203/rs.3.rs-3469475/v1
_version_ 1785146334730256384
author Bermingham, Kate M.
Smith, Harry A.
Gonzalez, Javier T.
Duncan, Emma L
Valdes, Ana M.
Franks, Paul W.
Delahanty, Linda
Dashti, Hassan S.
Davies, Richard
Hadjigeorgiou, George
Wolf, Jonathan
Chan, Andrew T.
Spector, Tim D.
Berry, Sarah E.
author_facet Bermingham, Kate M.
Smith, Harry A.
Gonzalez, Javier T.
Duncan, Emma L
Valdes, Ana M.
Franks, Paul W.
Delahanty, Linda
Dashti, Hassan S.
Davies, Richard
Hadjigeorgiou, George
Wolf, Jonathan
Chan, Andrew T.
Spector, Tim D.
Berry, Sarah E.
author_sort Bermingham, Kate M.
collection PubMed
description BACKGROUND: Continuous glucose monitors (CGMs) provide high-frequency information regarding daily glucose variation and are recognised as effective for improving glycaemic control in individuals living with diabetes. Despite increased use in individuals with non-diabetic blood glucose concentrations (euglycemia), their utility as a health tool in this population remains unclear. OBJECTIVES: To characterise variation in time in range (TIR) and glycaemic variability in large populations without diabetes or impaired glucose tolerance; describe associations between CGM-derived glycaemic metrics and metabolic and cardiometabolic health traits; identify key diet and lifestyle factors associated with TIR and glycaemic variability. DESIGN: Glycaemic variability (coefficient of variation) and time spent in both the ADA secondary target range (TIR(ADA); 3.9–7.8 mmol/L) and a more stringent range (TIR(3.9–5.6); 3.9–5.6 mmol/L) were calculated during free-living in PREDICT 1, PREDICT 2, and PREDICT 3 euglycaemic community-based volunteer cohorts. Associations between CGM derived glycaemic metrics, markers of cardiometabolic health, diet (food frequency questionnaire and logged diet records), diet-habits, and lifestyle were explored. RESULTS: Data from N=4135 participants (Mean SD; Age: 47 12 y; Sex: 83% Female, BMI: 27 6 kg/m(2)). Median glycaemic variability was 14.8% (IQR 12.6–17.6%), median TIR(ADA) was 95.8% (IQR 89.6–98.6%) and TIR(3.9–5.6) was 75.0% (IQR 64.6–82.8%). Greater TIR(3.9–5.6) was associated with lower HbA1c, ASCVD 10y risk and HOMA-IR (all p < 0.05). Lower glycaemic variability was associated with lower % energy derived from carbohydrate (r(s): 0.17, p < 0.01), ultra-processed foods (NOVA 4, % EI; r(s): 0.12, p = 0.01) and a longer overnight fasting duration (r(s): −0.10, p = 0.01). CONCLUSIONS: A stringent TIR target provides sensitivity to detect changes in HOMA-IR, ASCVD 10 y risk and HbA1c that were not detected using ADA secondary targets. Associations among TIR, glycaemic variability, dietary intake (e.g. carbohydrate and protein) and habits (e.g. nocturnal fasting duration) highlight potential strategic targets to improve glycaemic metrics derived from continuous glucose monitors.
format Online
Article
Text
id pubmed-10635370
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher American Journal Experts
record_format MEDLINE/PubMed
spelling pubmed-106353702023-11-13 Glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes Bermingham, Kate M. Smith, Harry A. Gonzalez, Javier T. Duncan, Emma L Valdes, Ana M. Franks, Paul W. Delahanty, Linda Dashti, Hassan S. Davies, Richard Hadjigeorgiou, George Wolf, Jonathan Chan, Andrew T. Spector, Tim D. Berry, Sarah E. Res Sq Article BACKGROUND: Continuous glucose monitors (CGMs) provide high-frequency information regarding daily glucose variation and are recognised as effective for improving glycaemic control in individuals living with diabetes. Despite increased use in individuals with non-diabetic blood glucose concentrations (euglycemia), their utility as a health tool in this population remains unclear. OBJECTIVES: To characterise variation in time in range (TIR) and glycaemic variability in large populations without diabetes or impaired glucose tolerance; describe associations between CGM-derived glycaemic metrics and metabolic and cardiometabolic health traits; identify key diet and lifestyle factors associated with TIR and glycaemic variability. DESIGN: Glycaemic variability (coefficient of variation) and time spent in both the ADA secondary target range (TIR(ADA); 3.9–7.8 mmol/L) and a more stringent range (TIR(3.9–5.6); 3.9–5.6 mmol/L) were calculated during free-living in PREDICT 1, PREDICT 2, and PREDICT 3 euglycaemic community-based volunteer cohorts. Associations between CGM derived glycaemic metrics, markers of cardiometabolic health, diet (food frequency questionnaire and logged diet records), diet-habits, and lifestyle were explored. RESULTS: Data from N=4135 participants (Mean SD; Age: 47 12 y; Sex: 83% Female, BMI: 27 6 kg/m(2)). Median glycaemic variability was 14.8% (IQR 12.6–17.6%), median TIR(ADA) was 95.8% (IQR 89.6–98.6%) and TIR(3.9–5.6) was 75.0% (IQR 64.6–82.8%). Greater TIR(3.9–5.6) was associated with lower HbA1c, ASCVD 10y risk and HOMA-IR (all p < 0.05). Lower glycaemic variability was associated with lower % energy derived from carbohydrate (r(s): 0.17, p < 0.01), ultra-processed foods (NOVA 4, % EI; r(s): 0.12, p = 0.01) and a longer overnight fasting duration (r(s): −0.10, p = 0.01). CONCLUSIONS: A stringent TIR target provides sensitivity to detect changes in HOMA-IR, ASCVD 10 y risk and HbA1c that were not detected using ADA secondary targets. Associations among TIR, glycaemic variability, dietary intake (e.g. carbohydrate and protein) and habits (e.g. nocturnal fasting duration) highlight potential strategic targets to improve glycaemic metrics derived from continuous glucose monitors. American Journal Experts 2023-10-30 /pmc/articles/PMC10635370/ /pubmed/37961419 http://dx.doi.org/10.21203/rs.3.rs-3469475/v1 Text en https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) , which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.
spellingShingle Article
Bermingham, Kate M.
Smith, Harry A.
Gonzalez, Javier T.
Duncan, Emma L
Valdes, Ana M.
Franks, Paul W.
Delahanty, Linda
Dashti, Hassan S.
Davies, Richard
Hadjigeorgiou, George
Wolf, Jonathan
Chan, Andrew T.
Spector, Tim D.
Berry, Sarah E.
Glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes
title Glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes
title_full Glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes
title_fullStr Glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes
title_full_unstemmed Glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes
title_short Glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes
title_sort glycaemic variability, assessed with continuous glucose monitors, is associated with diet, lifestyle and health in people without diabetes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635370/
https://www.ncbi.nlm.nih.gov/pubmed/37961419
http://dx.doi.org/10.21203/rs.3.rs-3469475/v1
work_keys_str_mv AT berminghamkatem glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT smithharrya glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT gonzalezjaviert glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT duncanemmal glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT valdesanam glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT frankspaulw glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT delahantylinda glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT dashtihassans glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT daviesrichard glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT hadjigeorgiougeorge glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT wolfjonathan glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT chanandrewt glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT spectortimd glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes
AT berrysarahe glycaemicvariabilityassessedwithcontinuousglucosemonitorsisassociatedwithdietlifestyleandhealthinpeoplewithoutdiabetes