Differences in Glycemic Variability Between Normoglycemic and Prediabetic Subjects

Abstract

So far the criteria for NGT and abnormal glucose tolerance (AGT) are based on HbA1c and 75 g oGTT. We present data on GV and diurnal profiles in stratified cohorts with AGT versus controls. 28 NGT, 42 AGT (15 IGT, 11 IFG, 16 CGI) matched for age and BMI classified by 75 g oGTT underwent a CGM with test meal (TM). Diurnal profiles, glucose excursion after TM, and GV (SD, MAGE) were calculated for day 2 and 3. HbA1c, with its values of 5.5 ± 0.37% versus 5.65 ± 0.36%, was within normal range. Average interstitial glucose (AiG) was 5.84 ± 0.52 mmol/l) in NGT and 6.35 ± 0.65 mmol/l in AGT (P = .002). The 2 h incremental area under curve (iAUC) from TM until 2 h after TM was 1.94 ± 1.31 mmol/l*h versus 2.89 ( ± 1.75) mmol/l*h (P = .012), AiG 2 hours after TM was 5.99 ± 1.14 mmol/l*d versus 6.64 ± 1.30 mmol/l (P = .035). Peaks of AiG after TM were 7.69 ± 1.48 mmol/l*d versus 9.18 ± 1.67 mmol/l*d (P = .001). SD was significantly higher for AGT (1.12 ± 0.37 vs. 0.85 ± 0.32 mmol/l, P = .01) and MAGE 2.26 ± 0.84 vs. 1.60 ± 0.69 mmol/l, P = .005). In this comparative analysis NGT and AGT well matched for age, BMI, and comorbidities, CGM revealed significant differences in daytime AiG, pp glucose excursion and postprandial peaks. SD and MAGE was significantly higher for subjects with AGT. I Impaired glucose homeostasis a better characterizes degree of AGTe than HbA1c and 75 g OGTT.

Keywords: HbA1c; continuous glucose monitoring; glucose homeostasis; glycemic variability; normal glucose tolerance; prediabetes.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Andreas Thomas is employee of Medtronic GmbH.

© 2014 Diabetes Technology Society.

Figures

Figure 1.

Average interstitial glucose over 24 hours in subjects with normal glucose tolerance (NGT) and abnormal glucose tolerance (AGT) at day 2 of measurement.