In recent years, the understanding of glycemic control has evolved beyond traditional measures such as fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). A study published in Diabetes Care investigates the potential of continuous glucose monitoring (CGM) to provide deeper insights into cardiometabolic risk factors (CMRFs) in individuals without diabetes.
What this study does not show
While the study highlights associations between CGM measures and CMRFs, it does not establish causation or the effectiveness of CGM in clinical practice for risk reduction.
The research involved 1,356 participants from the Framingham Heart Study, all of whom were free from prevalent diabetes or cardiovascular disease (CVD). Participants wore a blinded Dexcom G6 Pro CGM for up to 10 days, allowing researchers to assess glycemic profiles through various metrics, including binary classification of glycemic burden and variability.
Findings revealed that CGM measures were positively associated with 10-year CVD risk estimates and individual CMRFs. Notably, a 1 standard deviation increase in the percentage of time spent above 140 mg/dL was linked to a 2% increase in 10-year CVD risk estimates, as well as a 21-26% increase in the odds of hypertension and dyslipidemia. These associations persisted even after adjusting for traditional measures like FPG.
Moreover, the study found that glycemic profiles indicative of higher CGM dysglycemia often did not align with traditional definitions of glycemic status. For instance, while 48.1-84.2% of individuals classified as having prediabetes based on traditional measures were identified as having higher dysglycemia through CGM profiles, these profiles were associated with a 6-7% increase in 10-year CVD risk estimates, alongside poorer CMRFs.
These results suggest that CGM could offer valuable insights into cardiometabolic risk that are not captured by traditional glycemic measures. The ability to monitor continuous glucose dynamics may help identify individuals at risk for CVD earlier, allowing for more tailored interventions.
Evidence scorecard
- Analytic validity: Established
- Clinical validity: Established
- Clinical utility: Partial
This evidence is based on a primary research study involving human participants.