Skip to main content
NUTRITION 2024 Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Session: Nutrient-Gene Interactions/Precision Nutrition (Poster Theater Flash Session 5)

(PTFS05-05-24) Unreliable Glycemic Responses to Duplicate Meals Measured by Continuous Glucose Monitors in Adults Without Diabetes

Sunday, June 30, 2024
10:16 AM – 10:20 AM CT
Location:  Hall F1 (The Hub) - Poster Theater
PRAC

    Presenting Author(s)

  • Aaron Hengist, PhD (he/him/his)

    Postdoctoral Visiting Fellow
    NIDDK, National Institutes of Health
    Bethesda, Maryland, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • JO

    Jude A. Ong

    NIDDK, National Institutes of Health, United States

  • KM

    Katherine McNeel

    NIDDK, National Institutes of Health, United States

  • JG

    Juen Guo, PhD

    NIH/NIDDK
    Bethesda, Maryland, United States

  • Kevin D. Hall, PhD

    Senior Investigator
    NIDDK, NIH
    Bethesda, Maryland, United States

Objectives: To explore within-subject variability of continuous glucose monitor (CGM) responses to duplicate meals in an inpatient setting.

Methods: CGM data were collected in two controlled feeding studies (NCT03407053 and NCT03878108) in 30 participants without diabetes (n=15 female, n=15 male; mean±SD age 30±7 y, body mass index 27.6±6.3 kg/m2, body fat 31.9±9.9%) capturing 1056 meal responses in duplicate ~1 week apart from four dietary patterns. One study used two different CGMs (Abbott Freestyle Libre Pro and Dexcom G4 Platinum) whereas the other study used only Dexcom. We calculated the incremental area under the curve (iAUC) for each 2-h post-meal period and compared within-subject iAUCs using the same CGM for the duplicate meals using linear correlations, intra-class correlation coefficients (ICC), Bland-Altman analyses, and compared individual variability of glycemic responses to duplicate meals versus different meals using standard deviations (SDs).

Results: There were weak to moderate positive linear correlations between within-subject iAUCs for duplicate meals (Abbott r=0.47, p< 0.0001, Dexcom r=0.43, p< 0.0001), with low within-participant reliability indicated by ICC (Abbott 0.31, Dexcom 0.14). Bland-Altman analyses indicated wide limits of agreement (Abbott -31.3 to 31.5 mg/dL, Dexcom -30.8 to 30.4 mg/dL) but no significant bias of mean iAUCs for duplicate meals (Abbott 0.1 mg/dL, Dexcom -0.2 mg/dL). Individual variability of glycemic responses to duplicate meals was similar to that of different meals evaluated each diet week for both Abbott (SDduplicate = 10.7 mg/dL , SDweek1 =12.4 mg/dL, SDweek2 =11.6 mg/dL, p=0.38) and Dexcom (SDduplicate = 11.1 mg/dL, SDweek1 = 11.5 mg/dL, SDweek2 =11.9 mg/dL, p=0.60).

Conclusions: Individual postprandial CGM responses to duplicate meals were unreliable in adults without diabetes. Personalized diet advice based on CGM measurements in adults without diabetes requires more reliable methods involving aggregated repeated measurements.

Funding Sources: Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health