Dataset Information

Effect of Exercise and Meals on Continuous Glucose Monitor Data in Healthy Individuals Without Diabetes.

ABSTRACT:

Objective

The aim of these analyses was to characterize the effect of exercise and meals on glucose concentrations in healthy individuals without diabetes.

Methods

Healthy individuals without diabetes (age ≥6 years) with nonobese body mass index were enrolled at 12 centers within the T1D Exchange Clinic Network. Participants wore a blinded Dexcom G6 for up to ten days. Throughout this sensor wear, participants completed a daily log indicating times and type of any exercise and start times of meals and snacks.

Results

A total of 153 participants (age 7-80 years) were included in the analyses. Exercise induced a mean change of -15 ± 18 mg/dL from baseline to nadir sensor glucose level. Mean nadir glucose concentration during nights following exercise days was 82 ± 11 mg/dL compared with 85 ± 11 mg/dL during nights following nonexercise days (P = .05). Mean change from baseline to nadir sensor glucose level during aerobic exercise was -15 ± 18 and -9 ± 12 mg/dL for resistance exercise (P = .25). Overnight nadir glucose during nights following aerobic and resistance exercise was 83 ± 12 and 76 ± 14 mg/dL, respectively (P = .25). Overall mean peak postprandial glucose per participant increased from 93 ± 10 mg/dL premeal to 130 ± 13 mg/dL with an average time to peak glucose per participant of 97 ± 31 minutes. Consumption of alcohol on the day prior did not impact overnight mean or nadir glucose.

Conclusion

The present analysis provides important data characterizing the effect of exercise and meals on glucose in healthy individuals without diabetes. These data provide a repository to which future therapies, whether pharmacologic or technologic, can be compared.

SUBMITTER: DuBose SN

PROVIDER: S-EPMC8120054 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundContinuous glucose monitors (CGMs) are being used to characterize postprandial glycemic responses and thereby provide personalized dietary advice to minimize glycemic excursions. However, the efficacy of such advice depends on reliable CGM responses.ObjectiveTo explore within-subject variability of CGM responses to duplicate meals in an inpatient setting.MethodsCGM data were collected in two controlled feeding studies (NCT03407053 and NCT03878108) in 30 participants without diabetes capturing 948 meal responses in duplicate ~1 week apart from three 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).ResultsThere were weak to moderate positive linear correlations between within-subject iAUCs for duplicate meals (Abbott r=0.47, p<0.0001, Dexcom r=0.40, p<0.0001), with low within-participant reliability indicated by ICC (Abbott 0.31, Dexcom 0.16). Bland-Altman analyses indicated wide limits of agreement (Abbott -31.4 to 31.5 mg/dL, Dexcom -32.3 to 31.6 mg/dL) but no significant bias of mean iAUCs for duplicate meals (Abbott 0.1 mg/dL, Dexcom -0.3 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, SDweek 1 =12.4 mg/dL, SDweek 2 =11.6 mg/dL, p=0.38) and Dexcom (SDduplicate = 11.8 mg/dL, SDweek 1 =12.2 mg/dL, SDweek 2 =12.4 mg/dL, p=0.80).ConclusionsIndividual 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.

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