Validity of continuous glucose monitoring for categorizing glycemic responses to diet : Implications for use in personalized nutrition
(2022) In American Journal of Clinical Nutrition 115(6). p.1569-1576- Abstract
Background: Continuous glucose monitor (CGM) devices enable characterization of individuals' glycemic variation. However, there are concerns about their reliability for categorizing glycemic responses to foods that would limit their potential application in personalized nutrition recommendations. Objectives: We aimed to evaluate the concordance of 2 simultaneously worn CGM devices in measuring postprandial glycemic responses. Methods: Within ZOE PREDICT (Personalised Responses to Dietary Composition Trial) 1, 394 participants wore 2 CGM devices simultaneously [n = 360 participants with 2 Abbott Freestyle Libre Pro (FSL) devices; n = 34 participants with both FSL and Dexcom G6] for ≤14 d while consuming standardized (n = 4457) and ad... (More)
Background: Continuous glucose monitor (CGM) devices enable characterization of individuals' glycemic variation. However, there are concerns about their reliability for categorizing glycemic responses to foods that would limit their potential application in personalized nutrition recommendations. Objectives: We aimed to evaluate the concordance of 2 simultaneously worn CGM devices in measuring postprandial glycemic responses. Methods: Within ZOE PREDICT (Personalised Responses to Dietary Composition Trial) 1, 394 participants wore 2 CGM devices simultaneously [n = 360 participants with 2 Abbott Freestyle Libre Pro (FSL) devices; n = 34 participants with both FSL and Dexcom G6] for ≤14 d while consuming standardized (n = 4457) and ad libitum (n = 5738) meals. We examined the CV and correlation of the incremental area under the glucose curve at 2 h (glucoseiAUC0-2 h). Within-subject meal ranking was assessed using Kendall τ rank correlation. Concordance between paired devices in time in range according to the American Diabetes Association cutoffs (TIRADA) and glucose variability (glucose CV) was also investigated. Results: The CV of glucoseiAUC0-2 h for standardized meals was 3.7% (IQR: 1.7%-7.1%) for intrabrand device and 12.5% (IQR: 5.1%-24.8%) for interbrand device comparisons. Similar estimates were observed for ad libitum meals, with intrabrand and interbrand device CVs of glucoseiAUC0-2 h of 4.1% (IQR: 1.8%-7.1%) and 16.6% (IQR: 5.5%-30.7%), respectively. Kendall τ rank correlation showed glucoseiAUC0-2h-derived meal rankings were agreeable between paired CGM devices (intrabrand: 0.9; IQR: 0.8-0.9; interbrand: 0.7; IQR: 0.5-0.8). Paired CGMs also showed strong concordance for TIRADA with a intrabrand device CV of 4.8% (IQR: 1.9%-9.8%) and an interbrand device CV of 3.2% (IQR: 1.1%-6.2%). Conclusions: Our data demonstrate strong concordance of CGM devices in monitoring glycemic responses and suggest their potential use in personalized nutrition.
(Less)
- author
- organization
- publishing date
- 2022-06
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- continuous glucose monitoring, diet, glycemic variability, meal responses, precision nutrition
- in
- American Journal of Clinical Nutrition
- volume
- 115
- issue
- 6
- pages
- 8 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:35134821
- scopus:85130256988
- ISSN
- 0002-9165
- DOI
- 10.1093/ajcn/nqac026
- language
- English
- LU publication?
- yes
- id
- 9eadb0d5-3d79-4b0f-ad15-2c217466ec2f
- date added to LUP
- 2022-12-29 09:35:11
- date last changed
- 2024-11-01 13:12:45
@article{9eadb0d5-3d79-4b0f-ad15-2c217466ec2f,
abstract = {{<p>Background: Continuous glucose monitor (CGM) devices enable characterization of individuals' glycemic variation. However, there are concerns about their reliability for categorizing glycemic responses to foods that would limit their potential application in personalized nutrition recommendations. Objectives: We aimed to evaluate the concordance of 2 simultaneously worn CGM devices in measuring postprandial glycemic responses. Methods: Within ZOE PREDICT (Personalised Responses to Dietary Composition Trial) 1, 394 participants wore 2 CGM devices simultaneously [n = 360 participants with 2 Abbott Freestyle Libre Pro (FSL) devices; n = 34 participants with both FSL and Dexcom G6] for ≤14 d while consuming standardized (n = 4457) and ad libitum (n = 5738) meals. We examined the CV and correlation of the incremental area under the glucose curve at 2 h (glucoseiAUC0-2 h). Within-subject meal ranking was assessed using Kendall τ rank correlation. Concordance between paired devices in time in range according to the American Diabetes Association cutoffs (TIRADA) and glucose variability (glucose CV) was also investigated. Results: The CV of glucoseiAUC0-2 h for standardized meals was 3.7% (IQR: 1.7%-7.1%) for intrabrand device and 12.5% (IQR: 5.1%-24.8%) for interbrand device comparisons. Similar estimates were observed for ad libitum meals, with intrabrand and interbrand device CVs of glucoseiAUC0-2 h of 4.1% (IQR: 1.8%-7.1%) and 16.6% (IQR: 5.5%-30.7%), respectively. Kendall τ rank correlation showed glucoseiAUC0-2h-derived meal rankings were agreeable between paired CGM devices (intrabrand: 0.9; IQR: 0.8-0.9; interbrand: 0.7; IQR: 0.5-0.8). Paired CGMs also showed strong concordance for TIRADA with a intrabrand device CV of 4.8% (IQR: 1.9%-9.8%) and an interbrand device CV of 3.2% (IQR: 1.1%-6.2%). Conclusions: Our data demonstrate strong concordance of CGM devices in monitoring glycemic responses and suggest their potential use in personalized nutrition.</p>}},
author = {{Merino, Jordi and Linenberg, Inbar and Bermingham, Kate M. and Ganesh, Sajaysurya and Bakker, Elco and Delahanty, Linda M. and Chan, Andrew T. and Capdevila Pujol, Joan and Wolf, Jonathan and Al Khatib, Haya and Franks, Paul W. and Spector, Tim D. and Ordovas, Jose M. and Berry, Sarah E. and Valdes, Ana M.}},
issn = {{0002-9165}},
keywords = {{continuous glucose monitoring; diet; glycemic variability; meal responses; precision nutrition}},
language = {{eng}},
number = {{6}},
pages = {{1569--1576}},
publisher = {{Oxford University Press}},
series = {{American Journal of Clinical Nutrition}},
title = {{Validity of continuous glucose monitoring for categorizing glycemic responses to diet : Implications for use in personalized nutrition}},
url = {{http://dx.doi.org/10.1093/ajcn/nqac026}},
doi = {{10.1093/ajcn/nqac026}},
volume = {{115}},
year = {{2022}},
}