Dysglycemia In Adults At Risk For Or Living With Non-Insulin Treated Type 2 Diabetes: Insights From Continuous Glucose Monitoring

Background: Continuous glucose monitoring (CGM) has demonstrable benefits for people living with diabetes, but the supporting evidence is almost exclusively from White individuals with type 1 diabetes. Here, we have quantified CGM profiles in Hispanic/Latino adults with or at-risk of non-insulin treated type 2 diabetes (T2D).Methods: 100 participants (79 female, 86% Hispanic/Latino [predominantly Mexican], age 54.6 [+/- 12.0] years) stratified into (i) at risk of T2D, (ii) with pre-diabetes (pre-T2D), and (iii) with non-insulin treated T2D, wore blinded CGMs for 2 weeks. Beyond standardized CGM measures (average glucose, glucose variability, time in 70-140 mg/dL and 70-180 mg/dL ranges), we also examined additional CGM measures based on the time of day.Findings: Standardized CGM measures were significantly different for participants with T2D compared to at-risk and pre-T2D participants (p<0.0001). In addition, pre-T2D participants spent more time between 140 and 180 mg/dL during the day than at-risk participants (p<0.01). T2D participants spent more time between 140 and 180 mg/dL both during the day and overnight compared to at-risk and pre-T2D participants (both p<0.0001). Time in 70-140 mg/dL range during the day was significantly correlated with HbA(1c) (r=-0.72, p<0.0001), after adjusting for age, sex, BMI, and waist circumference (p<0.0001).Interpretation: Standardized CGM measures show a progression of dysglycemia from at-risk of T2D, to pre-T2D, and to T2D. Stratifying CGM readings by time of day and the range 140-180 mg/dL provides additional metrics to differentiate between the groups. (C) 2021 The Authors. Published by Elsevier Ltd.