Back to Search Start Over

The northeast glucose drift: Stratification of post-breakfast dysglycemia among predominantly Hispanic/Latino adults at-risk or with type 2 diabetes.

Authors :
Barua S
Sabharwal A
Glantz N
Conneely C
Larez A
Bevier W
Kerr D
Source :
EClinicalMedicine [EClinicalMedicine] 2021 Dec 20; Vol. 43, pp. 101241. Date of Electronic Publication: 2021 Dec 20 (Print Publication: 2022).
Publication Year :
2021

Abstract

Background: There is minimal experience in continuous glucose monitoring (CGM) among underserved racial/ethnic minority populations with or at risk of type 2 diabetes (T2D), and therefore a lack of CGM-driven insight for these individuals. We analyzed breakfast-related CGM profiles of free-living, predominantly Hispanic/Latino individuals at-risk of T2D, with pre-T2D, or with non-insulin treated T2D.<br />Methods: Starting February 2019, 119 participants in Santa Barbara, CA, USA, (93 female, 87% Hispanic/Latino [predominantly Mexican-American], age 54·4 [±12·1] years), stratified by HbA <subscript>1c</subscript> levels into (i) at-risk of T2D, (ii) with pre-T2D, and (iii) with non-insulin treated T2D, wore blinded CGMs for two weeks. We compared valid CGM profiles from 106 of these participants representing glucose response to breakfast using four parameters.<br />Findings: A "northeast drift" was observed in breakfast glucose responses comparing at-risk to pre-T2D to T2D participants. T2D participants had a significantly higher pre-breakfast glucose level, glucose rise, glucose incremental area under the curve (all p  < 0·0001), and time to glucose peak ( p  < 0·05) compared to pre-T2D and at-risk participants. After adjusting for demographic and clinical covariates, pre-breakfast glucose and time to peak ( p  < 0·0001) were significantly associated with HbA <subscript>1c</subscript> . The model predicted HbA <subscript>1c</subscript> within (0·55 ± 0·67)% of true laboratory HbA <subscript>1c</subscript> values.<br />Interpretation: For predominantly Hispanic/Latino adults, the average two-week breakfast glucose response shows a progression of dysglycemia from at-risk of T2D to pre-T2D to T2D. CGM-based breakfast metrics have the potential to predict HbA <subscript>1c</subscript> levels and monitor diabetes progression.<br />Funding: US Department of Agriculture (Grant #2018-33800-28404), a seed grant from the industry board fees of the NSF Engineering Research Center for Precise Advanced Technologies and Health Systems for Underserved Populations (PATHS-UP) (Award #1648451), and the Elsevier foundation.<br />Competing Interests: DK reports non-financial support from Abbott Diabetes Care, during the conduct of the study; grants from Lilly, personal fees from Sanofi, personal fees from NovoNordisk, personal fees from Glooko, outside the submitted work. NG, CC, AL, and WB report non-financial support from Abbott Diabetes Care, grants from US Dept of Agriculture, during the conduct of the study; grants from Lilly, outside the submitted work. SB and AS declare no competing interest(s).<br /> (© 2021 The Author(s).)

Details

Language :
English
ISSN :
2589-5370
Volume :
43
Database :
MEDLINE
Journal :
EClinicalMedicine
Publication Type :
Academic Journal
Accession number :
34988413
Full Text :
https://doi.org/10.1016/j.eclinm.2021.101241