863-P: In Patients without Diabetes, Glycemic Variability Derived from Continuous Glucose Monitoring (CGM) Data Relates to Hyperglycemia More Than Insulin Resistance

• Published in: Diabetes (New York, N.Y.) Vol. 69; no. Supplement_1
• Main Authors: ZHANG, YUAN, OLAWSKY, EVAN A., ALVEAR, ALISON C., EBERLY, LYNN E., CHOW, LISA S.
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01.06.2020
• Subjects: Blood glucose; Diabetes; Diabetes mellitus; Glucose; Glucose monitoring; Hyperglycemia; Insulin; Insulin resistance; Variability
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db20-863-P

In adults without diabetes, the relationship between CGM derived glycemic variability and glycemic measures is unknown. We hypothesized that greater dysglycemia will be associated with greater 2 week glycemic variability. Methods: Subjects without self-reported diabetes [n=22, 19F/3M, mean (SD): 44.8 (12.1) years, 34.4 (7.4) kg/m2, HbA1c: 5.5% (0.4) underwent 2 hr OGTT followed by 14 days of CGM (FreestyleLibrePro). Subjects were classified as either normal or dysglycemic using several glycemic measures [based on HbA1c, disposition index, HOMA-IR, Matsuda (Table1)]. Multiple assessments of glycemic variability were derived from CGM data (Table1). Results: Across all subjects, HbA1c significantly correlated with mean glucose, J-index, High blood glucose index and Area under the curve (r=0.4-0.5, p<0.05). HbA1c negatively correlated with Time in Range (70-99 mg/dl, r=-0.51, p<0.05). Glycemic variability measures did not correlate with HOMA-IR, Matsuda, or disposition index. Similar results were found when comparing glycemic variability measures between dysglycemia groups. Conclusion: In patients without diabetes, greater glycemic variability was associated with greater Hba1c. These findings support hyperglycemia rather than insulin resistance as the primary driver in glycemic variability in this population.