Glycemic variability assessed using continuous glucose monitoring in individuals without diabetes and associations with cardiometabolic risk markers: A systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis primarily synthesizing cross-sectional observational studies
PubMed 38401227 · doi:10.1016/j.clnu.2024.02.014
What was done
A systematic review and meta-analysis investigated associations between continuous glucose monitoring (CGM)-derived glycemic variability (measured for at least 24 hours) and cardiometabolic risk markers or outcomes in individuals without diabetes. Searches were conducted in PubMed/Medline, Embase, and Cochrane from inception through April 2022. Studies involving acute or critical illness were excluded. Two researchers conducted study selection, data extraction, and quality assessment, performing narrative synthesis and meta-analyses.
What was found
Across 71 included studies, the abstract reports directional findings without numerical values, pooled effect sizes, or confidence intervals. Multiple glycemic variability measures were higher in prediabetes compared to normal glucose tolerance and appeared inversely related to beta-cell function. Glycemic variability was not clearly associated with insulin sensitivity, fatty liver disease, adiposity, blood lipids, blood pressure, or oxidative stress. Glycemic variability was positively associated with the extent of atherosclerosis and cardiovascular events in populations with coronary disease.
Why it matters
This synthesis suggests that short-term glucose fluctuations outside diabetes are linked to beta-cell dysfunction and vascular disease rather than classical metabolic markers. It clarifies the scope of continuous glucose monitoring as an emerging risk-assessment tool.
Limits
The abstract reports no numerical effect sizes or total participant count. Most included studies were cross-sectional, precluding causal inference. Cardiovascular event associations were limited to individuals with pre-existing coronary disease rather than the general non-diabetic population.
Cited by
- supports Constant glucose spikes and crashes contribute to metabolic dysfunction and over time can progress to pre-diabetes.