title: Differences in Glycemic Variability Between Normoglycemic and Prediabetic Subjects.
abstract: So far the criteria for NGT and abnormal glucose tolerance (AGT) are based on HbA1c and 75 g oGTT. We present data on GV and diurnal profiles in stratified cohorts with AGT versus controls. 28 NGT, 42 AGT (15 IGT, 11 IFG, 16 CGI) matched for age and BMI classified by 75 g oGTT underwent a CGM with test meal (TM). Diurnal profiles, glucose excursion after TM, and GV (SD, MAGE) were calculated for day 2 and 3. HbA1c, with its values of 5.5 ± 0.37% versus 5.65 ± 0.36%, was within normal range. Average interstitial glucose (AiG) was 5.84 ± 0.52 mmol/l) in NGT and 6.35 ± 0.65 mmol/l in AGT (P = .002). The 2 h incremental area under curve (iAUC) from TM until 2 h after TM was 1.94 ± 1.31 mmol/l*h versus 2.89 ( ± 1.75) mmol/l*h (P = .012), AiG 2 hours after TM was 5.99 ± 1.14 mmol/l*d versus 6.64 ± 1.30 mmol/l (P = .035). Peaks of AiG after TM were 7.69 ± 1.48 mmol/l*d versus 9.18 ± 1.67 mmol/l*d (P = .001). SD was significantly higher for AGT (1.12 ± 0.37 vs. 0.85 ± 0.32 mmol/l, P = .01) and MAGE 2.26 ± 0.84 vs. 1.60 ± 0.69 mmol/l, P = .005). In this comparative analysis NGT and AGT well matched for age, BMI, and comorbidities, CGM revealed significant differences in daytime AiG, pp glucose excursion and postprandial peaks. SD and MAGE was significantly higher for subjects with AGT. I Impaired glucose homeostasis a better characterizes degree of AGTe than HbA1c and 75 g OGTT.
authors.affiliation: Study Centre Prof. Hanefeld, GWT-TUD GmbH, Dresden, Germany hanefeld@gwtonline-zks.de.
authors.forename: Markolf
authors.initials: M
authors.lastname: Hanefeld
authors.affiliation: Study Centre Prof. Hanefeld, GWT-TUD GmbH, Dresden, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sulk
authors.affiliation: Study Centre Prof. Hanefeld, GWT-TUD GmbH, Dresden, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Helbig
authors.affiliation: Medtronic GmbH Germany, Diabetes Division, PF, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Study Centre Prof. Hanefeld, GWT-TUD GmbH, Dresden, Germany.
authors.forename: Carsta
authors.initials: C
authors.lastname: Köhler
keywords: HbA1c; continuous glucose monitoring; glucose homeostasis; glycemic variability; normal glucose tolerance; prediabetes