BACKGROUND: High postprandial glucose excursions may increase risk for disease. Individuals have widely varying glucose responses to different meals, and precision nutrition approaches often seek to personalize diets to minimize postprandial glycemic responses as measured by continuous glucose monitors (CGMs). However, it is unknown whether different CGM devices result in concordant meal rankings according to postprandial glycemic excursions. OBJECTIVE: We explored whether meal rankings according to postprandial glycemic excursions differ between 2 simultaneously worn CGMs. METHODS: We collected 27,489 simultaneous measurements from Dexcom G4 Platinum and Abbott Freestyle Libre Pro CGMs during 28 inpatient days in 16 adults without diabetes. Simultaneous glucose measurements obtained for 2 h following 760 ad libitum meals were used to compare within-subject meal rankings between the CGM devices according to their incremental glucose response. RESULTS: Postprandial responses to ad libitum meals were highly variable, with the Abbott and Dexcom systems resulting in within-subject incremental mean ± SD glucose CVs of 91.7 ± 1.9% and 94.2 ± 2.7%, respectively. Within-subject meal rankings for incremental glycemic responses were relatively discordant between CGMs, with a mean Kendall rank correlation coefficient of 0.43 ± 0.05. Meals in the bottom compared with those in the top half of incremental glycemic responses ranked by Abbott resulted in 50 ± 10% (P = 0.0002) less glycemic reduction as measured by Dexcom, and vice versa. The missing glycemic reduction by eating meals ranked according to the discordant CGM was inversely correlated with each subject's Kendall rank correlation coefficient (r = -0.95; P < 0.0001). CONCLUSIONS: Precision nutrition approaches that use CGMs to personalize meal recommendations for minimizing glycemic excursions may be premature given the discordance of within-subject meal rankings between simultaneous CGM devices. More research is needed to clarify the source of this imprecision. This trial was registered at clinicaltrials.gov as NCT03407053. Published by Oxford University Press on behalf of the American Society for Nutrition 2020.
BACKGROUND: High postprandial glucose excursions may increase risk for disease. Individuals have widely varying glucose responses to different meals, and precision nutrition approaches often seek to personalize diets to minimize postprandial glycemic responses as measured by continuous glucose monitors (CGMs). However, it is unknown whether different CGM devices result in concordant meal rankings according to postprandial glycemic excursions. OBJECTIVE: We explored whether meal rankings according to postprandial glycemic excursions differ between 2 simultaneously worn CGMs. METHODS: We collected 27,489 simultaneous measurements from Dexcom G4 Platinum and Abbott Freestyle Libre Pro CGMs during 28 inpatient days in 16 adults without diabetes. Simultaneous glucose measurements obtained for 2 h following 760 ad libitum meals were used to compare within-subject meal rankings between the CGM devices according to their incremental glucose response. RESULTS: Postprandial responses to ad libitum meals were highly variable, with the Abbott and Dexcom systems resulting in within-subject incremental mean ± SD glucose CVs of 91.7 ± 1.9% and 94.2 ± 2.7%, respectively. Within-subject meal rankings for incremental glycemic responses were relatively discordant between CGMs, with a mean Kendall rank correlation coefficient of 0.43 ± 0.05. Meals in the bottom compared with those in the top half of incremental glycemic responses ranked by Abbott resulted in 50 ± 10% (P = 0.0002) less glycemic reduction as measured by Dexcom, and vice versa. The missing glycemic reduction by eating meals ranked according to the discordant CGM was inversely correlated with each subject's Kendall rank correlation coefficient (r = -0.95; P < 0.0001). CONCLUSIONS: Precision nutrition approaches that use CGMs to personalize meal recommendations for minimizing glycemic excursions may be premature given the discordance of within-subject meal rankings between simultaneous CGM devices. More research is needed to clarify the source of this imprecision. This trial was registered at clinicaltrials.gov as NCT03407053. Published by Oxford University Press on behalf of the American Society for Nutrition 2020.
Authors: Paul R Van Der Valk; Irene Van Der Schatte Olivier-Steding; Klaas-Jan C Wientjes; Adelbert J Schoonen; Klaas Hoogenberg Journal: Diabetes Care Date: 2002-11 Impact factor: 19.112
Authors: E E Blaak; J-M Antoine; D Benton; I Björck; L Bozzetto; F Brouns; M Diamant; L Dye; T Hulshof; J J Holst; D J Lamport; M Laville; C L Lawton; A Meheust; A Nilson; S Normand; A A Rivellese; S Theis; S S Torekov; S Vinoy Journal: Obes Rev Date: 2012-07-11 Impact factor: 9.213
Authors: Kevin D Hall; Alexis Ayuketah; Robert Brychta; Hongyi Cai; Thomas Cassimatis; Kong Y Chen; Stephanie T Chung; Elise Costa; Amber Courville; Valerie Darcey; Laura A Fletcher; Ciaran G Forde; Ahmed M Gharib; Juen Guo; Rebecca Howard; Paule V Joseph; Suzanne McGehee; Ronald Ouwerkerk; Klaudia Raisinger; Irene Rozga; Michael Stagliano; Mary Walter; Peter J Walter; Shanna Yang; Megan Zhou Journal: Cell Metab Date: 2019-05-16 Impact factor: 27.287
Authors: John M Ellison; Janet M Stegmann; Sandra L Colner; Ragui H Michael; Manoj K Sharma; Kenneth R Ervin; David L Horwitz Journal: Diabetes Care Date: 2002-06 Impact factor: 19.112
Authors: Marina Corrado; Jennifer H Ahn-Jarvis; Brendan Fahy; George M Savva; Cathrina H Edwards; Brittany A Hazard Journal: Food Funct Date: 2022-02-07 Impact factor: 5.396
Authors: Jordi Merino; Inbar Linenberg; Kate M Bermingham; Sajaysurya Ganesh; Elco Bakker; Linda M Delahanty; Andrew T Chan; Joan Capdevila Pujol; Jonathan Wolf; Haya Al Khatib; Paul W Franks; Tim D Spector; Jose M Ordovas; Sarah E Berry; Ana M Valdes Journal: Am J Clin Nutr Date: 2022-06-07 Impact factor: 8.472