Endocrine Abstracts

JOINT770

Background: Continuous Glucose Monitoring Systems (CGMS) have revolutionized the detection of glycemic abnormalities, providing detailed insights into glucose variability, especially in obese populations.

Objective: To evaluate the benefits of CGMS in diagnosing and managing glycemic abnormalities in obese individuals with normal fasting glucose, impaired fasting glucose, or other glucose tolerance abnormalities.

Methods: A comprehensive review of CGMS studies from 2000 to 2024 was conducted. Studies were selected based on their focus on obese children, adolescents, and adults with normal or impaired fasting glucose. Outcomes assessed include the detection of postprandial hyperglycemia, glycemic variability, nocturnal hypoglycemia, and overall glucose profiles.

Results: CGMS has demonstrated significant benefits across multiple studies:.

1. Enhanced Detection: CGMS uncovered glycemic abnormalities in up to 30% of individuals with normal fasting glucose, including postprandial hyperglycemia and nocturnal-hypoglycemia, which were undetectable by fasting glucose or HbA1c measurements.

2. Identification of Glycemic Variability: Approximately 45% of subjects with normal glucose tolerance exhibited significant glycemic variability, highlighting the utility of CGMS in identifying transient glucose excursions.

3. Early Diagnosis in High-Risk Groups: CGMS identified abnormal glycemic profiles in 40% of obese first-degree relatives of type 2 diabetes patients, emphasizing its role in early detection among genetically predisposed individuals.

4. Improved Screening in Pediatric Populations: Among obese children and adolescents, CGMS detected impaired glucose tolerance in 25% of cases and revealed early glycemic abnormalities in up to 30%, many of which were missed by OGTT or fasting glucose tests.

5. Dynamic Glycemic Profiles: CGMS captured real-time data on glucose fluctuations, allowing clinicians to detect postprandial glucose excursions exceeding 7.8 mmol/lin 30% of participants with normal glucose tolerance.

Conclusion: CGMS offers unparalleled benefits in detecting and managing glycemic abnormalities in obese individuals, even those with normal FPG. By capturing real-time glucose fluctuations and variability, CGMS allows early identification of at-risk individuals and supports timely, personalized interventions. Future research should explore cost-effectiveness and long-term outcomes of CGMS-guided interventions in these populations.