Maximal Speed of Glucose Change Significantly Distinguishes Prediabetes from Diabetes

TL;DR

This study introduces the maxSpeed index from continuous glucose monitoring data, which effectively differentiates prediabetes and diabetes types by capturing rapid glucose changes, aiding early diagnosis and management.

Contribution

The paper proposes the maxSpeed index and demonstrates its effectiveness in distinguishing prediabetes from diabetes, providing new tools for clinical assessment.

Findings

maxSpeed significantly distinguishes prediabetes from diabetes

meanSpeed, sdSpeed, GVP, and MAG differentiate non-diabetes from diabetes

MODD and CONGA of 24 hours differentiate non-diabetes from diabetes and T1D from others

Abstract

Rapid changes in blood glucose levels can have severe and immediate health consequences, leading to the need to develop indices for assessing these rapid changes based on continuous glucose monitoring (CGM) data. We proposed a CGM index, maxSpeed, that represents the maximum of speed of glucose change (SGC) in a subject, respectively, and conducted a clinical study to investigate this index along with SGC mean (meanSpeed) and SGC standard deviation (sdSpeed), coefficient of variation (CV), standard deviation (SD), glycemic variability percentage (GVP), mean amplitude of glycemic excursions (MAG), mean absolute glucose excursion (MAGE), mean of daily differences (MODD) and continuous overlapping net glycemic action (CONGA). Our study revealed that, there exist multiple patterns in distinguishing non-diabetes, prediabetes, type 1 diabetes (T1D) and type 2 diabetes (T2D). First, maxSpeed significantly distinguishes between either of non-diabetes and prediabetes and either of T1D and T2D. Second, meanSpeed, sdSpeed, GVP and MAG significantly distinguish between non-diabetes and either of T1D and T2D. Third, MODD and CONGA of 24 hours significantly distinguish between non-diabetes and either of T1D and T2D, between T1D and either of prediabetes and T2D. Fourth, SD, MAGE and CONGA of 12 hours significantly distinguish between non-diabetes and either of T1D and T2D, between T1D and pre-diabetes. Fifth, CV significantly distinguishes between T1D and either of Non-diabetes and T2D. maxSpeed assesses the rapid change of glucose in a short term, which is important both biologically and clinicially because our human body may not tolerate too rapid change in a short term.