Abstract
BackgroundRandomized controlled trials of time restricted eating (TRE) in adults have demonstrated improvements in glucose variability as captured by continuous glucose monitors (CGM). However, little is known about the feasibility of CGM use in TRE interventions in adolescents, or the expected changes in glycemic profiles in response to changes in meal-timing. As part of a pilot trial of TRE in adolescents with obesity, this study aimed to 1) assess the feasibility of CGM use, 2) describe baseline glycemic profiles in adolescents with obesity, without diabetes, and 3) compare the difference between glycemic profiles in groups practicing TRE versus control.MethodsThis study leverages data from a 12-week pilot trial (ClinicalTrials.gov Identifier: NCT03954223) of late TRE in adolescents with obesity compared to a prolonged eating window. Feasibility of CGM use was assessed by monitoring 1) the percent wear time of the CGM and 2) responses to satisfaction questionnaires. A computation of summary measures of all glycemic data prior to randomization was done using EasyGV and R. Repeat measures analysis was conducted to assess the change in glycemic variability over time between groups. Review of CGM tracings during periods of 24-hour dietary recall was utilized to describe glycemic excursions.ResultsFifty participants were enrolled in the study and 43 had CGM and dietary recall data available (16.4 + 1.3 years, 64% female, 64% Hispanic, 74% public insurance). There was high adherence to daily CGM wear (96.4%) without negative impacts on daily functioning. There was no significant change in the glycemic variability as measured by standard deviation, mean amplitude glycemic excursion, and glucose area under the curve over the study period between groups.ConclusionsCGM use appears to be a feasible and acceptable tool to monitor glycemic profiles in adolescents with obesity and may be a helpful strategy to confirm TRE dosage by capturing glycemic excursions compared to self-reported meal timing. There was no effect of TRE on glucose profiles in this study. Further research is needed to investigate how TRE impacts glycemic variability in this age group and to explore if timing of eating window effects these findings.
Highlights
Continuous glucose monitoring (CGM) provides serial interstitial glucose measurements in a noninvasive manner through a wearable device called a continuous glucose monitor [1–3]
Various CGM are approved by the U.S Food and Drug Administration (FDA) for use in youth with diabetes, little is known about the role and utility of CGM in the management of youth with obesity without diabetes [5]
There was no significant relationship between changes in glycemic excursion during fasting and weight status at week 12. This is the first study to simultaneously examine the feasibility of continuous glucose monitoring in adolescents with obesity participating in a time restricted eating (TRE) intervention, describe baseline glycemic profiles in adolescents with obesity, without diabetes, and evaluate the impact of TRE on glycemic variability compared to a prolonged eating window
Summary
Continuous glucose monitoring (CGM) provides serial interstitial glucose measurements in a noninvasive manner through a wearable device called a continuous glucose monitor [1–3]. Continuous glucose monitoring is increasingly used in obesity research in adults Through these studies, the CGM has emerged as a useful tool to understand and monitor glycemic variability, occurrence of hypoglycemia, and overall efficacy of dietary interventions on glycemic excursions [5–7]. Little is known about the feasibility of CGM use in TRE interventions in adolescents, or the expected changes in glycemic profiles in response to changes in meal-timing. As part of a pilot trial of TRE in adolescents with obesity, this study aimed to 1) assess the feasibility of CGM use, 2) describe baseline glycemic profiles in adolescents with obesity, without diabetes, and 3) compare the difference between glycemic profiles in groups practicing TRE versus control
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