Continuous Glucose Monitoring Reveals Abnormal Features of Postprandial Glycemic Excursions in Women with Polycystic Ovarian Syndrome

Abstract

Background: To determine the features of postprandial glycemic excursions (PPGEs) in patients with polycystic ovarian syndrome (PCOS) using continuous glucose monitoring (CGM). Methods: Forty-five women with PCOS and normal glucose tolerance and 45 healthy, age-matched women (control group) underwent a 3-day period of blood glucose (BG) monitoring using the CGM system. The glycemic level was calculated as the mean level of 24-hour BG value (MBG), and intra-day glycemic excursions were calculated as standard deviation of BG (SDBG) and mean amplitude of glycemic excursion (MAGE). Postprandial glycemic excursions were characterized by the amplitude of the postprandial BG spike and the interval between the meal and the maximal BG value. Results: Based on CGM, the times to peak glucose of patients with PCOS after 3 meals were higher than the control group (42 ± 18 min vs 32 ± 12 min, 54 ± 25 min vs 39 ± 18 min, and 45 ± 16 min vs 38 ± 16 min, respectively; P < 0.05), and the amplitude of PPGEs after breakfast was higher than the control group (P < 0.05). However, there were no significant differences between the amplitudes of PPGEs after lunch and dinner compared with the control group (P > 0.05). The 24-hour MBG, SDBG, and MAGE of the patients with PCOS were 5.45 ± 0.51 mmol/L, 0.74 ± 0.32 mmol/L, and 1.83 ± 0.97 mmol/L, respectively, and there were no statistically significant differences compared with the control group (P > 0.05). Conclusions: Women with PCOS and normal glucose tolerance have changes in PPGEs. Continuous glucose monitoring can detect alterations in a comprehensive and sensitive way.