Abstract

Background: Self-monitoring of blood glucose using capillary glucose testing (C) has a number of shortcomings compared to continuous glucose monitoring (CGM). We aimed to compare these two methods and used blood glucose measurements in venous blood (IV) as a reference. Postprandial blood glucose levels were measured after 50 g oral glucose load and after the consumption of a portion of different foods containing 50 g of carbohydrates. We also evaluated the associations between postprandial glucose responses and the clinical characteristics of the participants at the beginning of the study. Methods: 12 healthy volunteers (age: 36 ± 17 years, BMI: 24.9 ± 3.5 kg/m2) ate white bread (WB) and whole grain (WG) bread and drank a 50 g glucose drink as reference. Postprandial glucose responses were evaluated by CGM, IV and C blood glucose measurements. Incremental area under the curve (AUCi) of postprandial blood glucose was calculated for 1 h (AUCi 0-60) and 2 h (AUCi 0-120). Results: After the consumption of white bread and whole grain bread, the AUCi 0-60 min did not differ between CGM and IV or C. AUCi 0-120 min of CGM showed no difference compared to C. Correlation analyses revealed a positive association of age with glucose AUCi 0-120 (r = 0.768; P = 0.004) and WG AUCi 0-120 (r = 0.758; P = 0.004); fasting blood glucose correlated with WG AUCi 0-120 (r = 0.838; P < 0.001). Conclusion: Despite considerable inter-individual variability of postprandial glycemic responses, CGM evaluated postprandial glycemic excursions which had comparable results compared to standard blood glucose measurements under real-life conditions. Associations of AUCi 0-60 and AUCi 0-120 postprandial glucose response with age or fasting blood glucose could be shown.

Highlights

  • Self-monitoring of blood glucose (SMBG) levels in capillary blood samples is still the most widely-used method for the evaluation of glucose control in patients with glucometabolic diseases [1].Blood glucose measurement evaluates foods according to their impact on postprandial glycemic excursions [2]

  • After the consumption of white bread and whole grain bread the AUCi 0-60min did not differ between continuous glucose monitoring (CGM) and in venous blood (IV) but between C and IV (P < 0.01)

  • The usage of a CGM system for the evaluation of postprandial glycemic excursions in a real-world-setting resulted in comparable results as opposed to using the standard blood glucose measurement capillary glucose testing

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Summary

Introduction

Blood glucose measurement evaluates foods according to their impact on postprandial glycemic excursions [2]. Despite its importance, when considering increasing prevalence rates of impaired glucose tolerance and diabetes [5], no method exists for determining and predicting an individual postprandial blood glucose response to food [6]. Compared to standard measurement methods, such as capillary or venous blood glucose testing, continuous glucose monitoring (CGM). We aimed to compare these two methods and used blood glucose measurements in venous blood (IV) as a reference. Postprandial blood glucose levels were measured after 50 g oral glucose load and after the consumption of a portion of different foods containing 50 g of carbohydrates. Postprandial glucose responses were evaluated by CGM, IV and C blood glucose measurements. AUCi 0-120 min of CGM showed no difference compared to C

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