Real-time CGM can help shape patient education and glycemic index measurements in T2D

Malaysian researchers used real-time continuous glucose monitoring (CGM) data from study participants considered overweight or obese to assess their risk of type 2 diabetes (T2D) associated with eating a meal at rice base and its impact on postprandial hyperglycemia.

Data from real-time continuous glucose monitoring (rtCGM) has been shown to be a reliable measure of the glycemic index (GI) of a variety of rice-based meals in a new study from Malaysia, indicating that the Diabetes technology could have wider utility as a tool for GI measurement and for patient education among those who may be classified as overweight or obese.

The authors of this new study cited the convenience and sophistication of rtCGM systems in reaching this conclusion, as well as the fact that the data produced by these systems are more robust, and they published their findings in a recent issue of food.

The 14 study participants were young adults with a mean (SD) age of 22.8 (4.6) years and their mean body mass index (BMI) was 32.9 (5.8) kg/ m2. To be included in this study, they had to have a BMI of at least 25 kg/m2 and a fasting blood glucose level below 5.6 mmol/L. They were randomized to 1 of 3 rice-based meals, each containing 50 g of carbohydrate: white rice flour (WRM), brown rice flour (BRM) or parboiled basmati rice flour (PBRM). A reference drink of 50 g of glucose was added every other day. In addition to rice, 100g of grilled chicken and salad were served with the meals.

The primary outcome was the impact on postprandial hyperglycemia, which was associated with an increased risk of type 2 diabetes (T2DM) as measured by GI, glycemic variability, 24-hour mean blood glucose and target blood glucose ranges.

“Preferences of rice varieties were compared to those of reference data and determined at the end of the study period,” the authors wrote.

Of the 3 rice-based meals, the mean glycemic index was lowest for PBRM and highest for WRM:

  • PBRM: 45.35 (2.06)
  • GRE: 56.44 (2.34)
  • WRM: 83.03 (2.19)

In addition, the reference drink had the highest average glucose level and the lowest PBRM:

  • Glycemic reference drink: 5.37 (0.54) mmol/L
  • WRM: 5.29 (0.62) mmol/L
  • MRB: 5.03 (0.45) mmol/L
  • PRRM: 4.87 (0.66) mmol/L

The GI is measured on a scale of 0 to 100, and foods that are high on this scale are those that tend to be digested quickly and spike blood sugar quickly. A 50 g measure of food, as administered in this study, is the standardized amount given when determining the GI of a food.

For 24-hour blood glucose, PBRM was also significantly associated with a lower overall mean measure, but a higher percent within target compared to WRM (P P

Participants’ food preferences also changed over the course of the study. At the start of the study, the overwhelming preference was for WRM, at 64.3%), but by the end it had shifted to PBRM, at 71.4% (P

The study authors noted that about 90% of people with T2D are classified as overweight or obese, and that nearly 39% of the world’s adult population falls into these same weight categories. Furthermore, “rice is the second most consumed staple food in the world, providing 16.5% of global calorie intake and providing up to 66% of daily energy intake in Southeast Asia, where the prevalence of obesity has recently increased,” they added. wrote.

These results are remarkable, especially for those who consume white rice daily, because compared to the widely used method of assessing GI over a 2-hour period, the use of rtCGM data can help inform the profile. glycemia over a 24-hour period. Additionally, the authors wrote, glucose levels “did not fall back to baseline after a 2-hour period for all foods, emphasizing the importance of assessing these levels beyond the 2-hour period.” . The meals they served also mimicked the type of meal eaten daily in the general population of Malaysia.

“This current study suggests that the rtCGM system can potentially be used as a new technique for measuring the GI of foods because it is convenient to use and more sophisticated, as it produces more robust data continuously over 24 hours. [hours] and is less invasive,” the authors concluded. “The rtCGM system can also potentially be used as an educational tool producing real-time information for overweight and obese people to select lower GI foods in their daily diets.”

Reference

Chekima K, Wong BTZ, Noor MI, Ooi YBH, Yan SW, Chekima B. Use of a continuous glucometer to determine the glycemic index of rice-based compound meals, their effect on a 24-h glycemic profile, and its influence on overweight and food preferences of obese young adults. food. Published online March 28, 2022. doi:10.3390/foods11070983