Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indices

Abstract Background Efficiently assessing glucose handling capacity is a critical public health challenge. This study assessed the utility of relatively easy-to-measure continuous glucose monitoring (CGM)-derived indices in estimating glucose handling capacities calculated from resource-intensive cl...

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Main Authors: Hikaru Sugimoto, Ken-ichi Hironaka, Tomoaki Nakamura, Tomoko Yamada, Hiroshi Miura, Natsu Otowa-Suematsu, Masashi Fujii, Yushi Hirota, Kazuhiko Sakaguchi, Wataru Ogawa, Shinya Kuroda
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00819-5
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author Hikaru Sugimoto
Ken-ichi Hironaka
Tomoaki Nakamura
Tomoko Yamada
Hiroshi Miura
Natsu Otowa-Suematsu
Masashi Fujii
Yushi Hirota
Kazuhiko Sakaguchi
Wataru Ogawa
Shinya Kuroda
author_facet Hikaru Sugimoto
Ken-ichi Hironaka
Tomoaki Nakamura
Tomoko Yamada
Hiroshi Miura
Natsu Otowa-Suematsu
Masashi Fujii
Yushi Hirota
Kazuhiko Sakaguchi
Wataru Ogawa
Shinya Kuroda
author_sort Hikaru Sugimoto
collection DOAJ
description Abstract Background Efficiently assessing glucose handling capacity is a critical public health challenge. This study assessed the utility of relatively easy-to-measure continuous glucose monitoring (CGM)-derived indices in estimating glucose handling capacities calculated from resource-intensive clamp tests. Methods We conducted a prospective study of 64 individuals without prior diabetes diagnosis. The study performed CGM, oral glucose tolerance tests (OGTT), and hyperglycemic and hyperinsulinemic-euglycemic clamp tests. We validated CGM-derived indices characteristics using an independent dataset from another country and mathematical models with simulated data. Results A CGM-derived index reflecting the autocorrelation function of glucose levels (AC_Var) is significantly correlated with clamp-derived disposition index (DI), a well-established measure of glucose handling capacity and predictor of diabetes onset. Multivariate and machine learning models indicate AC_Var’s contribution to predicting clamp-derived DI independent from other CGM-derived indices. The model using CGM-measured glucose standard deviation and AC_Var outperforms models using commonly used diabetes diagnostic indices, such as fasting blood glucose, HbA1c, and OGTT measures, in predicting clamp-derived DI. Mathematical simulations also demonstrate the association of AC_Var with DI. Conclusions CGM-derived indices, including AC_Var, serve as valuable tools for predicting glucose handling capacities in populations without prior diabetes diagnosis. We develop a web application that calculates these CGM-derived indices ( https://cgm-ac-mean-std.streamlit.app/ ).
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spelling doaj-art-e9d68cbe82ee4ab8a5502cabb2c9a17b2025-08-20T02:20:00ZengNature PortfolioCommunications Medicine2730-664X2025-04-015111210.1038/s43856-025-00819-5Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indicesHikaru Sugimoto0Ken-ichi Hironaka1Tomoaki Nakamura2Tomoko Yamada3Hiroshi Miura4Natsu Otowa-Suematsu5Masashi Fujii6Yushi Hirota7Kazuhiko Sakaguchi8Wataru Ogawa9Shinya Kuroda10Department of Biochemistry and Molecular Biology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-kuDepartment of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-kuDepartment of Diabetes and Endocrinology, Akashi Medical Center, 743-33 Okubo-cho Yagi, AkashiDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, KobeDepartment of Diabetes and Endocrinology, Takatsuki General Hospital, 1-3-13 Kosobe-cho, TakatsukiDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, KobeDepartment of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-kuDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, KobeDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, KobeDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, KobeDepartment of Biochemistry and Molecular Biology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-kuAbstract Background Efficiently assessing glucose handling capacity is a critical public health challenge. This study assessed the utility of relatively easy-to-measure continuous glucose monitoring (CGM)-derived indices in estimating glucose handling capacities calculated from resource-intensive clamp tests. Methods We conducted a prospective study of 64 individuals without prior diabetes diagnosis. The study performed CGM, oral glucose tolerance tests (OGTT), and hyperglycemic and hyperinsulinemic-euglycemic clamp tests. We validated CGM-derived indices characteristics using an independent dataset from another country and mathematical models with simulated data. Results A CGM-derived index reflecting the autocorrelation function of glucose levels (AC_Var) is significantly correlated with clamp-derived disposition index (DI), a well-established measure of glucose handling capacity and predictor of diabetes onset. Multivariate and machine learning models indicate AC_Var’s contribution to predicting clamp-derived DI independent from other CGM-derived indices. The model using CGM-measured glucose standard deviation and AC_Var outperforms models using commonly used diabetes diagnostic indices, such as fasting blood glucose, HbA1c, and OGTT measures, in predicting clamp-derived DI. Mathematical simulations also demonstrate the association of AC_Var with DI. Conclusions CGM-derived indices, including AC_Var, serve as valuable tools for predicting glucose handling capacities in populations without prior diabetes diagnosis. We develop a web application that calculates these CGM-derived indices ( https://cgm-ac-mean-std.streamlit.app/ ).https://doi.org/10.1038/s43856-025-00819-5
spellingShingle Hikaru Sugimoto
Ken-ichi Hironaka
Tomoaki Nakamura
Tomoko Yamada
Hiroshi Miura
Natsu Otowa-Suematsu
Masashi Fujii
Yushi Hirota
Kazuhiko Sakaguchi
Wataru Ogawa
Shinya Kuroda
Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indices
Communications Medicine
title Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indices
title_full Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indices
title_fullStr Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indices
title_full_unstemmed Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indices
title_short Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indices
title_sort improved detection of decreased glucose handling capacities via continuous glucose monitoring derived indices
url https://doi.org/10.1038/s43856-025-00819-5
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