CGM Patterns Linked to Cardiometabolic Risk Without Diabetes

Continuous glucose monitoring (CGM) measures were associated with estimated 10-year cardiovascular disease (CVD) risk and cardiometabolic risk factors among adults without diabetes, according to a cross-sectional study in Diabetes Care. Dynamic glucose patterns may provide information beyond fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c), the investigators reported.

Investigators analyzed 1,356 Framingham Heart Study participants without diabetes or CVD. Participants wore a blinded Dexcom G6 Pro CGM for up to 10 days. Glycemic profiles were characterized by glycemic burden and variability classifications and unsupervised clustering. Multivariable models evaluated associations with PREVENT-estimated 10-year CVD risk and individual cardiometabolic risk factors.

Participants had a mean age of 59.3 years; 55.8% were women, and 92.6% were non-Hispanic White. A 1-SD increase in time above 140mg/dL—equivalent to 15.4%—was associated with 2% higher estimated 10-year CVD risk and 21% to 26% higher odds of hypertension and dyslipidemia after adjustment for FPG. Glycemic burden showed stronger associations than glycemic variability.

CGM profiles also showed discordance with glycemic status defined by FPG and HbA1c. Traditionally defined prediabetes was present in 48.1% of participants in the moderate-dysglycemia profile and 84.2% in the high-dysglycemia profile. These profiles were associated with 6% to 7% higher estimated 10-year CVD risk and less favorable cardiometabolic risk factors.

The cross-sectional design prevented assessment of long-term outcomes, the predominantly White cohort may limit generalizability, and the profiles require external validation. The authors concluded that CGM may offer additional insight into dysglycemia and cardiometabolic risk, while longitudinal studies are needed to assess its role in screening, prevention, and risk stratification.

Source:Bakhshi B, Lin H, Sultana N, et al. Beyond traditional glycemic measures: CGM glycemic profiles reveal associations with cardiometabolic risk in individuals without diabetes. Diabetes Care. 2026;49(11):1-10. doi:10.2337/dc26-1197