Interindividual and intraindividual variations in postprandial glycemia peak time complicate precise recommendations for self-monitoring of glucose in persons with type 1 diabetes mellitus

Abstract

Background: In glycemic control, postprandial glycemia may be important to monitor and optimize as it reveals glycemic control quality, and postprandial hyperglycemia partly predicts late diabetic complications. Self-monitoring of blood glucose (SMBG) may be an appropriate technology to use, but recommendations on measurement time are crucial. Method: We retrospectively analyzed interindividual and intraindividual variations in postprandial glycemic peak time. Continuous glucose monitoring (CGM) and carbohydrate intake were collected in 22 patients with type 1 diabetes mellitus. Meals were identified from carbohydrate intake data. For each meal, peak time was identified as time from meal to CGM zenith within 40-150 min after meal start. Interindividual (one-way Anova) and intraindividual (intraclass correlation coeficient) variation was calculated. Results: Nineteen patients were included with suficient meal data quality. Mean peak time was 87 ± 29 min. Mean peak time difered significantly between patients (p = 0.02). Intraclass correlation coeficient was 0.29. Conclusions: Significant interindividual and intraindividual variations exist in postprandial glycemia peak time, thus hindering simple and general advice regarding postprandial SMBG for detection of maximum values. © Diabetes Technology Society.