PREdiabetes GLycemic Impact and Data Evaluation

Prediabetes is considered a critical stage at which effective prevention of the development of diabetes is possible, provided that early detection and adequate glycemic control. International clinical guidelines and multicenter studies suggest that early intensive glycemic control is associated with a better prognosis and a reduced risk of complications. However, standard self-monitoring has limited information on glycemic variability, which is especially important in the early stages of carbohydrate metabolism disorders, including prediabetes. Routine indicators such as fasting blood glucose, 1 and 2 hours after a meal, and glycated hemoglobin (HbA1c) do not always clearly differentiate between diabetes, prediabetes, and normal carbohydrate metabolism. Recently, there has been a need for more comprehensive blood glucose monitoring strategies that cover the entire spectrum of glycemic variability. Continuous glucose monitoring (CGMs) technology provides real-time glucose concentration data, overcoming the limitations of traditional monitoring methods. Recently, not only among people with diabetes, but also among people with prediabetes, there has been an increasing trend towards using CGM as a personal device to monitor glucose levels and promote healthy habits such as increased activity, diet, and sleep. Their motivation is to improve their own glycemic control and avoid the future development of diabetes and its associated complications, to optimize blood glucose levels to achieve peak mental or physical performance, and to use personal monitoring data to develop sustainable behavioral skills. The contactless 24-hour monitoring system is considered a promising tool for personalized glycemic control, but its use in people with prediabetes has not been studied enough This is a prospective, open-label, randomized controlled trial involving 80 adult patients with prediabetes recruited at the Bogomolets National Medical University. Participants were randomized in a 1:1 ratio to either the Real-Time Continuous Glucose Monitoring (CGM group) or the control group (standard Self-Monitoring of Blood Glucose \[SMBG\] using conventional glucometers). Participants will undergo a 3-month observation period. The use of the assigned monitoring devices (CGM or SMBG glucometer) and pedometers will last for the first 1 month. The study consists of three visits: Visit 1 (baseline), Visit 2 (1 month, end of intervention), and Visit 3 (3 months, follow-up period). During these visits, researchers will collect data on glycated hemoglobin (HbA1c), fructosamine, Cpeptide, HOMA-IR index, lipid profile, anthropometric indicators (body mass index (BMI), waist circumference), bioimpedance measurement, physical activity monitoring using pedometers, and SF-36 questionnaire to assess quality of life.

The gathered data will help determine whether continuous monitoring provided by CGM systems improves glycemic control and increases patient adherence to lifestyle changes compared to conventional SMBG methods.

• Homeostatic Model Assessment of Insulin Resistance (HOMA2-IR) [Time frame: at 3 month (follow-up period) compared to baseline]
• insulin sensitivity (%S) [Time frame: at 3 month (follow-up period) compared to baseline]
• β-cell function (%B) [Time frame: at 3 month (follow-up period) compared to baseline]
• body mass index (BMI) [Time frame: at 1 month (end of intervention) and 3 month (follow-up period) compared to baseline]
• waist circumferences (WC) [Time frame: at 1 month (end of intervention) and 3 month (follow-up period) compared to baseline]
• visceral fat content [Time frame: at 1 month (end of intervention) and 3 month (follow-up period) compared to baseline]
• Total Cholesterol (TC) [Time frame: at 3 month (follow-up period) compared to baseline]
• Tryglicerides (TG) [Time frame: at 3 month (follow-up period) compared to baseline]
• LDL-Cholesterol (LDL-C) [Time frame: at 3 month (follow-up period) compared to baseline]]
• Physical activity levels [Time frame: at 1 month (end of intervention) and 3 month (follow-up period) compared to baseline]
• Quality of Life Evaluation: Medical Outcomes Study Short-Form 36 (SF-36) [Time frame: at 1 month (end of intervention) and 3 month (follow-up period) compared to baseline]