Imprecision nutrition? Different simultaneous continuous glucose monitors provide discordant meal rankings for incremental postprandial glucose in subjects without diabetes

Postprandial glucose responses varied significantly, with the Abbott and Dexcom CGMs showing within-subject incremental mean glucose coefficients of variation of 91.7 ± 1.9% and 94.2 ± 2.7%, respectively.

• Meal rankings based on incremental glycemic responses differed notably between the two CGM devices, with a mean Kendall rank correlation coefficient of 0.43 ± 0.05.
• Meals ranked in the bottom half for glycemic response by Abbott showed a 50 ± 10% lower glycemic reduction when measured by Dexcom.
• Conversely, meals ranked by Dexcom that were in the bottom half resulted in similarly discordant glycemic reductions when assessed by Abbott.
• The discrepancy in glycemic reduction linked to discordant meal rankings was found to have a strong inverse correlation with each subject's Kendall rank correlation coefficient (r = -0.95; P < 0.0001).
• These findings suggest that current precision nutrition strategies using CGMs may not reliably minimize glycemic excursions.

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