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Principal Investigator: Nicole L Spartano
Organization: BOSTON UNIVERSITY MEDICAL CAMPUS
Fiscal Year: 2024
Award: $424,130
Funding agency: National Institute of Diabetes and Digestive and Kidney Diseases
Project Abstract
Almost half of adults have either diabetes mellitus (DM) or prediabetes (preDM), but many of those have
undiagnosed conditions. Current DM diagnosis and risk prediction are based on single “snapshot”
measurements, including fasting blood glucose, postprandial glucose, and hemoglobin (Hb)A1c. However,
some individuals that do not fall into high-risk categories by traditional DM biomarkers have occasional
glycemic excursions similar to individuals with preDM or even DM. Understanding the determinants of these
glycemic patterns and whether they confer risk in developing DM will elucidate the pathophysiology
responsible for the progression toward DM and could improve DM risk prediction. We will use continuous
glucose monitoring (CGM) to measure glycemic patterns in 2700 adults (mean age 58 years) from the
community-based Framingham Heart Study Third Generation cohort and Omni 2, a multi-ethnic cohort. We
aim to describe normative glycemic patterns in a large sample of healthy individuals (most of whom do not
have DM), exploring how standard clinical measures (body mass index, fasting blood glucose, HbA1c), blood
metabolites, gut microbiome, dietary patterns, physical activity, family history of DM, and polygenic risk score
for DM relate to CGM-derived glycemic variables. The CGM-derived variables we will explore include time
spent in glycemic ranges (e.g. 70-140 mg/dL), hyper/hypoglycemic episodes, mean glucose and glucose
variability. Furthermore, we will examine whether CGM-derived glycemic variables predict development of DM
over 2-3 years follow-up (through an annual self-reported health history) and relate to prevalence of
cardiovascular disease (cross-sectionally). Our study will provide information that could improve the prediction
of developing DM and DM complications. Our findings may also lead to new discoveries that will tailor and
target prevention of DM.
Terms: <21+ years old><Active Follow-up><Adult><Adult Human><Adult-Onset Diabetes Mellitus><Age><American><Awareness><BMI><BMI percentile><BMI z-score><Behavior><Biochemical><Biological Markers><Blood><Blood Glucose><Blood Reticuloendothelial System><Blood Sample><Blood Sugar><Blood specimen><Body System><Body mass index><Brittle Diabetes Mellitus><Cardiovascular><Cardiovascular Body System><Cardiovascular Diseases><Cardiovascular Organ System><Cardiovascular system><Categories><Characteristics><Clinical><Clinical Markers><Communities><Complications of Diabetes Mellitus><Continuous Glucose Monitor><Cross Sectional Analysis><Cross-Sectional Analyses><Cross-Sectional Studies><Cross-Sectional Survey><D-Glucose><Data><Development><Dextrose><Diabetes Complications><Diabetes Mellitus><Diabetes prevention><Diabetes-Related Complications><Diabetic Complications><Diagnosis><Diet><Dietary Practices><Disease Frequency Surveys><Dysfunction><Endocrinologist><Epidemiology><Exhibits><Family Medical History><Family Medical History Epidemiology><Family history of><Fasting><Fingers><Framingham Heart Study><Functional disorder><Future><GI microbiome><Generations><Genetic><Glucose><Glycohemoglobin A><Glycosylated hemoglobin A><Goals><Hb A1><Hb A1a+b><Hb A1c><HbA1><HbA1c><Health><Health Care Technology><Health Technology><Healthcare Technology><Heart Vascular><Hemoglobin A(1)><History><Humulin R><Hypoglycemia><IDDM><Individual><Insulin><Insulin-Dependent Diabetes Mellitus><Investigators><Juvenile-Onset Diabetes Mellitus><Ketosis-Prone Diabetes Mellitus><Ketosis-Resistant Diabetes Mellitus><Life Style><Lifestyle><Link><Managed Care><Maturity-Onset Diabetes Mellitus><Measurement><Measures><Metabolic dysfunction><Modification><Monitor><NIDDM><Non-Insulin Dependent Diabetes><Non-Insulin-Dependent Diabetes Mellitus><Noninsulin Dependent Diabetes><Noninsulin Dependent Diabetes Mellitus><Novolin R><Obesity><Organ System><Participant><Patient Self-Report><Patients><Pattern><Pharmaceutical Agent><Pharmaceuticals><Pharmacologic Substance><Pharmacological Substance><Physical activity><Physiopathology><Population><Prediabetes><Prediabetes syndrome><Prediabetic State><Predicting Risk><Prevalence><Publishing><Quetelet index><Recording of previous events><Regular Insulin><Research Personnel><Researchers><Risk><Sampling><Self-Report><Slow-Onset Diabetes Mellitus><Stable Diabetes Mellitus><Sudden-Onset Diabetes Mellitus><T1 DM><T1 diabetes><T1D><T1DM><T2 DM><T2D><T2DM><Technology><Time><Type 1 Diabetes Mellitus><Type 1 diabetes><Type 2 Diabetes Mellitus><Type 2 diabetes><Type I Diabetes Mellitus><Type II Diabetes Mellitus><Type II diabetes><Woman><active followup><adiposity><adult onset diabetes><adulthood><ages><bacteria in the gut><bio-markers><biologic marker><biomarker><cardiorespiratory fitness><cardiorespiratory health><cardiovascular disorder><circulatory system><cohort><continuous blood glucose monitor><continuous blood sugar monitor><continuous glucose measurement><continuous sugar monitor><corpulence><deep learning based model><deep learning model><developmental><diabetes><diabetes management><diabetes mellitus management><diabetes risk><diabetic management><dietary pattern><diets><digestive tract microbiome><enteric microbiome><epidemiologic><epidemiological><falls><fasted><fasting glucose><fasting plasma glucose><fasts><follow up><follow up assessment><follow-up><followed up><followup><followup assessment><forecasting risk><gastrointestinal microbiome><glycemic control><gut bacteria><gut microbiome><gut-associated microbiome><hemoglobin A1c><high risk><histories><hypoglycemic><hypoglycemic episodes><improved><insulin dependent diabetes><insulin dependent type 1><interstitial><intestinal biome><intestinal microbiome><juvenile diabetes><juvenile diabetes mellitus><ketosis prone diabetes><ketosis resistant diabetes><m-Health><mHealth><maturity onset diabetes><mobile health><monitoring device><multi-ethnic><multiethnic><novel><pathophysiology><pharmaceutical><polygenic risk score><pre-diabetes><pre-diabetic><prediabetic><predict risk><predict risks><predicted risk><predicted risks><predicting risks><predictive risk><predicts risk><recruit><response><risk prediction><risk predictions><tool><type 2 DM><type I diabetes><type II DM><type one diabetes><type two diabetes>