Continuous Glucose Monitoring Metrics Using FreeStyle Libre3 in Patients with Type 2 Diabetes and Gastroparesis: A Pilot Prospective Investigator-Initiated Study

Abstract

Introduction:

Gastroparesis (GP) is a well-recognized complication in patients with long-standing type 2 diabetes (T2D), impacting glycemic control and continuous glucose monitoring (CGM) metrics. We performed a prospective study to characterize real-time glucose metrics in patients with T2D with gastroparesis.

Methods:

This pilot prospective study involved 11 adult patients with T2D and GP (GP group) and 20 patients with T2D without GP (non-GP group). Patients used real-time CGM (rtCGM) FreeStyle Libre 3 throughout the 4-week study. Fifteen glycemic metrics, including time in range (TIR), time above range (TAR), and time below range (TBR), were analyzed from the rtCGM profiles of study participants.

Results:

Compared with the non-GP group, patients in the GP group had higher mean CGM glucose levels (GP group [172 ± 51 mg/dL] vs. non-GP group [157 ± 41 mg/dL]) and lower TIR, indicating inadequate glucose control. The GP group also had greater TAR, increased TBR, and higher standard deviation (SD) and coefficient of variation (CV), indicating greater glucose excursions and glucose variability.

Conclusion:

Patients with T2D and GP showed distinct and altered CGM glucose metrics compared with those with T2D without GP. These findings highlight the need for better glycemic control in this population. Whether CGM metrics could help identify a specific biomarker for gastroparesis remains to be determined. Further validation with a broader population, including patients with T1D and GLP-1RAs, is necessary.