Glycemic Variability and Control by CGM in Healthy Older and Young Adults and Their Relationship With Diet

Continuous glucose monitoring (CGM) might be beneficial for investigating healthy aging since high glycemic variability may increase protein glycation, oxidative stress, and inflammation, resulting in vascular damage. Additionally, CGM data on the risks for hypoglycemia and hyperglycemia are scarce, have not been analyzed by individual day and night blocks, and have not been related to diet. Therefore, this study aimed to compare glucose parameters of healthy older and young adults and the relationship with diet. Participants were 34 young (age 20-35 years) and 27 older volunteers (age 60-75 years) with a normal glycated hemoglobin A_1c less than 39 mmol/mol hemoglobin, free of disorders and medication. Twenty-four CGM-derived glucose parameters measured over 5 consecutive days were analyzed for whole days and for individual daytime and nighttime blocks. Dietary intake was determined by 3-day dietary record. Neither intraday nor interday glycemic variability differed between the healthy age groups. Glycemic control was good in both age groups, but somewhat poorer in older adults. The risk of hyperglycemia was higher and of hypoglycemia lower in older adults. During the daytime, mean and minimum glucose were higher in older adults. During the nighttime, age group differences were small. The carbohydrate intake correlated positively with glycemic variability in both age groups. The protein intake correlated positively with the hypoglycemic risk in young adults, but negatively in older adults. Results suggest that healthy aging does not increase glycemic variability and the risk of hypoglycemia. The effect of diet on hypoglycemic and hyperglycemic risk might change with aging.