While glycated hemoglobin (HbA1c) represents the historical gold standard for evaluating three-month average glycemia, it provides zero insight into intra-day glycemic variability, postprandial glucose excursions, or nocturnal hypoglycemia. Continuous Glucose Monitoring (CGM) provides real-time ambulatory glucose profiles that transform patient engagement and clinical outcomes.
Key Consensus CGM Metrics (Advanced Diabetes Technologies)
- Time in Range (TIR, 70–180 mg/dL): Target > 70% of readings for non-pregnant adults with T2D.
- Time Below Range (TBR, < 70 mg/dL): Target < 4% (< 1% for severe hypoglycemia < 54 mg/dL).
- Time Above Range (TAR, > 180 mg/dL): Target < 25% (< 5% for severe hyperglycemia > 250 mg/dL).
- Glycemic Coefficient of Variation (%CV): Measure of glycemic variability; target ≤ 36% to indicate stable glycemic control.
Postprandial Excursions & Endothelial Oxidative Stress
Acute postprandial glycemic spikes generate excessive mitochondrial superoxide production in endothelial cells, leading to protein kinase C activation and advanced glycation end-product (AGE) synthesis. CGM visualization enables patients to immediately observe how macronutrient sequencing (consuming protein and fiber prior to carbohydrates) blunts postprandial glucose spikes.