661-P: Exploring the Real-World Impact of Late-Day Glucose Spikes on Weight Loss in People without Diabetes

Background and Aims: Population-level distribution of various glucose spikes throughout the day for people without diabetes is a relatively under-researched domain. Enhanced insights at population-level as well as individual patterns in the timing of glucose spikes and their correlation with weight loss may shed light on behavior modifications that individuals may adopt to stimulate weight loss or pause / reverse weight gain. Methods: As part of a larger study (in partnership with Dexcom), we analyzed the correlation patterns between participants' weight trajectories and the timing of their glucose spikes using data from more than 19,000 participants (median age: 46, 66% women, 76% overweight or obese) wearing a Dexcom G6 or G7 real-time CGM. Participants were also utilizing the Signos personalized program for weight management. We identify glucose spikes based on individual variability in CGM signals for each participant and will further review glucose spike definitions. Results: Overall, the earlier the glucose spikes occurred during the day, the more weight loss that individual experienced. The pattern is observed at both population level and demographic cohort level, e.g. for gender, age, BMI cohorts. The earliest-spiking cohort (~20% of participants) started their latest glucose excursion before 4 pm, whereas the latest-spiking cohort (~20% of participants) started their spikes after 6:15 pm. The observed 180-day Total Body Weight Loss for the earliest-spiking cohort was twice more compared to the latest-spiking cohort (p-value < 0.01). Conclusions: The observed data suggests that having glucose spikes earlier in the day (e.g. shifting heavier carb intake earlier in the day) is a positive behavior modification for weight management. Further research into time-based postprandial glucose excursion monitoring and the associated behavior modifications is needed.