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Continuous Glucose Monitoring and Behavioral Outcomes During a Multicomponent Lifestyle Intervention in Healthy Young Adults: A Single-Group Pre–Post Pilot Study
ABSTRACT
Background:
Continuous glucose monitoring (CGM) can characterize lifestyle-related glucose patterns in people without diabetes, but the responsiveness of conventional CGM metrics to short-term behavioral interventions remains uncertain.
Objective:
This study examined within-participant changes in CGM-derived and behavioral outcomes during a multicomponent lifestyle intervention in healthy young adults.
Methods:
This prospective, nonrandomized, single-group pre-post pilot study included 10 adults aged 22-26 years. Participants completed a 15-day habitual-lifestyle phase followed by a 15-day intervention addressing Mediterranean-style diet, physical activity, sleep, and stress management. Outcomes included time in range (70-140 mg/dL), time above and below range, glucose coefficient of variation, mean glucose, glucose management indicator, daily steps, sleep duration, and perceived stress. PRE-POST differences were assessed using exact Wilcoxon signed-rank tests with Benjamini-Hochberg correction. Associations among changes were explored using Spearman correlations.
Results:
All participants completed both phases. Mean daily steps increased from 7905 to 11,417 steps/day (mean change 3511; P=.002; adjusted P=.018), and mean perceived stress decreased from 3.83 to 1.72 points (mean change -2.11; P=.004; adjusted P=.018). Mean glucose decreased by 5.2 mg/dL, but this difference did not remain statistically significant after multiplicity correction (P=.04; adjusted P=.12). No conventional CGM outcome or sleep duration differed significantly after correction. Exploratory associations between increased steps and reduced glucose variability (ρ=-0.794; adjusted P=.11) and between increased sleep and reduced stress (ρ=-0.758; adjusted P=.13) did not remain statistically significant after multiplicity correction.
Conclusions:
Daily steps increased and perceived stress decreased during the intervention phase, whereas no conventional CGM-derived outcome remained statistically significant after adjustment for multiple comparisons. The small sample, fixed phase sequence, and absence of a control group preclude causal inference. Larger randomized studies using standardized interventions and prespecified dynamic or postprandial CGM outcomes are warranted.
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