Diurnal Glycemic Redistribution in Obesity Despite Matched Mean Glucose

Obesity is linked to diurnal glycemic redistribution despite matched mean glucose, with higher nighttime glucose (+6.18 mg/dL from 00:00–06:00) and lower afternoon glucose (-5.11 mg/dL from 12:00–18:00) in 261 matched pairs.

• Why it matters: Mean glucose and HbA1c may miss 24-hour distribution, leaving unclear whether obesity has a distinct temporal glucose pattern when average glycemia is comparable.
• What they did: In a cross-sectional AI-READI analysis, continuous glucose monitoring profiles were compared by clock time and sleep onset in lean adults and adults with obesity matched for mean glucose (and glucose standard deviation), with sensitivity analyses tightening the mean-glucose caliper from 10 to 2 mg/dL.
• The result: Nighttime-high and afternoon-low differences persisted in sleep-aligned analyses, including among healthy participants and those with prediabetes, and remained significant with a 2 mg/dL caliper (nighttime +3.86 mg/dL; afternoon -4.27 mg/dL; both adjusted P<0.001).