CGM Devices Reveal Glucose Patterns Linked to Heart Disease Risk in Non-Diabetics

The standard way doctors check your blood sugar—a fasting test in the morning, or a three-month average called hemoglobin A1c—captures only a single moment or a blurred summary. They miss the actual story of how your glucose moves through the day, the peaks and valleys, the hours spent too high or too low. Continuous glucose monitoring devices, worn on the skin and reading glucose every few minutes, are changing what we can see.

Researchers at Boston University's Chobanian & Avedisian School of Medicine have now shown that these detailed glucose patterns matter even for people who don't have diabetes. In a study published in Diabetes Care, they analyzed continuous glucose monitoring data from roughly 1,300 participants in the Framingham Heart Study—people without diabetes and without existing heart disease—and found that the glucose patterns their monitors captured were linked to markers of cardiometabolic risk: high blood pressure, elevated cholesterol, the early warning signs of cardiovascular trouble.

The connection was specific. Adults whose average glucose was higher, and those who spent a larger percentage of time with blood sugar above 140 mg/dL, showed greater risk of hypertension or high cholesterol. The finding suggests that glucose patterns, even in people whose standard blood tests look normal, may reveal something important about their heart and metabolic health. Nicole Spartano, an assistant professor of medicine and corresponding author on the work, framed it this way: understanding how glucose behaves over time could be crucial to catching early or intermittent dysglycemia—blood sugar dysregulation that comes and goes—and the downstream risks it carries.

The implications are substantial. Continuous glucose monitoring has already become routine for people managing diabetes. But this research points toward a different use: screening for cardiovascular disease risk in people who haven't yet developed diabetes. Bahar Bakhshi, the study's lead author and a PhD candidate, noted that other emerging research has found that spending more time above 140 mg/dL is associated with the later development of type 2 diabetes and cardiometabolic problems in people who don't currently have diabetes. This study adds cross-sectional evidence—a snapshot showing the association exists—but the field is building toward understanding whether these glucose patterns actually predict future disease.

The work was funded by the National Heart, Lung and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases, with additional support from the American Heart Association. Dexcom, a major CGM manufacturer, provided devices at a reduced cost. The researchers are careful about their claims: they found associations, not proof of cause and effect. Additional studies will be needed to confirm whether intervening on glucose patterns in non-diabetic adults actually prevents heart disease.

But the direction is clear. If glucose monitoring can identify people at risk before they develop diabetes or heart disease, it could reshape how doctors think about prevention. Instead of waiting for a diagnosis, clinicians might use these devices to spot metabolic trouble early, when intervention might still change the course. The question now is whether the medical system will move toward that practice, and whether the cost and logistics of widespread glucose monitoring can be solved.