Abstract
BACKGROUND: While lifestyle modification remains fundamental for prediabetes management, the potential added value of real-time continuous glucose monitoring (RT-CGM) in diabetes health education programs warrants investigation. This study evaluated whether an individualized diabetes health education program using RT-CGM could improve glycemic control compared to general dietary guidance in prediabetic individuals. METHODS: In this randomized controlled trial conducted at Guangdong Provincial People's Hospital (initiated September 2022), we enrolled 41 adults (>18 years) with prediabetes, randomly assigning them to either: (1) RT-CGM group (n=20) receiving meal adjustments based on continuous glucose data and energy balance, or (2) control group (n=21) receiving adjustments based solely on energy balance. The study comprised two intensive 14-day education sessions (baseline and 1-year follow-up) with metabolic assessments (HbA1c, fasting blood glucose, BMI, lipid profile, and uric acid) conducted at baseline, 1-year, and 2-year timepoints. RESULTS: The RT-CGM group demonstrated significantly greater improvements in HbA1c compared to controls at both 1-year (p=0.007) and 2-year (p=0.033) follow-ups. CONCLUSION: Our findings suggest that incorporating RT-CGM into diabetes health education program can enhance glycemic control in prediabetic individuals compared to general dietary guidance alone. These results support the potential clinical utility of RT-CGM in prediabetes management strategies.