Tracking Glucose Trends, Unveiling Clinical Patterns: Insights From Continuous Glucose Monitoring in Patients at the Extreme of BMI and Eating Disorders Psychopathology

Objective: Disturbances of glucose homoeostasis are claimed to act as both a consequence and maintaining factor in eating disorders (EDs). This study explored glucose trends and their association with real-time food intake and self-report eating psychopathology in a sample of patients with anorexia nervosa (AN) and binge-eating disorder (BED). Method: 30 patients (AN, 15; BED, 15) wore continuous glucose monitoring (CGM) sensors while synchronously collecting data on daily food intake. CGM outputs were extracted and correlated with nutritional intake, daily meals composition and self-report eating psychopathology (BES, NEQ, GQ, Y-FAS). Results: Up to 74% of participants experienced hypoglycaemia in the study period, with unique trends by diagnosis (prolonged, interprandial, nocturnal episodes in AN; brief, postprandial, daytime episodes in BED). Significant association between the average number of daily meals, glucose coefficient of variation, and symptomatic events was evident in AN. Self-report night eating and food addiction symptoms in AN, and self-report grazing in BED, associated, respectively, with daytime and symptomatic hypoglycaemia. Conclusions: Hypoglycaemia is a frequent finding in patients with AN and BED and is associated with daily meals composition and dysfunctional eating behaviours. Theoretical explanations are provided for a diagnosis-specific effect on hypoglycemia events. CGM could valuably contribute to understanding, clinical staging, and customised treatments of EDs.