Continuous glucose monitoring trajectories in patients with acute coronary syndrome
Authors' conclusion
After ACS, CGM reveals substantial inter-individual heterogeneity and a reproducible late-morning vulnerability window. From discharge to mid-term follow-up, deterioration-also affecting patients without diabetes-may be preferentially detected by tight-range and variability/risk metrics that traditional monitoring of blood glucose and static measures such as HbA1c may overlook
Study context
- Population
- Consecutive high-risk acute coronary syndrome (ACS) patients wearing FreeStyle Libre 3/3 Plus continuous glucose monitoring (CGM) for 14–15 days near discharge and again at ≈4 monthsanalyzable baseline CGM
- Participants
- 213 patients
- Outcome
- CGM metrics in early post-ACS period
- Follow-up
- Near discharge
Methodological detailsmulticenter, observational, ORACLE program
- Multicenter
- Observational
- ORACLE program
Main finding
As reported in the abstract
- Median [IQR] TIR 70-180 mg/dL
- 96.57% [86.91-98.92]
- Time in tight range 70-140 mg/dL
- 85.00% [62.16-93.24]
- TAR >180 mg/dL
- 1.12% [0.18-9.82]
- TBR <70 mg/dL
- 0.43% [0.00-1.84]
- Mean glucose
- 114.26 mg/dL [106.26-133.96]
- Median GMI
- 6.04% [5.85-6.51]
Observational data: associations, not effects.
Further findings
Change in CGM metrics from baseline to ≈4 months
- Tight-range time decreased (p = 0.008)
- 4.5%
- Mean glucose increased (p = 0.03)
- 4.67 mg/dL
- HbA1c remained stable over follow-up
- Deterioration including in patients without diabetes
Worsening trajectory · ≈4 months
- Patients with worsening trajectory across CGM endpoints
- ≈20-40%
- Worsening by broad TIR thresholds
- 20.2%
- Hypertension and COPD independently associated with tight-range worsening
Original publication
Continuous glucose monitoring trajectories in patients with acute coronary syndrome. Cardiovasc Diabetol. Published 20 April 2026. doi:10.
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