High blood glucose index stratifies glycaemic severity and identifies occult type 2 diabetes risk in prediabetes via single‐day continuous glucose monitoring: A multi‐cohort study
Authors' conclusion
HBGI is a device-agnostic metric that effectively stratifies glycaemic severity. A single-day HBGI assessment provides complementary risk stratification by unmasking occult risk in prediabetes with established CGM indices within recommended ranges.
Study context
- Population
- Healthy individuals and individuals with prediabetes or diabetes with continuous glucose monitoring (CGM) records365 valid CGM records
- Exposure
- High Blood Glucose Index (HBGI) vs other CGM indices for predicting progression to T2D
- Outcome
- Platform-independent robustness of CGM-derived HBGI and predictive utility of a single day for progression to T2D
Methodological detailsthree CGM devices, four independent cohorts, cross-sectional and longitudinal analyses
- Three CGM devices
- Four independent cohorts
- Cross-sectional and longitudinal analyses
Main finding
As reported in the abstract
HBGI variance, gradient across glycaemic stages and prediction of progression
- Share of total HBGI variance explained by device type
- 3.4%
- Share of total HBGI variance explained by metabolic status
- 31.8%
- Stepwise increase in HBGI from healthy through prediabetes to diabetes (cross-sectional)
- p < 0.001
- Baseline HBGI differentiated progressors from non-progressors
- p = 0.005
- AUC of single-day baseline HBGI for progression
- 0.74 (95% CI 0.61-0.85)
Observational data: associations, not effects.
Further findings
Progression risk in prediabetes with established glycaemic indices within recommended ranges, by elevated HBGI (>0.174)
- Elevated HBGI identified an occult high-risk subgroup; fold-higher progression risk
- 5.39- to 6.13-fold
Original publication
High blood glucose index stratifies glycaemic severity and identifies occult type 2 diabetes risk in prediabetes via single‐day continuous glucose monitoring: A multi‐cohort study. Diabet Med. Published 13 August 2026. doi:10.
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