2026 Volume 2 Issue 1 Pages 408-416
Background: Glucose variability may be associated with autonomic symptoms such as palpitations, dizziness, and nocturnal awakenings, yet daily patterns are difficult to capture with conventional t esting. Continuous glucose monitoring (CGM) can visualize temporal patterns and support behavior change.
Case: A woman in her 40s developed diarrhea, abdominal distension, insomnia, palpitations, and e pisodic anxiety after interpersonal stress and a flu-like illness. Symptoms clustered around meals a nd at night. CGM showed a post-lunch spike to 246 mg/dL and nocturnal low-range values of 50 –70 mg/dL. Stepwise interventions included optimizing carbohydrate amount and snack timing, brie f postprandial walking, bedtime intake of carbohydrate, medium-chain triglycerides, and essential a mino acids, and adjustment of Kampo medication timing, with improvement in nocturnal awakenin gs, palpitations, and anxiety.
Conclusion: CGM-guided visualization may facilitate individualized lifestyle and nutritional interve ntions; symptom improvement may have been associated with reduced glucose variability. Further studies are warranted to clarify causality and generalizability.
