IMPACT OF DAILY GLUCOSE SPIKES ON GASTROINTESTINAL HEALTH IN SOUTH ARAL REGION

Postprandial glucose excursions, characterized by rapid increases in blood glucose levels following meals, are increasingly recognized as contributors to metabolic dysregulation and systemic inflammation. However, their specific impact on gastrointestinal (GI) health remains insufficiently characterized, especially in populations exposed to environmental stressors such as those in the South Aral region. This study aimed to evaluate the association between daily glucose variability and gastrointestinal symptomatology in this vulnerable population. A prospective observational cohort study was conducted involving 150 adult participants without diagnosed diabetes, residing in the South Aral region. Continuous glucose monitoring (CGM) over 14 days quantified glucose fluctuations, defined as postprandial spikes exceeding 30 mg/dL above baseline within two hours of meals. Gastrointestinal symptoms were assessed weekly via the validated Gastrointestinal Symptom Rating Scale (GSRS). Dietary intake was evaluated using detailed food frequency questionnaires (FFQ), and environmental exposures were documented through standardized surveys. Multivariate linear regression models adjusted for confounding variables. The cohort exhibited an average of 3.8 ± 1.2 daily glucose spikes. Increased glucose spike frequency was significantly correlated with higher total GSRS scores (β = 0.45, p < 0.001), with pronounced effects on domains of abdominal pain, bloating, and bowel irregularity. Participants with >4 spikes per day reported nearly double the GI symptom burden compared to those with fewer spikes. High intake of refined carbohydrates was positively associated with glucose variability (r = 0.52, p < 0.001). Environmental pollutant exposure showed a modest exacerbation of symptoms but was not directly linked to glucose fluctuations. Frequent postprandial glucose spikes contribute to increased gastrointestinal symptomatology in the South Aral population, suggesting a pathophysiological link potentially mediated by metabolic inflammation and gut barrier dysfunction. These findings underscore the need for integrated metabolic and environmental health interventions aimed at reducing glucose variability and improving GI health in at-risk populations.