Translating glycated hemoglobin A1c into time spent in glucose target range: A multicenter study

Area of Science:

• Pediatrics
• Endocrinology
• Diabetes Management

Background:

• Continuous glucose monitoring (CGM) is widely used by children and adolescents with type 1 diabetes in Sweden, with approximately 90% utilizing real-time or intermittently scanned devices.
• Time in target range (TIT) is an easily understood metric for evaluating glycemic control.

Purpose of the Study:

• To investigate the relationship between Time in Target Range (TIT) and hemoglobin A1c (HbA1c) in pediatric patients with type 1 diabetes.

Main Methods:

• 105 children and adolescents with type 1 diabetes from three Swedish centers provided 60 days of CGM data.
• HbA1c levels were obtained from the SWEDIABKIDS registry.
• TIT was defined as 3.9–7.8 mmol/L (70–140 mg/dL).

Main Results:

• A significant nonlinear relationship was observed between TIT over 60 days and HbA1c (R² = 0.69).
• Mean TIT was 40.9% (±12.2%), mean time in range (TIR) was 60.8% (±13.1%), and mean HbA1c was 7.1% (±0.7%).

Conclusions:

• Time in target range (TIT) demonstrates a nonlinear association with HbA1c in pediatric type 1 diabetes.
• TIT is a potentially valuable metric for assessing glycemic control, complementing HbA1c measurements.