The Correlation between Time in Range and Diabetic Microvascular Complications Utilizing Information Management...

Area of Science:

• Endocrinology
• Metabolic Diseases
• Clinical Data Science

Background:

• Time in Range (TIR) is emerging as a crucial metric in diabetes management, offering insights beyond traditional glycemic control indicators.
• While TIR is recognized for its potential in evaluating glycemic control efficacy and predicting diabetic complications, its precise relationship with these outcomes requires further elucidation.

Purpose of the Study:

• To investigate the correlation between Time in Range (TIR) and Glycosylated Hemoglobin (HbA1C) using a large-scale clinical data platform.
• To assess the association between TIR and the risk of microvascular complications, including retinopathy, nephropathy, and neuropathy, in type 2 diabetes patients.
• To establish a theoretical foundation for the clinical application of TIR and determine optimal TIR ranges for diabetes management.

Main Methods:

• Analysis of data from 5,644 type 2 diabetes patients hospitalized between April 2017 and June 2020.
• Utilized fingertip capillary blood glucose monitoring (FCGM) data, excluding non-diabetic, pregnant, or ketosis patients.
• Examined the proportion of time within the target blood glucose range (70–180 mg/dl) and its correlation with HbA1C and microvascular complication risks.

Main Results:

• A significant inverse linear correlation was observed between TIR and HbA1C (R²=0.458, P<0.01), with lower TIR associated with higher HbA1C levels.
• Lower TIR was significantly linked to an increased risk of diabetic nephropathy (DN) (TIR < 40% OR=1.249), diabetic peripheral neuropathy (DPN) (TIR < 70% OR=1.030), and diabetic retinopathy (DR) (TIR < 50% OR=1.092).
• Statistical differences in TIR values were significant between patients with and without each microvascular complication (P<0.05 for DN, P<0.01 for DPN and DR).

Conclusions:

• Time in Range (TIR) serves as a valuable indicator for short-term glycemic control in diabetes management.
• TIR strongly reflects clinical blood glucose regulation and effectively predicts the risk of developing diabetic microvascular complications.
• The findings support the integration of TIR monitoring into routine diabetes care to improve patient outcomes and reduce complication rates.