Time above range for predicting the development of type 2 diabetes

Area of Science:

• Endocrinology
• Metabolic Diseases
• Diabetes Research

Background:

• Type 2 diabetes (T2D) is a growing global health concern.
• Early identification of individuals at high risk is crucial for prevention strategies.
• Traditional markers like glycated hemoglobin (HbA1c) have limitations in predicting T2D development.

Purpose of the Study:

• To evaluate the prognostic capability of continuous glucose monitoring (CGM) time range metrics for predicting T2D.
• To determine if CGM data offers additional predictive value beyond established risk factors.

Main Methods:

• A 5-year prospective study followed 499 individuals without diabetes.
• Continuous glucose monitoring (CGM) was used to measure time range metrics at baseline.
• Medical records were analyzed for T2D development, adjusting for covariates.

Main Results:

• Twenty-two participants developed T2D over the 5-year follow-up.
• Time above range (TAR), defined as glucose >140 mg/dL, was significantly associated with increased T2D risk (OR=1.06, CI 1.01-1.11) after multivariate adjustment.
• The model incorporating TAR demonstrated strong predictive performance (AUC=0.94).

Conclusions:

• Time above range (TAR) measured by CGM is a significant predictor of future type 2 diabetes development.
• CGM-derived TAR provides incremental prognostic information compared to glycated hemoglobin (HbA1c).
• These findings support the use of CGM metrics in identifying individuals at higher risk for T2D in population-based settings.