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Using Time in Tight Glucose Range as a Health-Promoting Strategy in Preschoolers With Type 1 Diabetes

Frida Sundberg1, Carmel E Smart2, John Samuelsson3,4

  • 1Department of Paediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Diabetes Care
|November 15, 2024
PubMed

Insights

Time in tight range (TITR) is a key metric for managing type 1 diabetes in young children. Achieving >50% TITR is a realistic and health-promoting goal for preschoolers with type 1 diabetes.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Early-onset type 1 diabetes (T1D) in children poses risks of long-term hyperglycemia, complications, and cognitive impairment due to effects on the developing brain.
  • Evaluating insulin treatment efficacy requires glucose value thresholds, leading to the definition of Time in Tight Range (TITR) as a measure of normoglycemia.
  • International guidelines suggest >70% time in range (70-180 mg/dL) or >50% TITR (70-140 mg/dL) for preschoolers with T1D.

Purpose of the Study:

  • To review and discuss international knowledge and experiences regarding Time in Tight Range (TITR) as a health-promoting strategy for preschoolers with T1D.
  • To explore the application of TITR on both structural and individual levels within pediatric diabetes care.

Main Methods:

  • Review of international literature and clinical practices concerning Time in Tight Range (TITR) in pediatric type 1 diabetes management.
  • Analysis of Swedish registry data indicating glycemic control in children under 7 years old.
  • Discussion of experiences from pediatric diabetes teams in setting and achieving glycemic targets.

Main Results:

  • Swedish registry data show that over 50% of children under 7 years old achieve >50% Time in Tight Range (TITR).
  • Pediatric diabetes teams in Sweden have focused on a target range of 70-140 mg/dL (3.9-7.8 mmol/L) for the past two decades.
  • The study highlights the feasibility of achieving significant Time in Tight Range (TITR) in young children with T1D.

Conclusions:

  • As insulin treatment advances, maximizing time in normoglycemia (TITR) is a reasonable and explainable goal for families of children with T1D.
  • A realistic target for children with access to experienced healthcare teams and technology is achieving at least 50% Time in Tight Range (TITR).
  • Time in Tight Range (TITR) serves as a valuable health-promoting strategy for managing type 1 diabetes in preschoolers.

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