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Moving the Goalposts: Do Adults With Type 1 Diabetes Want Time in Tight Range?
Molly L Tanenbaum1, Mabelle B Pasmooij2, Rachel Tam3
1Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, California; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California; Stanford University School of Medicine, Stanford Diabetes Research Center, Stanford, California.
Adults with type 1 diabetes have mixed views on time in tight range (TITR) management. While some see health benefits, others worry about increased burden and psychological risks, advocating for personalized targets.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Diabetes Management
Background:
- Type 1 diabetes (T1D) requires continuous glucose monitoring (CGM) for optimal management.
- Time in tight range (TITR: 70-140 mg/dL) is an emerging metric for glycemic control.
- Understanding patient attitudes towards TITR is crucial for implementing new CGM metrics.
Purpose of the Study:
- To explore attitudes of adults with T1D towards TITR.
- To inform educational strategies for introducing new CGM metrics.
- To optimize glycemic and quality of life outcomes in T1D patients.
Main Methods:
- Focus groups conducted with adult CGM users with T1D.
- Discussions centered on a potential shift towards TITR targets.
- Data analyzed using qualitative content analysis.
Main Results:
- 33 adults with T1D participated; 88% used automated insulin delivery.
- Some participants favored TITR for potential long-term health improvements.
- Concerns included increased management burden, anxiety, hypoglycemia, disordered eating, and feelings of failure.
Conclusions:
- TITR may benefit some T1D patients but poses risks and burdens, even with advanced technology.
- Patient perspectives are vital for implementing new CGM metrics effectively.
- Personalized targets and improved technology/access are needed for broader TITR achievability.
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