Determination of Time in Range Associated With HbA1c ≤7% in a Prospective Cohort of Patients With Type 1 Diabetes Using Continuous Glucose Monitoring for Three Months

Ana María Gómez, Diana Cristina Henao C, Martín Rebolledo, Pablo Esteban Jaramillo P, Oscar Mauricio Muñoz V, Laura María Niño G, Carlos Augusto Yepes C

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Resumen

Introduction: Finding a goal of time in range (%TIR) that defines good glycemic control is necessary. Previous retrospective studies suggest good concordance between HbA1c ≤7% with a TIR >70%; however, the studies that included the largest number of patients used blood glucose measurement data with a follow-up time of less than 90 days. This study defined the TIR value that best discriminates HbA1c ≤7%. Methods: We performed a prospective study of diagnostic tests based on a cohort of patients with type 1 diabetes (T1D) treated with a hybrid closed loop (HCL) followed for three months. The ability of %TIR to distinguish patients with HbA1c ≤7% was evaluated through receiver operating characteristic curve analysis. We determined the %TIR cutoff point with the best operating characteristics. Results: A total of 118 patients were included (58.1% women, 47% overweight or obese, and 33% with high glycemic variability). A moderate negative correlation (R = −.54, P <.001) was found between %TIR and HbA1c. The discrimination ability was moderate, with an area under the curve of 0.7485 (95% confidence interval = 0.6608-0.8363). The cutoff point that best predicted HbA1c ≤7% was %TIR ≥75.5 (sensitivity 70%, specificity 67%). The findings were similar among those with a coefficient of variation (CV%) ≥36%. Conclusions: Our data suggest that the %TIR adequately identifies patients with HbA1c ≤7%. A target of TIR ≥75%, rather than the currently recommended TIR ≥70%, may be a more suitable value for optimal glycemic control.

Idioma originalInglés
Páginas (desde-hasta)345-350
Número de páginas6
PublicaciónJournal of Diabetes Science and Technology
Volumen18
N.º2
DOI
EstadoPublicada - mar. 2024
Publicado de forma externa

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