TY - JOUR
T1 - 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
AU - Gómez, Ana María
AU - Henao C, Diana Cristina
AU - Rebolledo, Martín
AU - Jaramillo P, Pablo Esteban
AU - Muñoz V, Oscar Mauricio
AU - Niño G, Laura María
AU - Yepes C, Carlos Augusto
N1 - Publisher Copyright:
© 2022 Diabetes Technology Society.
PY - 2024/3
Y1 - 2024/3
N2 - 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.
AB - 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.
KW - HbA1c
KW - closed-loop systems
KW - continuous glucose monitoring
KW - time in range (TIR)
KW - type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85133825032&partnerID=8YFLogxK
U2 - 10.1177/19322968221108424
DO - 10.1177/19322968221108424
M3 - Article
C2 - 35791440
AN - SCOPUS:85133825032
SN - 1932-2968
VL - 18
SP - 345
EP - 350
JO - Journal of Diabetes Science and Technology
JF - Journal of Diabetes Science and Technology
IS - 2
ER -