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The Optimal 'Time in Range' and 'Time below Range' are Difficult to Coordinate in Patients with Type 1 Diabetes
- Source :
- The Tohoku Journal of Experimental Medicine. 255:221-227
- Publication Year :
- 2021
- Publisher :
- Tohoku University Medical Press, 2021.
-
Abstract
- Achieving the optimal glucose level time in range (TIR), as recently proposed by the "International Consensus on Time in Range," is challenging. We retrospectively analyzed data from 192 patients, including 58 with type 1 diabetes, using the FreeStyle Libre Pro system. This device was used by physicians for continuous glucose monitoring (CGM) and for making therapeutic decisions based on unbiased data, as the patients were blinded to their blood glucose levels during monitoring. The desired 70% TIR among patients with type 2 diabetes corresponded to an HbA1c of 7.7%. Importantly, however, a 70% TIR for patients with type 1 diabetes corresponded to an HbA1c of 6.9%, which diverged markedly from the HbA1c of 7.9% that corresponded to the desired 4% time below range (TBR). Moreover, these dissociations were observed more in patients with type 1 diabetes with a higher % coefficient of variation (> 36%). Hence, while the TIR is strongly correlated with HbA1c, it is difficult to coordinate with the TBR in Japanese patients with type 1 diabetes. As these metrics (which are critical indicators in clinical practice) are rapidly gaining popularity globally, including in Japan, our data strongly support the cautious use of new CGM metrics such as TIR and TBR/time above range, and emphasize the importance of individualized treatment in achieving the optimal TIR and TBR, especially in patients with type 1 diabetes.
- Subjects :
- Blood Glucose
Type 1 diabetes
medicine.medical_specialty
Continuous glucose monitoring
business.industry
Blood Glucose Self-Monitoring
Coefficient of variation
General Medicine
Type 2 diabetes
medicine.disease
Time optimal
General Biochemistry, Genetics and Molecular Biology
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Diabetes mellitus
Internal medicine
medicine
Range (statistics)
Humans
In patient
business
Retrospective Studies
Subjects
Details
- ISSN :
- 13493329 and 00408727
- Volume :
- 255
- Database :
- OpenAIRE
- Journal :
- The Tohoku Journal of Experimental Medicine
- Accession number :
- edsair.doi.dedup.....592ee32806f808b32ee0bf1deb954aef