Impact of time in tight range on all‐cause and cardiovascular mortality in type 2 diabetes: A prospective cohort study

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 27, 2025

Currently, there is a lack of evidence regarding time in tight range (TITR) and long-term adverse outcomes. We aimed to investigate the association between TITR risk all-cause cardiovascular mortality among patients with type 2 diabetes. A total 6061 diabetes were prospectively recruited single centre. was measured continuous glucose monitoring (CGM) at baseline defined as percentage target 3.9-7.8 mmol/L (70-140 mg/dL) during 24-h period. Cox proportion hazard regression models used examine mortality. During median follow-up period 10.9 years, 1898 (31.3%) death events confirmed, 689 (11.4%) due The restricted cubic spline revealed significant linear relationships lower higher risks (p for linearity <0.01). In fully adjusted model including glycated haemoglobin A1c, each 10% decrease associated 4% (95% confidence interval, 1.01-1.06) increased 1.00-1.08) Subgroup analyses showed that relationship sustained A1c <7.0% fasting plasma <7.0 mmol/L. Lower an diabetes, indicating glycaemic control within physiological may be crucial reducing risk, especially those seemingly well-controlled

Language: Английский

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The Relationship Between Glycated Albumin and Time in Tight Range in Type 2 Diabetes

Journal of Diabetes, Journal Year: 2025, Volume and Issue: 17(3)

Published: March 1, 2025

Among the new glucose metrics derived from continuous monitoring, concept of time in tight range (TITR) has gained increasing attention. We aimed to assess association between TITR and traditional glycemic indicators, such as glycated albumin (GA). A total 310 patients with type 2 diabetes on a stable glucose-lowering regimen over previous 3 months were enrolled. (TIR) calculated using monitoring data collected minimum 5 days. Spearman correlation analysis was performed relationships including GA HbA1c, TIR. Receiver operating characteristic curves used evaluate predictive value for > 50% TIR 70%. The median levels HbA1c 15.6% (14.0%, 17.3%) 6.5% (6.1%, 7.1%), respectively. Median 70.0% (56.0%, 81.0%) 91.0% (84.0%, 96.8%), showed moderate negative relationship both optimal cutoff identifying either or 70% 17.4%. Moreover, combining fasting plasma 2-h postprandial significantly enhanced ability identify 50%, achieving performance comparable combination glucose. In diabetes, 17.4% effectively identifies 50%.

Language: Английский

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The automated correction index (ACI), a novel report-derived metric correlated to glucose control and variability in patients with type 1 diabetes on advanced hybrid closed loop therapy

Diabetes Research and Clinical Practice, Journal Year: 2025, Volume and Issue: unknown, P. 112173 - 112173

Published: April 1, 2025

This study aimed to correlate the parameters of advanced hybrid closed loop (AHCL) function glycometabolic outcomes in a cohort patients with type 1 diabetes (T1D) using different AHCL systems. was retrospective cross-sectional on 124 adult (n = 87) and pediatric 37) correlating total daily insulin dose (TDD), basal (TDBa) bolus (TDBo) doses, percentage auto-bolus out (Automated Correction Index - ACI) glycated hemoglobin (HbA1c) sensor-derived metrics. The ACI only AHCL-derived parameter directly associated HbA1c (p 0.03) time above range (TAR180-250 mg/dL, 10-13.9 mmol/L, p < 0.01), inversely correlated (TIR70-180 3.9-10 0.01). Patients 30 % showed reduced levels (6.21 ± 0.5 vs. 6.95 0.8, 0.02) higher probability having TIR > 70 (OR 3.18, CI 1.19-8.46, coefficient variation (CV) 36 2.86, 1.07-8.27, compared those ≥ %. could represent useful easy-to-assess metric for AHCL-treated individuals T1D. In our an better glucose control variability.

Language: Английский

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Use of an insulin titration protocol based on continuous glucose monitoring in postoperative cardiac surgery patients with type 2 diabetes and prediabetes: a randomized controlled trial

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: May 14, 2025

Maintaining optimal glucose control is critical for postoperative care cardiac surgery patients. Continuous monitoring (CGM) in this setting remains understudied. We evaluated the efficacy of CGM with a specialized titration protocol patients type 2 diabetes (T2D) and prediabetes. In randomized-controlled trial, 54 were randomized one day post-surgery, 27 25 point-of-care (POC) completing study. The group used Dexcom G6 CGM-specialized protocol, while POC standard blinded CGM. primary outcome was time-in-range (TIR) 100-180 mg/dL 7 days post-surgery. Secondary outcomes included various glycemic metrics surgical outcomes. Multiple comparison adjustments performed using false-discovery-rate (FDR). Thirty-one (59.6%) had 21 (40.4%) While TIR showed no difference (74.7% vs. 71.6%, FDR-adjusted p = 0.376), demonstrated improvements 70-180 (83.8% 75.8%, 0.026), time-in-tight-range (TITR) 100-140 (46.3% 36.3%, 0.018), TITR 70-140 (55.3% 40.5%, 0.003). Both groups maintained very low rates time below range (< 70 mg/dL: 0.03% 0.18%, 0.109). lower atrial fibrillation (AF) (18.8% 55.6%, 0.04999). not achieved, safe TITRs T2D observed reduction AF warrants further investigation. ClinicalTrials.gov NCT06275971.

Language: Английский

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