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Objetive <p>To analyze the Time in Tight Range (TITR) (70–140 mg/dL) and the relationship between TITR-Time in Range (TIR) and assess their possible differences according to Coefficient of Variation (CV) in a cohort of patients with type 1 Diabetes Mellitus (DM) and Multiple Daily Injections in real life.</p> Patients and methods <p>355 adult users of Continuous Glucose Monitoring (CGM) with at least one HbA1c (October 1, 2023-October 1, 2024) and glucose data in the 90 days prior were included.</p> Results <p>Age 46.9 years (SD 13.6); 57.2% male; time of evolution 21.6 years (SD 12.6). Mean TITR was 38.4% (SD 14.6) and 20.3% had a TITR ≥ 50%. The correlation TITR-TIR was strong (β = 0.83; CI 95% 0.8–0.87; R<sup>2</sup> Adjusted 0.89; <i>p</i> &lt; 0.001) and varied according to CV [CV ≤ 36% (β = 0.88; CI 95% 0.83–0.93; R<sup>2</sup> Adjusted 0.89; <i>p</i> &lt; 0.001); CV &gt; 36% (β = 0.84; CI 95% 0.81–0.87; R<sup>2</sup> Adjusted 0.93; <i>p</i> &lt; 0.001)]. The cutoff value for TIR to discriminate TITR ≥ 50% varied according to CV [(CV ≤ 36% 75.9% (sensitivity 98%, specificity 94%, AUC 0.99, <i>p</i> &lt; 0.001); CV &gt; 36% 70.5% (sensitivity 100%, specificity 98%, AUC 0.99, <i>p</i> &lt; 0.001)]. The variables that were independently associated with TITR in CV ≤ 36% group were TIR (β = 0.74; CI 95% 0.57–0.9; <i>p</i> &lt; 0.001) and mean glucose (β = −0.11; CI 95% −0.21 to −0.01; <i>p</i> = 0.045). However, in CV &gt; 36% group were time of evolution (β = 0.04; CI 95% 0.01–0.07; <i>p</i> = 0.008), HbA1c (β = −0.63; CI 95% −1.22 to −0.4; <i>p</i> = 0.036; CV (β = 0.33; CI 95% 0.24–0.41; <i>p</i> &lt; 0.001) and TIR (β = 0.84; CI 95% 0.74–0.93; <i>p</i> &lt; 0.001).</p> Conclusions <p>The correlation between TITR-TIR was strong and higher in patients with CV &gt; 36%. Cutoff value for TIR to discriminate TITR ≥ 50% and factors that were associated with TITR also differ depending on CV. It is essential to take glycemic variability into account when interpreting metabolic control data.</p>

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Time in Tight Range (TITR) stratified by Coefficient of Variation (CV) in a cohort of patients with type 1 Diabetes Mellitus and Multiple Daily Injections. A real-life study

  • 期刊论文

  • 发表日期：

    2025年8月26日

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  • Sandra Herranz-Antolín,
  • Verónica Esteban-Monge,
  • María Covadonga López-Virgos,
  • Sofía Ramos-Garrido,
  • Clara Coton-Batres,
  • Silvia Lallena-Pérez,
  • Miguel Torralba

摘要

Objetive

To analyze the Time in Tight Range (TITR) (70–140 mg/dL) and the relationship between TITR-Time in Range (TIR) and assess their possible differences according to Coefficient of Variation (CV) in a cohort of patients with type 1 Diabetes Mellitus (DM) and Multiple Daily Injections in real life.

Patients and methods

355 adult users of Continuous Glucose Monitoring (CGM) with at least one HbA1c (October 1, 2023-October 1, 2024) and glucose data in the 90 days prior were included.

Results

Age 46.9 years (SD 13.6); 57.2% male; time of evolution 21.6 years (SD 12.6). Mean TITR was 38.4% (SD 14.6) and 20.3% had a TITR ≥ 50%. The correlation TITR-TIR was strong (β = 0.83; CI 95% 0.8–0.87; R2 Adjusted 0.89; p < 0.001) and varied according to CV [CV ≤ 36% (β = 0.88; CI 95% 0.83–0.93; R2 Adjusted 0.89; p < 0.001); CV > 36% (β = 0.84; CI 95% 0.81–0.87; R2 Adjusted 0.93; p < 0.001)]. The cutoff value for TIR to discriminate TITR ≥ 50% varied according to CV [(CV ≤ 36% 75.9% (sensitivity 98%, specificity 94%, AUC 0.99, p < 0.001); CV > 36% 70.5% (sensitivity 100%, specificity 98%, AUC 0.99, p < 0.001)]. The variables that were independently associated with TITR in CV ≤ 36% group were TIR (β = 0.74; CI 95% 0.57–0.9; p < 0.001) and mean glucose (β = −0.11; CI 95% −0.21 to −0.01; p = 0.045). However, in CV > 36% group were time of evolution (β = 0.04; CI 95% 0.01–0.07; p = 0.008), HbA1c (β = −0.63; CI 95% −1.22 to −0.4; p = 0.036; CV (β = 0.33; CI 95% 0.24–0.41; p < 0.001) and TIR (β = 0.84; CI 95% 0.74–0.93; p < 0.001).

Conclusions

The correlation between TITR-TIR was strong and higher in patients with CV > 36%. Cutoff value for TIR to discriminate TITR ≥ 50% and factors that were associated with TITR also differ depending on CV. It is essential to take glycemic variability into account when interpreting metabolic control data.