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Background <p>Continuous glucose monitoring (CGM) has improved diabetes management, yet not all patients benefit equally. We previously developed a predictive calculator using clinical and socioeconomic variables to estimate the likelihood of achieving optimal control after CGM initiation. This study prospectively validated the calculator in a real-world cohort.</p> Methods <p>A single-center prospective study included 102 adults with type 1 or pancreatic diabetes using multiple daily insulin injections, followed for three months. Optimal control was defined as time in range (TIR, 70–180 mg/dL) &gt; 70% and time below range (TBR, &lt;70 mg/dL) &lt; 4%. Model performance was assessed using ROC analysis and correlation tests.</p> Results <p>Of 102 participants, 85 completed follow-up (median age: 53.6 years; 48% women; median diabetes duration: 12.9 years; baseline HbA1c: 7.6%). Thirty-three (38.8%) achieved optimal control. The calculator showed moderate discrimination (AUC = 0.639) and significant correlations with TIR (<i>p</i> = 0.230, <i>p</i> = 0.023) and time in tight range (TITR, 70–140 mg/dL) (<i>p</i> = 0.271, <i>p</i> = 0.019). Overall accuracy was 61.9%, lower than in the original cohort. Smoking predicted non-completion (<i>p</i> = 0.038).</p> Conclusions <p>The calculator shows moderate accuracy in predicting glycemic control and TITR after CGM initiation. CGM adherence remains a challenge, warranting further study in publicly funded healthcare settings.</p>

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Validation of a predictive calculator for optimal glycemic control and time-in-tight-range following CGM sensor placement in type 1 diabetes and pancreatic diabetes: a prospective study

  • 期刊论文

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  • 发表日期：

    2025年8月26日

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  • Fernando Sebastian-Valles,
  • Juan Javier López-Hidalgo,
  • Silvia Cañas Sierra,
  • Victor Navas-Moreno,
  • Jose Alfonso Arranz Martín,
  • Miguel Antonio Sampedro-Núñez,
  • Mónica Marazuela

摘要

Background

Continuous glucose monitoring (CGM) has improved diabetes management, yet not all patients benefit equally. We previously developed a predictive calculator using clinical and socioeconomic variables to estimate the likelihood of achieving optimal control after CGM initiation. This study prospectively validated the calculator in a real-world cohort.

Methods

A single-center prospective study included 102 adults with type 1 or pancreatic diabetes using multiple daily insulin injections, followed for three months. Optimal control was defined as time in range (TIR, 70–180 mg/dL) > 70% and time below range (TBR, <70 mg/dL) < 4%. Model performance was assessed using ROC analysis and correlation tests.

Results

Of 102 participants, 85 completed follow-up (median age: 53.6 years; 48% women; median diabetes duration: 12.9 years; baseline HbA1c: 7.6%). Thirty-three (38.8%) achieved optimal control. The calculator showed moderate discrimination (AUC = 0.639) and significant correlations with TIR (p = 0.230, p = 0.023) and time in tight range (TITR, 70–140 mg/dL) (p = 0.271, p = 0.019). Overall accuracy was 61.9%, lower than in the original cohort. Smoking predicted non-completion (p = 0.038).

Conclusions

The calculator shows moderate accuracy in predicting glycemic control and TITR after CGM initiation. CGM adherence remains a challenge, warranting further study in publicly funded healthcare settings.