期刊
DIABETES TECHNOLOGY & THERAPEUTICS
卷 25, 期 6, 页码 378-383出版社
MARY ANN LIEBERT, INC
DOI: 10.1089/dia.2022.0447
关键词
Cardiovascular disease; Continuous glucose monitoring; Diabetes complications; Diabetic retinopathy; Hypoglycemia
Glycemic target range, measured as time in range (TIR), is being studied as a surrogate endpoint for long-term diabetes-related outcomes. This analysis found that TIR, specifically derived TIR (dTIR), at 12 months was significantly associated with time to first major adverse cardiovascular event, severe hypoglycemic episode, or microvascular event. The study suggests that targeting TIR >70% and using dTIR as a clinical biomarker could be useful in managing type 2 diabetes.
Time spent in glycemic target range (time in range [TIR]; plasma glucose 70-180 mg/dL [3.9-10.0 mmol/L]) as a surrogate endpoint for long-term diabetes-related outcomes requires validation. This post hoc analysis investigated the association between TIR, derived from 8-point glucose profiles (derived TIR [dTIR]) at 12 months, and time to cardiovascular or severe hypoglycemic episodes in people with type 2 diabetes in the DEVOTE trial. At 12 months, dTIR was significantly negatively associated with time to first major adverse cardiovascular event (P = 0.0087), severe hypoglycemic episode (P < 0.0001), or microvascular event (P = 0.024). A nonsignificant trend was seen toward association between 12-month hemoglobin A1c (HbA1c) and these outcomes, but this was no longer seen after addition of dTIR to the model. The results support targeting TIR >70% and suggest dTIR could be used in addition to, or in some instances in place of, HbA1c as a clinical biomarker.
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