Aiming for the Best Glycemic Control Beyond Time in Range: Time in Tight Range as a New Continuous Glucose Monitoring Metric in Children and Adolescents with Type 1 Diabetes Using Different Treatment Modalities

• DOI: 10.1089/dia.2023.0373
• Publication Date: 2023-10-30T15:22:28Z
• Authors: Stefano Passanisi; Claudia Piona; Giuseppina Salzano; Marco Marigliano; Bruno Bombaci; Anita Morandi; Angela Alibrandi; Claudio Maffeis; Fortunato Lombardo
• Keywords: Target range

Introduction. To evaluate time in tight range (TITR) 70-140 mg/dL (3.9- 7.8 mmol/L), its correlation with standard continuous glucose monitoring (CGM) metrics and the clinical variables that possibly have a substantial impact on value, large cohort of pediatric subjects using different treatment strategies. Material methods. A total 854 children adolescents type 1 diabetes were consecutively recruited this real-world, dual-center, cross-sectional study. Participants categorized into four groups (multiple daily injections + real-time CGM, multiple intermittently scanned sensor augmented pump, hybrid closed loop (HCL)). Demographical data, including CGM collected analyzed. Results. The overall study population exhibited an average TITR 36.4±12.8%. HCL users showed higher levels compared to other (p<0.001). (TIR) cut-off value 71.9% identified achieving TITR≥50% (AUC 0.98; 95%CI 0.97–0.99, p<0.001), strong positive between these two was observed (r=0.95, p<0.001). An increase TIR 1% associated 1.84 (R2 Nagelkerke=0.35, p<0.001) increased likelihood TITR≥50%. Use systems (B=7.78; disease duration (B=-0.26, p=0.006), coefficient variation (B=-0.30, p=0.004), glycated haemoglobin (B=-8.82; emerged as significant predictors levels. Conclusions. Our highlights most present below 50%, except those HCL. Tailored interventions strategies should be implemented TITR.