Association between worsening time in range and microvascular complications in type 1 diabetes: real-world 5-year study
Authors' conclusion
CGM-derived glucometrics were associated with the 5-year incidence of microvascular complications in this real-world cohort, with ΔTIR potentially providing additional prognostic information beyond HbA1c.
Study context
- Population
- Adults with T1D, tertiary referral center; median age 40 [28–53] years, diabetes duration 24 [13–33] years
- Participants
- 246 adults
- Exposure
- Change in time in range (TIR) over follow-up: ≥10% decrease vs stable vs ≥10% increase
- Outcome
- Composite microvascular endpoint:
- Nephropathy (persistent albuminuria ≥20 µg/min, eGFR <60 mL/min/1.73 m², and/or RAAS inhibitor use for albuminuria)
- Severe retinopathy (proliferative retinopathy, maculopathy, and/or blindness)
- Peripheral neuropathy (monofilament score <6/6 and/or abnormal nerve conduction)
- Follow-up
- 5 years
Methodological detailsfive-year follow-up, tertiary referral center
- Five-year follow-up
- Tertiary referral center
Main finding
As reported in the abstract
Composite microvascular complication rate by change in TIR
P = 0.011
Observational data: associations, not effects.
Further findings
HbA1c over follow-up
- HbA1c decreased from 7.6% (59 mmol/mol) to 7.2% (55 mmol/mol)
TIR (70-180 mg/dL) over follow-up
- TIR increased from 50 ± 14% to 61 ± 15%
Other predictors
- BMI and systolic blood pressure were not significant
Discrimination of models with glucometrics and age
- AUCs
- 0.757-0.787
- Acceptable discriminative performance
Original publication
Association between worsening time in range and microvascular complications in type 1 diabetes: real-world 5-year study. J Clin Endocrinol Metab. Published 16 September 2026. doi:10.
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