The association of chronic complications with time in tight range and time in range in people with type 1 diabetes: a retrospective cross-sectional real-world study
Authors' conclusion
TITR and TIR are inversely associated with the presence of microvascular complications and CVA in people with type 1 diabetes. Although this study was not designed to establish a causal relationship, this analysis adds validity to the use of TITR and TIR as key measures in glycaemic management.
Study context
- Population
- Adults with T1D
- Participants
- 808 adults
- Exposure
- Association of TITR/TIR with chronic complications
- Outcome
- Prevalence of microvascular complications (diabetic retinopathy, diabetic nephropathy, DPN) and macrovascular complications according to sensor-measured TITR/TIR
Methodological detailsreal-world
- Real-world
Main finding
As reported in the abstract
Association of each 10% increase in TITR with complications (unadjusted)
- Any microvascular complication, OR per 10% TITR increase
- 0.762 (95% CI 0.679, 0.855; p<0.001)
- Diabetic retinopathy, OR
- 0.757 (95% CI 0.670, 0.856; p<0.001)
- Background diabetic retinopathy, OR
- 0.760 (95% CI 0.655, 0.882; p<0.001)
- Severe diabetic retinopathy, OR
- 0.854 (95% CI 0.731, 0.998; p=0.048)
- Diabetic nephropathy, OR
- 0.799 (95% CI 0.699, 0.915; p<0.001)
- DPN, OR
- 0.837 (95% CI 0.717, 0.977; p=0.026)
- Cerebrovascular accident (CVA), OR
- 0.651 (95% CI 0.470, 0.902; p=0.010)
Observational data: associations, not effects.
Further findings
Mean TITR and TIR
- Mean TITR, % (± 12.8%)
- 33.9
- Mean TIR, % (± 15.0%)
- 52.5
Prevalence of complications
- Any microvascular complication
- 46.0%
- Diabetic retinopathy
- 34.5%
- Diabetic nephropathy
- 23.8%
- DPN
- 16.0%
- Any macrovascular complication
- 16.3%
Association of each 10% increase in TITR with complications, adjusted for HbA1c
- Any microvascular complication, OR
- 0.867 (95% CI 0.762, 0.988; p=0.032)
- Diabetic retinopathy, OR
- 0.837 (95% CI 0.731, 0.959; p=0.010)
- Background diabetic retinopathy, OR
- 0.831 (95% CI 0.705, 0.979; p=0.027)
- CVA, OR
- 0.619 (95% CI 0.426, 0.899; p=0.012)
- Similar results when controlling for HbA1c and other confounding factors
Original publication
The association of chronic complications with time in tight range and time in range in people with type 1 diabetes: a retrospective cross-sectional real-world study. Diabetologia. Published 24 May 2024. doi:10.
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