Association of Achieving Time in Range Clinical Targets With Treatment Modality Among Youths With Type 1 Diabetes
Authors' conclusion
In this multinational cohort study of youths with type 1 diabetes, concurrent use of real-time CGM and an insulin pump was associated with increased probability of achieving recommended clinical targets and time in range target as well as lower probability of severe adverse events compared with other treatment modalities.
Study context
- Population
- Youths <21 years with T1D for ≥6 months who provided continuous glucose monitoring (CGM) data, 2016–2021, SWEET registry; median age 14.4 years, median HbA1c 7.4%
- Participants
- 5,219 participants
- Exposure
- rtCGM or isCGM, each with insulin pump or injections
- Outcome
- Proportion in each treatment modality achieving recommended CGM clinical targets
Methodological detailsSWEET registry, 21 countries
- SWEET registry
- 21 countries
Main finding
As reported in the abstract
TIR >70% target achieved (adjusted)
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Values | P value |
|---|---|---|
| TAR <25% target achievedrtCGM + pump vs isCGM + pump | rtCGM + pump 32.5% (95% CI 30.4%–34.7%) · isCGM + pump 12.8% (95% CI 10.6%–15.4%) | P < 0.001 |
| TBR <4% target achievedrtCGM + pump vs isCGM + pump | rtCGM + pump 73.1% (95% CI 71.1%–75.0%) · isCGM + pump 47.6% (95% CI 44.1%–51.1%) | P < 0.001 |
| Adjusted TIR | rtCGM + pump 64.7% (95% CI 62.6%–66.7%) |
Adjusted TIR
- Adjusted TIR highest with rtCGM + pump
Safety
Severe hypoglycaemia and DKA
- Treatment modality was associated with the proportion experiencing severe hypoglycemia and DKA events
Original publication
Association of Achieving Time in Range Clinical Targets With Treatment Modality Among Youths With Type 1 Diabetes. JAMA Netw Open. Published 1 February 2023. doi:10.
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