Do Metrics of Temporal Glycemic Variability Reveal Abnormal Glucose Rates of Change in Type 1 Diabetes?
Authors' conclusion
Individuals with T1D spend significant time with glucose RoC exceeding those observed in health. Existing GV-timing metrics are strongly correlated with time with abnormal RoC. Incorporation of a GV-timing metric in clinical practice is recommended.
Study context
- Population
- Healthy individuals (normal rates of change (RoC) range) and a separate continuous glucose monitoring (CGM) dataset of individuals with T1D
- Exposure
- T1D vs healthy individuals
- T1Dn = 736
- Outcome
- Time in fluctuation (TIF): % of time glucose RoC over 1-h intervals exceeds healthy percentile thresholds (L1: >99% or <1%; L2: >99.9% or <0.1%)
Main finding
As reported in the abstract
Time in fluctuation
| Group | Value | TIF-L2 median (IQR) |
|---|---|---|
| T1D | median 16.7% (IQR 12.7–21.5) | 5.0% [3.1-7.8] |
| Healthy | median 1.4% (IQR 0.6–2.8) | 0.0% [0.0-0.2] |
Value
T1Dmedian 16.7% (IQR 12.7–21.5)
Healthymedian 1.4% (IQR 0.6–2.8)
TIF-L2 median (IQR)
T1D5.0% [3.1-7.8]
Healthy0.0% [0.0-0.2]
Observational data: associations, not effects.
Further findings
Extremum percentiles of RoC in health
- 0.1% percentile
- −80 mg/dL/h
- 1% percentile
- −50 mg/dL
- 99% percentile
- +56 mg/dL/h
- 99.9% percentile
- +89 mg/dL/h
Correlation of MAG and continuous overlapping net glycemic action (CONGA) with TIF-L1 and TIF-L2
- MAG and CONGA highly correlated with TIF-L1 and TIF-L2, each pairwise comparison
- r > .95
Original publication
Do Metrics of Temporal Glycemic Variability Reveal Abnormal Glucose Rates of Change in Type 1 Diabetes? J Diabetes Sci Technol. Published 11 November 2024. doi:10.
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