Time in Tight Range Versus Time in Range for Predicting Diabetic Retinopathy in Adults with Type 1 Diabetes Using Multiple Daily Insulin Injections: A Retrospective Longitudinal Study with isCGM Data
Authors' conclusion
TITR provides modestly superior predictive value over TIR for incident DR, particularly in individuals with near-target HbA1c, but both metrics perform similarly for predicting progression. CGM-derived metrics should be interpreted in the context of overall glycemic control and clinical risk factors.
Study context
- Population
- Adults with T1D on MDI using isCGM; ophthalmological assessment at baseline and after 12 months (May 2024-May 2025)
- Participants
- 309 adults
- Exposure
- Time in tight range (TITR) vs time in range (TIR) for predicting diabetic retinopathy (DR)
- Outcome
- Incident DR (in those free of DR at baseline) and DR progression (in those with established DR), ETDRS criteria
- Follow-up
- 12 months
Methodological detailslongitudinal, isCGM data
- Longitudinal
- isCGM data
Main finding
As reported in the abstract
Incident DR
| Group | AUC | aOR per % increase |
|---|---|---|
| TITR | 0.580 | 0.965 (95% CI 0.950-0.980) |
| TIR | 0.430 |
AUC
TITR0.580
TIR0.430
aOR per % increase
TITR0.965 (95% CI 0.950-0.980)
TIR— not stated in the abstract
- TITR vs TIR: P < 0.001 — superior discrimination for TITR
- Incident DR
- 10/198 (5.1%)
Observational data: associations, not effects.
Further findings
DR progression · 12 months
- Progressed among baseline DR
- 26/111 (23.4%)
- Both TITR and TIR associated with lower risk of DR progression in models including HbA1c, with similar discrimination
Incident DR by HbA1c stratum
- TITR predicted incident DR only with HbA1c below cohort median (7.1%)
Baseline DR status
- No DR
- 198 (64.1%)
- Nonproliferative DR
- 71 (23.0%)
- Proliferative DR
- 40 (12.9%)
Original publication
Time in Tight Range Versus Time in Range for Predicting Diabetic Retinopathy in Adults with Type 1 Diabetes Using Multiple Daily Insulin Injections: A Retrospective Longitudinal Study with isCGM Data. Diabetes Technol Ther. Published 11 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →