Time-in-range as a target in type 2 diabetes: An urgent need

Saboo, Banshi; Kesavadev, Jothydev; Shankar, Arun; Krishna, Meera B.; Sheth, Shruti; Patel, V B; Krishnan, Gopika

doi:10.1016/j.heliyon.2021.e05967

Cited by 21 publications

(20 citation statements)

References 30 publications

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“…Glycated hemoglobin has always been the golden indicator to reflect blood sugar control [ 7 ]. However, due to the interference of many conditions such as anemia and pregnancy, it cannot reflect the rapid changes in blood sugar in a short period of time [ 8 , 9 ]. The TIR is not interfered by the average blood sugar level and other pathological factors and can describe the blood sugar control level more realistically [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study on the Time in Range of Blood Glucose and Type 2 Diabetic Peripheral Neuropathy

Chang

et al. 2022

BioMed Research International

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Background. Time in range (TIR) is one of the basic indicators to assess glycemic control. In this study, the TIR of DPN patients was used as the observation index to further evaluate the correlation between TIR and DPN, so as to provide new ideas for preventing the occurrence of DPN and delaying its disease progression. Methods. A total of 120 patients with T2DM (T2DM) who were hospitalized in the Endocrinology Department of our hospital from October 2018 to February 2020 were included and divided into two groups according to whether the nerve conduction velocity was normal or not, the diabetic peripheral neuropathy group (DPN) and the other groups. No diabetic peripheral neuropathy group (NDPN). According to the corresponding inclusion and exclusion criteria, the baseline data were recorded, and test indicators such as homocysteine and blood lipids were collected at the same time, and TIR was collected by a transient blood glucose meter. To explore the relationship between TIR and other indicators and peripheral neuropathy in T2DM. Results. A total of 120 T2DM patients participated in the study, including 82 in the DPN group and 38 in the NDPN group. There were no statistically significant differences in basic indicators such as age, height, and weight between the two groups. Glycated hemoglobin (HbA1c) and homocysteine (Hcy) in DPN group were higher than those in NDPN group, while TIR and HDL-C were lower than those in NDPN group ( P < 0.05 ). Logistic regression analysis showed that HbA1c and Hcy were risk factors for DPN, and TIR and HDL-C were protective factors for DPN, with statistical significance ( P < 0.05 ). The prediction results of TIR, Hcy, HDL-C, and HbA1c on diabetic peripheral neuropathy were analyzed by ROC curve, and the prediction results of the five variables were all statistically significant ( P < 0.05 ) and have a better prediction effect. Conclusion. (1) The results of TIR level suggest that the longer the blood sugar is in the good control range, the more beneficial it is to reduce the occurrence of DPN. (2) TIR and HDL-C are protective factors for DPN, and HbA1c and Hcy are risk factors for DPN. (3) The results of ROC curve analysis showed that TIR, Hcy, HbA1c, and HDL-C had a good predictive effect on the occurrence of DPN.

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Section: Introductionmentioning

confidence: 99%

A Retrospective Study on the Time in Range of Blood Glucose and Type 2 Diabetic Peripheral Neuropathy

Chang

et al. 2022

BioMed Research International

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“…He recommended the urgent inclusion of TIR -in the routine management of type 2 diabetes with an objective to prevent long term complications. (19). Beck et al in their study conducted by utilizing the datasets of 545 adults with type 1 diabetes (T1D) revealed that in T1D, CGM measures such as TIR and mean glucose that reflects hyperglycemia are highly correlated with each other but only moderately correlated with A1c and for a given TIR or change in TIR there exists a wide range of possible corresponding A1c values (20).…”

Section: Time In Range (Ic-tir)mentioning

confidence: 99%

“…In South Asia, especially in rural and semi-urban regions, hypoglycemia is more common because of poor health education, unavailability of medical facilities, malnutrition, and poor economic status (22,23). Occurrence of hypoglycemia leads to decreased drug compliance, cardiovascular events, increased mortality, frequent falls, and frequent emergency visits (16,19).…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Time-in-range and frequency of continuous glucose monitoring: Recommendations for South Asia

Kesavadev

Misra

Saboo

et al. 2022

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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“…Early studies suggest that time-in-range is just as good a predictor of long-term diabetes complications [23,38] The effect of GV has been also assessed on the morphological features of coronary plaques in CAD patients treated with lipid-lowering therapy. Using MAGE, GV was identified as the only independent predictor of the thin-cap fibro-atheroma, evaluating 166 lesions in 72 CAD patients [47].…”

Section: Mean Of Daily Differencementioning

confidence: 99%

The Role of Glycemic Variability in Cardiovascular Disorders

Alfieri

Myasoedova

Vinci

et al. 2021

IJMS

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Diabetes mellitus (DM) is one of the most common and costly disorders that affect humans around the world. Recently, clinicians and scientists have focused their studies on the effects of glycemic variability (GV), which is especially associated with cardiovascular diseases. In healthy subjects, glycemia is a very stable parameter, while in poorly controlled DM patients, it oscillates greatly throughout the day and between days. Clinically, GV could be measured by different parameters, but there are no guidelines on standardized assessment. Nonetheless, DM patients with high GV experience worse cardiovascular disease outcomes. In vitro and in vivo studies showed that high GV causes several detrimental effects, such as increased oxidative stress, inflammation, and apoptosis linked to endothelial dysfunction. However, the evidence that treating GV is beneficial is still scanty. Clinical trials aiming to improve the diagnostic and prognostic accuracy of GV measurements correlated with cardiovascular outcomes are needed. The present review aims to evaluate the clinical link between high GV and cardiovascular diseases, taking into account the underlined biological mechanisms. A clear view of this challenge may be useful to standardize the clinical evaluation and to better identify treatments and strategies to counteract this DM aspect.

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Time-in-range as a target in type 2 diabetes: An urgent need

Cited by 21 publications

References 30 publications

A Retrospective Study on the Time in Range of Blood Glucose and Type 2 Diabetic Peripheral Neuropathy

A Retrospective Study on the Time in Range of Blood Glucose and Type 2 Diabetic Peripheral Neuropathy

Time-in-range and frequency of continuous glucose monitoring: Recommendations for South Asia

The Role of Glycemic Variability in Cardiovascular Disorders

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