Time in tight range and time in range for predicting the achievement of typical glucose management indicator and HbA1c targets

Diabetologia. 2025 May 7. doi: 10.1007/s00125-025-06442-2. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: This study aimed to compare the ability of time in tight range (TITR) and time in range (TIR) to predict the achievement of typical glucose management indicator (GMI) and HbA_1c targets.

METHODS: This cross-sectional analysis included 773 adults with diabetes receiving insulin therapy who visited Samsung Medical Center between June 2019 and December 2023 and wore a Dexcom G6 or FreeStyle Libre continuous glucose monitor for at least 90 days (sensor wear time, ≥70%). A receiver operating characteristic analysis was used to compare the ability of TITR and TIR to predict GMI and HbA_1c targets.

RESULTS: TITR had significantly greater AUC values than TIR for predicting GMIs of <53 mmol/mol (7.0%) and <48 mmol/mol (6.5%) among participants using a Dexcom G6 or FreeStyle Libre continuous glucose monitor. TITR also had significantly greater AUC values than TIR for predicting HbA_1c levels of <53 mmol/mol (7.0%) (95% CI for difference: 0.006, 0.03) and <48 mmol/mol (6.5%) (95% CI for difference: 0.001, 0.03) among participants using the FreeStyle Libre. In the HbA_1c range of 48-53 mmol/mol (6.5-7.0%), TIR exhibited broader variations than TITR across CV groups. The modifying effect of CV on the association between TITR and GMI or HbA_1c was minimised around a GMI and HbA_1c level of 53 mmol/mol (7.0%).

CONCLUSIONS/INTERPRETATION: TITR might be a more useful indicator than TIR of the achievement of typical GMI and HbA_1c targets among adults with diabetes on insulin therapy.

PMID:40332559 | DOI:10.1007/s00125-025-06442-2