Viral Shah, MD: Time in Range Associated with Diabetic Retinopathy in T1D

Viral Shah, MD

Credit: University of Colorado

New research suggests continuous glucose metrics (CGM), including time in range (70-180 mg/dL), were associated with the development of incidental diabetic retinopathy in adults with type 1 diabetes (T1D).¹

The results, presented at the 83rd Scientific Sessions of the American Diabetes Association, suggest other CGM metrics, including time in tight target range (70-140 mg/dL) and time above range (>180 mg/dL), were additionally associated with diabetic retinopathy (P <.001).

“I think our data clearly shows that the CGM metrics are associated with diabetic retinopathy,” Viral Shah, MD, associate professor, Barbara Davis Center for Diabetes, the University of Colorado Anschutz told HCPLive at ADA 2023.

CGM metrics, including time in range, and their goals, have been indicated as new metrics to assess diabetes management.² However, there is a lack of longitudinal studies validating time in range with complications of diabetes. Shah and colleagues analyzed up to 7 years of retrospective longitudinal CGM data of 92 adults with T1D without a diagnosis of diabetic retinopathy (control group) and 71 adults with a new incident diagnosis of diabetic retinopathy between June 2018 - December 2020 but had normal eye examinations in the past.

The study team assessed the association between diabetic retinopathy and CGM metrics via linear mixed models adjusting for age and diabetes duration. The analysis revealed A1c was positively associated with the development of diabetic retinopathy in adults with T1D. Time in range was associated with a 16% increase in diabetic retinopathy in people with T1D, after adjustments by age and diabetes duration. Additionally, time in tight target range was associated with a 26% increase in risk for incidental diabetic retinopathy

“I think our data reinforces and brings evidence in such a better way that we can have a little more confidence that the time in range does have an association with diabetes complications, and therefore, I think time in range in clinical practice and improving the time in range would lead to a reduction in those microvascular complications in people with diabetes,” Shah said.

For more insight into this analysis, watch the full interview with Shah below:

Relevant disclosures for Shah include Novo Nordisk, Dexcom Inc., Insulet Corporation, Tandem Diabetes Care, and others.

References

1. Shah VN, Sakamoto C, Pyle L, Akturk HK, Polsky S, Forlenza GP, Snell-Bergeon JK. Time in Range Is Associated with Incident Diabetic Retinopathy in Adults with Type 1 Diabetes—A Seven-Year Longitudinal Study. Oral presentation at the 83rd Scientific Sessions of the American Diabetes Association. June 23 – 26, 2023.
2. Time in range. Time in Range | American Diabetes Association. Accessed June 26, 2023. https://professional.diabetes.org/content-page/time-range.