Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?

Introduction: Hybrid closed-loop systems (HCLS) use has shown that time in range (TIR) tends to improve more during the nighttime than during the day. This study aims to compare the conventional TIR, currently accepted as 70 to 180 mg/dL, with a proposed recalculated time in range (RTIR) considering...

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Autores: Maia, A, Andujar, DS, Yuste, C, Albert, L, Vilaverde, J, Cardoso, MH, Rigla, M
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2024
País:España
Recursos:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositório:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p4589
Acesso em linha:https://i3pt.portalinvestigacion.com/publicaciones/4589
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188298370&doi=10.1177%2f19322968241236456&partnerID=40&md5=75d8813cfcdee8ee069375bfd4ed3311
Access Level:Acceso aberto
Palavra-chave:type 1 diabetes mellitus
automated insulin delivery
hybrid closed-loop systems
continuous glucose monitoring
time in range
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spelling Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?Maia, AAndujar, DSYuste, CAlbert, LVilaverde, JCardoso, MHRigla, Mtype 1 diabetes mellitusautomated insulin deliveryhybrid closed-loop systemscontinuous glucose monitoringtime in rangeIntroduction: Hybrid closed-loop systems (HCLS) use has shown that time in range (TIR) tends to improve more during the nighttime than during the day. This study aims to compare the conventional TIR, currently accepted as 70 to 180 mg/dL, with a proposed recalculated time in range (RTIR) considering a tighter glucose target of 70 to 140 mg/dL for the nighttime fasting period in T1DM patients under HCLS.Methods: We conducted a retrospective study that included adults patients receiving treatment with Tandem t:slim X2 Control-IQ. Daytime TIR was characterized as glucose values between 70 and 180 mg/dL during the 07:01 to 23:59 time frame. Nighttime fasting TIR was specified as glucose values from 70 to 140 mg/dL between 00:00 and 07:00. The combination of the daytime and nighttime fasting glucose targets results in an RTIR, which was compared with the conventional TIR for each patient. The 14 days Dexcom G6 CGM data were downloaded from Tidepool platform and analyzed.Results: We included 22 patients with a mean age of 49.7 years and diabetes duration of 24.7 years, who had been using automatic insulin delivery (AID) HCLS for a median of 305.3 days. We verified a mean conventional TIR of 68.7% vs a mean RTIR of 60.3%, with a mean percentage difference between these two metrics of -8.4%. A significant decrease in conventional TIR was verified when tighter glucose targets were considered during the nighttime period. No significant correlation was found between the percentage difference values and RTIR, even among the group of patients with the lowest conventional TIR.Conclusions: Currently, meeting the conventional TIR metrics may fall short of achieving an ideal level of glycemic control. An individualized strategy should be adopted until further data become available for a precise definition of optimal glucose targets.SAGE PUBLICATIONS INC2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/4589https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188298370&doi=10.1177%2f19322968241236456&partnerID=40&md5=75d8813cfcdee8ee069375bfd4ed3311Journal of Diabetes Science and TechnologyISSN: 19322968reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p45892026-06-21T15:30:37Z
dc.title.none.fl_str_mv Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
title Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
spellingShingle Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
Maia, A
type 1 diabetes mellitus
automated insulin delivery
hybrid closed-loop systems
continuous glucose monitoring
time in range
title_short Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
title_full Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
title_fullStr Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
title_full_unstemmed Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
title_sort Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
dc.creator.none.fl_str_mv Maia, A
Andujar, DS
Yuste, C
Albert, L
Vilaverde, J
Cardoso, MH
Rigla, M
author Maia, A
author_facet Maia, A
Andujar, DS
Yuste, C
Albert, L
Vilaverde, J
Cardoso, MH
Rigla, M
author_role author
author2 Andujar, DS
Yuste, C
Albert, L
Vilaverde, J
Cardoso, MH
Rigla, M
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv type 1 diabetes mellitus
automated insulin delivery
hybrid closed-loop systems
continuous glucose monitoring
time in range
topic type 1 diabetes mellitus
automated insulin delivery
hybrid closed-loop systems
continuous glucose monitoring
time in range
description Introduction: Hybrid closed-loop systems (HCLS) use has shown that time in range (TIR) tends to improve more during the nighttime than during the day. This study aims to compare the conventional TIR, currently accepted as 70 to 180 mg/dL, with a proposed recalculated time in range (RTIR) considering a tighter glucose target of 70 to 140 mg/dL for the nighttime fasting period in T1DM patients under HCLS.Methods: We conducted a retrospective study that included adults patients receiving treatment with Tandem t:slim X2 Control-IQ. Daytime TIR was characterized as glucose values between 70 and 180 mg/dL during the 07:01 to 23:59 time frame. Nighttime fasting TIR was specified as glucose values from 70 to 140 mg/dL between 00:00 and 07:00. The combination of the daytime and nighttime fasting glucose targets results in an RTIR, which was compared with the conventional TIR for each patient. The 14 days Dexcom G6 CGM data were downloaded from Tidepool platform and analyzed.Results: We included 22 patients with a mean age of 49.7 years and diabetes duration of 24.7 years, who had been using automatic insulin delivery (AID) HCLS for a median of 305.3 days. We verified a mean conventional TIR of 68.7% vs a mean RTIR of 60.3%, with a mean percentage difference between these two metrics of -8.4%. A significant decrease in conventional TIR was verified when tighter glucose targets were considered during the nighttime period. No significant correlation was found between the percentage difference values and RTIR, even among the group of patients with the lowest conventional TIR.Conclusions: Currently, meeting the conventional TIR metrics may fall short of achieving an ideal level of glycemic control. An individualized strategy should be adopted until further data become available for a precise definition of optimal glucose targets.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/4589
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188298370&doi=10.1177%2f19322968241236456&partnerID=40&md5=75d8813cfcdee8ee069375bfd4ed3311
url https://i3pt.portalinvestigacion.com/publicaciones/4589
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188298370&doi=10.1177%2f19322968241236456&partnerID=40&md5=75d8813cfcdee8ee069375bfd4ed3311
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SAGE PUBLICATIONS INC
publisher.none.fl_str_mv SAGE PUBLICATIONS INC
dc.source.none.fl_str_mv Journal of Diabetes Science and Technology
ISSN: 19322968
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
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repository.mail.fl_str_mv
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