1945-P: Associations of Time in Tight Range, Time in Range, and Glycated Hemoglobin with Albuminuria and Diabetic Kidney Disease in Adult Type 2 Diabetes: A Cross-Sectional Study

Introduction and Objective: To evaluate associations of the indicators of glycemic control, HbA1c, continuous glucose monitoring (CGM)-derived time in tight range (TITR; 70-140 mg/dL), and time in range (TIR; 70-180 mg/dL) with albuminuria and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study included 697 patients with T2DM. Albuminuria (UACR ≥30 mg/g) and DKD (eGFR <60 mL/min/1.73 m² or albuminuria) were assessed. Multivariable logistic regression analyzed associations of TITR, TIR, and HbA1c (continuous/tertiles) with albuminuria and DKD. Results: Among the participants, the prevalence of albuminuria and DKD was 34.6% and 37.9%, respectively. After full adjustment, higher TITR and TIR were independently associated with lower odds of albuminuria (TITR: OR 0.98, 95% CI 0.97-0.99; TIR: OR 0.98, 0.97-0.99) and DKD (TITR: OR 0.98, 0.97-0.99; TIR: OR 0.98, 0.97-0.99). The highest (vs. lowest) tertiles of TITR and TIR had significantly reduced risks (for albuminuria; TITR: OR 0.42, TIR: OR 0.50; for DKD, TITR OR 0.39, TIR: OR 0.46; all p <0.05). HbA1c showed weaker threshold effects (highest tertile ORs: albuminuria 1.99, DKD: 2.14; p <0.05) Restricted cubic spline analysis demonstrated a significant dose-response relationship, wherein higher levels of TITR/TIR were associated with progressively lower risks of albuminuria and DKD. Subgroup analyses demonstrated stronger protective effects for TITR/TIR regarding albuminuria and DKD in patients with diabetes duration ≥10 years (interaction p ≤0.043). Conclusion: Higher TITR and TIR are independently associated with lower risks of albuminuria and DKD in T2DM, with superior association distinct from HbA1c. These CGM metrics may better reflect renal risk, especially in long-duration diabetes. Disclosure Y. Yang: None. Z. Liu: None. Y. Huang: None. H. Deng: None. X. Yang: None. J. Yan: None. L. Zeng: None. B. Lin: None. W. Xu: None.