Key result
Each 10% increase in continuous glucose monitoring-derived time in range (70 to 180 mg/dL) was significantly associated with lower odds of definite cardiovascular autonomic neuropathy (OR 0.876).
Why the study?
Continuous glucose monitoring-derived metrics are emerging indicators of glycemic control and complications beyond hemoglobin A1c, prompting investigation into their association with cardiovascular autonomic neuropathy in type 2 diabetes.
Does higher time in range (TIR) on continuous glucose monitoring correlate with reduced cardiovascular autonomic neuropathy in outpatients with type 2 diabetes?
Cross-Sectional (n=284)
No
Does higher time in range (TIR) on continuous glucose monitoring correlate with reduced cardiovascular autonomic neuropathy in outpatients with type 2 diabetes?
Odds Ratio: 0.876 (95% CI 0.79–0.98)
p-value: p=0.017
In outpatients with type 2 diabetes, higher time in range (70-180 mg/dL) on continuous glucose monitoring is significantly associated with a lower prevalence and severity of cardiovascular autonomic neuropathy.
Higher TIR associated with lower CAN odds in T2D; hypothesis-generating and requires prospective validation before practice change.
Abstract BackgroundContinuous glucose monitoring (CGM)-derived metrics including time in range (TIR) are attracting attention as new indicators of glycemic control and diabetes complications beyond hemoglobin A1c. This study investigated the association between CGM-derived TIR, hyperglycemia, hypoglycemia metrics, and cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes.MethodsA total of 284 patients with type 2 diabetes who underwent CGM for three days and autonomic function tests within three months based on outpatient data were recruited. The definition of CGM-derived metrics was subject to the most recent international consensus. CAN was defined as an abnormal case in two or more parasympathetic and the severity of CAN was estimated as the sum of the scores of the five cardiovascular autonomic function tests.ResultsMultiple logistic regression analysis revealed that the odds ratio of definite CAN was 0.876 [95% confidence interval (CI): 0.79–0.98] per 10% increase in the TIR of 70 to 180 mg/dL, after adjusting for age, sex, diabetes duration, any medications, and glycemic variability. A 10% increase in TIR was significantly inversely associated with the presence of advanced CAN (OR: 0.89, 95% CI: 0.81–0.98). In addition, there was a strong inverse association between a 10% increase in the TIR and the total CAN score (p for trend = 0.001). Among the metrics of hyperglycemia, a time above range (TAR) of greater than 180 mg/dL was also independently correlated with the presence of definite CAN (OR: 1.013, 95% CI: 1.00–1.02) and advanced CAN (OR: 1.01, 95% CI: 1.00–1.02).ConclusionsA TIR value of 70 to 180 mg/dL and a TAR value of greater than 180 mg/dL were significantly associated with cardiovascular autonomic neuropathy in outpatients with type 2 diabetes.
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Kim et al. (2020) conducted a cross-sectional in Type 2 Diabetes and Cardiovascular Autonomic Neuropathy (n=284). Time in range (TIR) of 70 to 180 mg/dL (per 10% increase) vs. Lower time in range was evaluated on Presence of definite cardiovascular autonomic neuropathy (CAN) (OR 0.876, 95% CI 0.79-0.98, p=0.017). Each 10% increase in continuous glucose monitoring-derived time in range (70 to 180 mg/dL) was significantly associated with lower odds of definite cardiovascular autonomic neuropathy (OR 0.876).
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