Time In Tight Range in children and adolescents with type 1 diabetes: A cross‐sectional observational single centre study evaluating efficacy of new advanced technologies

Abstract Introduction Early and tight glycaemic control is crucial to prevent long‐term complications of Type 1 Diabetes (T1D). The aim of our study was to compare glucose metrics, including Time In Tight Range (TITR), in a real‐world setting. Methods We performed a single‐centre cross‐sectional study in 534 children and adolescents with T1D. Participants were divided into four groups (multiple daily injections + real‐time Continuous glucose monitoring (CGM), multiple daily injections + intermittently scanned CGM, sensor augmented pump (SAP), and Advanced Hybrid Closed‐Loop (AHCL). Demographical and clinical data were collected and analysed. Results The group with AHCL showed significantly higher Time In Range (TIR) (71.31% ± 10.88) than SAP (57.82% ± 14.98; p < 0.001), MDI + rtCGM (54.56% ± 17.04; p < 0.001) and MDI + isCGM (52.17% ± 19.36; p < 0.001) groups with a lower Time Above Range ( p < 0.001). The group with AHCL also showed lower Time Below Range than MDI + isCGM and SAP groups ( p < 0.01). The overall TITR was 37% ± 14 with 19% of participants who reached a TITR ≥50% with a mean TIR of 81%. AHCL had significantly higher TITR (45.46% ± 11.77) than SAP (36.25% ± 13.53; p < 0.001), MDI + rtCGM (34.03% ± 13.89; p < 0.001) and MDI + isCGM (33.37% ± 15.84; p < 0.001) groups with a lower Coefficient of Variation ( p < 0.001). Conclusions Our study indicates that AHCL ensures a better glycaemic control with an improvement in both TIR and TITR, along with a reduction in CV. Implementation of automated insulin delivery systems should be considered in the treatment of children and adolescents with T1D.