An Assessment of Clinical Continuous Glucose Monitoring Targets for Older and High-Risk People Living with Type 1 Diabetes.

To assess relationships between continuous glucose monitoring (CGM) time in range (TIR), 70-180 mg/dL, time below range (TBR), <70 mg/dL, time above range (TAR), >180 mg/dL, and glucose coefficient of variation (CV) in relation to currently recommended clinical CGM targets for older people, which recommend reduced TIR and TBR targets relative to the general type 1 diabetes population. We conducted a post hoc analysis using the JDRF Australia Adult Hybrid Closed Loop trial database examining correlations in 120 adults with type 1 diabetes of 3 weeks masked CGM (Guardian Sensor 3; Medtronic) metrics ( = 61 on multiple daily injections, 59 on non-CGM augmented pumps) using manual insulin dosing at baseline and at 26-weeks, with 50% randomized to automated insulin dosing (AID). Correlations between baseline TIR and TAR were strong ( = -0.966;  < 0.0001), weak for TBR ( = 0.363;  < 0.0001), and glucose CV ( = 0.037;  = 0.687) while moderate between CV and TBR ( = 0.726;  < 0.0001). Associations were similar for participants aged >60 years ( = 15) versus younger subjects. Correlations of changes in (Δ) TIR with ΔTAR over 26 weeks were strong ( = -0.945;  < 0.001) and correlations for ΔTBR were weak ( = 0.025;  = 0.802). ΔCV did not significantly correlate with ΔTAR ( = -0.064;  = 0.526) but did with ΔTBR ( = 0.770;  = <0.001). Changes in TIR are not associated with changes in TBR. Thus, we recommend that for older AID users whilst TBR targets should be prioritized to reduce hypoglycemia-related risk, TBR should be addressed independently of TIR. Clinical Trial Registratrion number: (ACTRN12617000520336).