Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Jaeb Center for Health Research, Tampa, FL, USA.
Diabetes Technol Ther. 2024 Apr;26(4):246-251. doi: 10.1089/dia.2023.0486. Epub 2024 Feb 13.
To evaluate the association between continuous glucose monitoring (CGM)-based time in various ranges and the subsequent development of diabetic retinopathy (incident DR) in adults with type 1 diabetes. Between June 2018 and March 2022, adults with type 1 diabetes with incident DR or no retinopathy (control) were identified. CGM data were collected retrospectively for up to 7 years before the date of eye examination defining incident DR or control. Associations between incident DR and CGM metrics were evaluated using logistic regression models. This analysis included 71 adults with incident DR (mean age 27 years, 52% females, and mean diabetes duration 15 years) and 92 adults without DR (mean age 38 years, 48% females, and mean diabetes duration 20 years). Adjusting for age, diabetes duration, and CGM type, each 0.5% increase in glycated hemoglobin (HbA1c), 10 mg/dL increase in mean glucose, 5% decrease in time in target range 70-180 mg/dL (TIR), 5% decrease in time in tight target range 70-140 mg/dL (TITR), and 5% increase in time above 180 mg/dL (TAR) were associated with 24%, 22%, 18%, 28%, and 20% increase in odds of incident DR, respectively. Spearman correlations of TIR, TITR, TAR, and mean glucose with each other were all ≥0.97. Similar to HbA1c, TIR, TITR, TAR, and mean glucose were associated with increased risk for incident DR in adults with type 1 diabetes. These CGM metrics are highly correlated indicating that they provide similar information on glycemic control and diabetic retinopathy risk.
评估连续血糖监测（CGM）在不同范围内的时间与 1 型糖尿病成人中糖尿病视网膜病变（DR）发病的相关性。在 2018 年 6 月至 2022 年 3 月期间，确定了患有 1 型糖尿病且有或无 DR（对照组）的成人。收集了在眼部检查确定 DR 发病或对照组前长达 7 年的 CGM 数据。使用逻辑回归模型评估 DR 发病与 CGM 指标之间的相关性。这项分析包括 71 名患有 DR 发病的成年人（平均年龄 27 岁，女性占 52%，糖尿病病程 15 年）和 92 名无 DR 的成年人（平均年龄 38 岁，女性占 48%，糖尿病病程 20 年）。调整年龄、糖尿病病程和 CGM 类型后，糖化血红蛋白（HbA1c）每增加 0.5%、平均血糖增加 10mg/dL、目标范围 70-180mg/dL（TIR）时间减少 5%、严格目标范围 70-140mg/dL（TITR）时间减少 5%和血糖高于 180mg/dL（TAR）时间增加 5%，与 DR 发病的几率分别增加 24%、22%、18%、28%和 20%相关。TIR、TITR、TAR 和平均血糖之间的 Spearman 相关系数均≥0.97。与 HbA1c 相似，TIR、TITR、TAR 和平均血糖与 1 型糖尿病成人中 DR 发病风险增加相关。这些 CGM 指标高度相关，表明它们提供了关于血糖控制和糖尿病视网膜病变风险的相似信息。
