2026-05-06T00:02:35Zhttps://uvadoc.uva.es/oai/requestoai:uvadoc.uva.es:10324/751972025-03-03T20:01:13Zcom_10324_1181com_10324_931com_10324_894col_10324_1387
Utility of time in tight range (TITR) in evaluating metabolic control in pediatric and adult patients with type 1 diabetes in treatment with advanced hybrid closed-loop systems
Bahillo Curieses, María del Pilar
Fernández Velasco, Pablo
Pérez López, Paloma
Vidueira Martínez, Ana María
Nieto de la Marca, María de la O
Díaz Soto, Gonzalo
Type 1 diabetes
Time in range
Time in tight range
Advanced hybrid closed loop
Glucose variability
32 Ciencias Médicas
Producción Científica
Purpose To analyze the time in tight range (TITR), and its relationship with other glucometric parameters in patients with
type 1 diabetes (T1D) treated with advanced hybrid closed-loop (AHCL) systems.
Methods A prospective observational study was conducted on pediatric and adult patients with T1D undergoing treatment
with AHCL systems for at least 3 months. Clinical variables and glucometric parameters before and after AHCL initiation
were collected.
Results A total of 117 patients were evaluated. Comparison of metabolic control after AHCL initiation showed significant
improvements in HbA1c (6.9 ± 0.9 vs. 6.6 ± 0.5%, p < 0.001), time in range (TIR) (68.2 ± 11.5 vs. 82.5 ± 6.9%, p < 0.001),
TITR (43.7 ± 10.8 vs. 57.3 ± 9.7%, p < 0.001), glucose management indicator (GMI) (6.9 ± 0.4 vs. 6.6 ± 0.3%, p < 0.001),
time below range (TBR) 70–54 mg/dl (4.3 ± 4.5 vs. 2.0 ± 1.4%, p < 0.001), and time above range (TAR) > 180 mg/dl
(36.0 ± 7.6 vs. 15.1 ± 6.4%, p < 0.001). Coefficient of variation (CV) also improved (36.3 ± 5.7 vs. 30.6 ± 3.7, p < 0.001),
while time between 140–180 mg/dl remained unchanged. In total, 76.3% achieved TITR > 50% (100% pediatric). Corre-
lation analysis between TITR and TIR and GRI showed a strong positive correlation, modified by glycemic variability.
Conclusions AHCL systems achieve significant improvements in metabolic control (TIR > 70% in 93.9% patients). The
increase in TIR was not related to an increase in TIR 140–180 mg/dl. Despite being closely related to TIR, TITR allows for a
more adequate discrimination of the achieved control level, especially in a population with good initial metabolic control.
The correlation between TIR and TITR is directly influenced by the degree of glycemic variability.
Publicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCLE
2025-03-03T10:09:04Z
2025-03-03T10:09:04Z
2024
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Endocrine, 2024, vol. 86, n. 2, p. 539-545
https://uvadoc.uva.es/handle/10324/75197
10.1007/s12020-024-03881-6
539
2
545
Endocrine
86
1559-0100
eng
https://link.springer.com/article/10.1007/s12020-024-03881-6
Atribución 4.0 Internacional
info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by/4.0/
© 2024 The Author(s)
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https://uvadoc.uva.es/handle/10324/75197