Zhongguo quanke yixue (Jun 2023)
Relationship between Time in Range and Long-term HbA1c Glycemic Variability in Elderly Male Patients with Type 2 Diabetes
Abstract
Background As a new indicator of glycemic management, time in range (TIR) is significantly related to short-term glycemic variability, but whether it is also associated with long-term glycemic variability is still unclear. Objective To investigate the relationship of TIR with coefficient of variability (CV) of HbA1c and HbA1c variability score (HVS) during a long-term follow-up in elderly male patients with type 2 diabetes. Methods Two hundred elderly male type 2 diabetic inpatients from the Second Medical Center of PLA General Hospital were enrolled from January 2007 to January 2011. All of them underwent continuous glucose monitoring (CGM) during hospitalization, and by the baseline TIR derived from CGM, they were divided into TIR≥85% group (n=141) and TIR<85% group (n=59), and followed up for (12.5±1.1) years. The CV of HbA1c and HVS in the follow-up were compared between the groups. The relationships of TIR with the CV of HbA1c and HVS were analyzed using Pearson correlation analysis and multivariate linear regression analysis. Results The long-term CV of HbA1c〔 (9.7±3.8) % vs (8.2±4.5) %, P=0.028〕 and HVS〔 (48.7±20.4) vs (32.5±20.8), P<0.001〕 in TIR<85% group were both significantly higher than those in TIR≥85% group. Pearson correlation analysis suggested that TIR showed a significant linear negative correlation with CV of HbA1c (r=-0.239, P<0.001) or HVS (r=-0.400, P<0.001). Multiple linear regression analysis indicated that TIR had an impact on long-term CV of HbA1c〔b (95%CI) =-0.07 (-0.12, -0.03), P<0.05〕or HVS〔b (95%CI) =-0.44 (-0.67, -0.21), P<0.05〕after adjusting for confounding factors. Conclusion TIR was independently associated with long-term CV of HbA1c or HVS in elderly male patients with type 2 diabetes. With the decrease of TIR, the long-term HbA1c glycemic variability increased gradually during follow-up.
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