Association of Time in Range levels with Lower Extremity Arterial Disease in patients with type 2 diabetes

Abstract

Background and aims: Time in range (TIR) is a new metric of glycemic control, assessed by continuous glucose monitoring (CGM). Previous studies have shown that is associated with microvascular complications of diabetes. We aimed to investigate the relationship between TIR levels and Lower Extremity Arterial Disease (LEAD) in patients with type 2 diabetes (T2DM).

Methods: This cross-sectional study evaluated a total of 336 patients with T2DM, including 179 patients with LEAD and 157 without patients. Analysis of covariance was performed after adjusting for confounders. A logistic regression model was used to evaluate the relationship between TIR levels and LEAD.

Results: The results of our tests indicate that TIR levels were significantly lower in T2DM with LEAD than in those without (73.05 ± 18.13 versus 65.62 ± 16.43, P < 0.01). Furthermore, the prevalence of LEAD by severity decreased with ascending quartiles of TIR (P < 0.05). After adjusting for other covariates, TIR were independent determinants for LEAD occurrence in patients with T2DM (OR = 0.979, 95%CI: 0.965, 0.992) and the TIR levels were significantly different according to the severity of LEAD.

Conclusions: TIR is significantly and independently associated with diabetic lower artery extremity disease in Type 2 Diabetes. We suggest that TIR should be more broadly accepted as a research endpoint or clinical measure.

Keywords: Continuous glucose monitoring; Diabetic lower artery extremity disease; Time in range; Type 2 diabetes.