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Time in Range from Continuous Glucose Monitoring: A Novel Metric for Glycemic Control

Diabetes & Metabolism Journal 2020년 44권 6호 p.828 ~ 839
유지희, 김재현,
소속 상세정보
유지희 ( Yoo Jee-Hee ) - Yonsei University Wonju College of Medicine Department of Medicine
김재현 ( Kim Jae-Hyeon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine

Abstract


Glycosylated hemoglobin (HbA1c) has been the sole surrogate marker for assessing diabetic complications. However, consistently reported limitations of HbA1c are that it lacks detailed information on short-term glycemic control and can be easily interfered with by various clinical conditions such as anemia, pregnancy, or liver disease. Thus, HbA1c alone may not represent the real glycemic status of a patient. The advancement of continuous glucose monitoring (CGM) has enabled both patients and healthcare providers to monitor glucose trends for a whole single day, which is not possible with HbA1c. This has allowed for the development of core metrics such as time spent in time in range (TIR), hyperglycemia, or hypoglycemia, and glycemic variability. Among the 10 core metrics, TIR is reported to represent overall glycemic control better than HbA1c alone. Moreover, various evidence supports TIR as a predictive marker of diabetes complications as well as HbA1c, as the inverse relationship between HbA1c and TIR reveals. However, there are more complex relationships between HbA1c, TIR, and other CGM metrics. This article provides information about 10 core metrics with particular focus on TIR and the relationships between the CGM metrics for comprehensive understanding of glycemic status using CGM.

키워드

Blood glucose; Blood glucose self-monitoring; Diabetes complications; Glycated hemoglobin A

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