Time in Range Linked to Abnormal Carotid Intima-Media Thickness in T2D

Atherosclerosis. Computer artwork of a narrowed artery, due to a cholesterol plaque.
Researchers observed an association between the time in range metric, carotid intima-media thickness, and subsequent macrovascular disease in primarily male patients with type 2 diabetes.

An association between the time in range (TIR) metric of glycemic control and carotid intima-media thickness (CIMT) suggests a link between TIR and macrovascular disease in male patients with type 2 diabetes (T2D), according to study results published in Diabetes Technology & Therapeutics.

Investigators performed a cross-sectional analysis of data from 2215 patients aged 59.5±11.8 years with T2D from Shanghai Jiao Tong University Affiliated Sixth People’s Hospital in China. They defined TIR as the percentage of time in the target glucose range of 70.27 to 180.18 mg/dL during a 24-hour period and evaluated TIR using continuous glucose monitoring. Researchers used high-resolution B-mode ultrasonography, with a mean CIMT ≥1 mm defined as abnormal, to measure CIMT.

Investigators detected abnormal CIMT in 271 of the patients (12.2%). Patients with abnormal CIMT had significantly lower TIR (P <.001) than patients with normal CIMT. When controlling for traditional cardiovascular disease risk factors, each 10% increase in TIR was associated with 6.4% lower risk for abnormal CIMT. When examining the relationship between sex, TIR, and CIMT, results demonstrated that TIR was significantly associated with CIMT in men, regardless of the confounders. Each 10% increase in TIR was associated with a 9.1% lower risk for abnormal CIMT in male patients. Researchers did not observe any statistically significant relationship between TIR and CIMT in female patients.

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The study was limited by the short (3-day) duration of continuous glucose monitoring, which may have led to suboptimal evaluation of glycemic control. In addition, the use of data from Chinese hospitalized patients with T2D may limit the ability to generalize the results to other diabetic populations.

“[We] found a significant association of TIR with CIMT, a predictor of future cardiovascular events, in a large sample of patients with [T2D], and this association is more pronounced in men than in women,” the investigators wrote. “Prospective studies and clinical trials are needed to better elucidate the relationship between TIR and [cardiovascular disease] outcomes,” they concluded.

Disclosure: One of the study authors declared affiliations with a medical device company. Please see the original reference for a full list of authors’ disclosures.

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Lu J, Ma X, Shen Y, et al. Time in range is associated with carotid intima-media thickness in type 2 diabetes [published online October 11, 2019]. Diabetes Technol Ther. doi:10.1089/dia.2019.0251