Time-in-Range (TIR) has been recently established as a treatment target in diabetes to complement the time-tested A1c. Studies in the Caucasian population have shown that every 10% increase in TIR corresponds to 0.8% reduction in A1c. To study the relationship between TIR with A1c in the Asian-Indian population, CGM data from EMR of patients with type 1 and type 2 diabetes (n=424) followed up by a telemedicine program (DTMS) at our comprehensive diabetes care center in Kerala was obtained. Mann Whitney U test, t-test, ANOVA, and Pearson correlation coefficient were used for univariate analysis. Baseline characteristics were age 54 + 14 years, Gender frequency: F/M 127/297, diabetes duration 10.83+8.24 years, A1c 7.44+1.17 (%), eA1c 6.74+1.24 (%), and Average Blood Glucose (ABG) 146.96 + 35.62 (mg/dL). All the patients were eligible for a reduction of A1C <7.5%. In this subset of Asian-Indian population, our statistical analysis revealed that a TIR of >70% corresponds to an A1c level of <7.5% in agreement with the previous studies. In our telemedicine-based chronic care model, an A1c of <7.5% was achieved in 67.5% of the subjects. However only 36% achieved a TIR >70% and 66% achieved a TIR >60%; a finding which underscores the significance of TIR independent of A1c levels. The study suggests that TIR should evolve as a powerful target and predictor of diabetes complications and should be a routine measure in diabetes care.


J. Kesavadev: Speaker’s Bureau; Self; Biocon, Novo Nordisk Inc., Sanofi-Aventis. A. Shankar: None. G. Krishnan: None. B.D. Saboo: None. G. Sanal: None. M. Krishna B: None. S. Ts: None. S. Jothydev: None.

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