Evaluation of association between time in range, a continuous glucose monitoring metric, and cardiac autonomic neuropathy in type 2 diabetes patients

• Published in: Annals of African medicine 2024-01, Vol.23 (1), p.19-24
• Main Authors: Karthikeyan, Aditya, Ramakrishna, Manjunath P, Swamy, Niveditha Alok, Latha, A Tharuni
• Format: Article
• Language: English
• Subjects: Analysis; Blood Glucose; Blood Glucose Self-Monitoring; Blood sugar monitoring; Cardiovascular disease; Continuous Glucose Monitoring; Dextrose; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetics; Glucose; Glucose monitoring; Glycated Hemoglobin; Glycosylated hemoglobin; Health aspects; Humans; Medical testing products; Nervous System Diseases; Patient monitoring equipment; Risk factors; Type 2 diabetes
• ISSN: 1596-3519; 0975-5764
• DOI: 10.4103/aam.aam_117_23

Time in range (TIR), a metric of continuous glucose monitoring (CGM) provides better information regarding the individual's glycemic variability than a static measure like glycated hemoglobin (HbA1c). TIR is emerging as an independent risk factor for diabetic complications, both microvascular and macrovascular complications independent of HbA1c. Hence, this study evaluates the association between TIR and cardiac autonomic neuropathy (CAN) in type 2 diabetic patients. A total of 42 patients with type 2 diabetes mellitus were enrolled in this study and underwent a 3-day CGM using the "FreeStyle Libre Pro Flash Glucose Monitoring System Sensor" along with tests for CAN within the 3 days of attaching the CGM. Out of 42 patients, 36 patients (85.7%) were diagnosed with CAN (early CAN 57.1% and definite CAN 28.6%) and the mean TIR was 64.4% ±23.5%. Out of those with TIR 70%. Patients with more severe CAN were found to have a lower TIR (P = 0.115). The study found a high prevalence of cardiac autonomic neuropathy (CAN) of around 85.7% in type 2 diabetes patients. Lower TIR values were associated with a higher incidence of definite CAN (42.9% vs. 14.3% in TIR 70% groups). The findings suggest TIR is inversely associated with the presence and severity of cardiac autonomic neuropathy in type 2 diabetic patients and also a potential link between TIR and CAN severity.