Future of Time-in-Range Goals in the Era of Advanced Hybrid Closed-Loop Automated Insulin Delivery Systems

Diabetes Technol Ther. 2024 Mar;26(S3):102-106. doi: 10.1089/dia.2023.0432.

Abstract

The concept of maintaining blood glucose levels within the 70-180 mg/dL range, known as time-in-range, has raised questions regarding its representation of true physiological euglycemia. Some have speculated that focusing on the time spent within the 70-140 mg/dL range, introduced as time in tight range (TITR) through the International Consensus statement, could serve as a more precise metric for assessing normoglycemia in individuals with type 1 diabetes. This article delves into the current status of TITR as an emerging marker and explores how advanced hybrid closed-loop systems may offer a promising avenue for achieving this higher level of glycemic control.

Keywords: Automated insulin delivery; Closed-loop; Glucose control; Insulin pump; Insulin therapy; MiniMed™; Time in tight range.

MeSH terms

  • Blood Glucose
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 1* / drug therapy
  • Goals
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Insulin / therapeutic use
  • Insulin Infusion Systems

Substances

  • Hypoglycemic Agents
  • Insulin
  • Blood Glucose