There is evidence that time in range (TIR) correlates with microvascular complications of diabetes including diabetic retinopathy and albuminuria. We sought to investigate the association of TIR with carotid intima-media thickness (CIMT) as a surrogate marker of cardiovascular disease (CVD).
2, 215 hospitalized patients with type 2 diabetes were recruited. TIR of 3.9-10.0 mmol/L was evaluated with CGM. CIMT was measured using high-resolution B-mode ultrasonography and abnormal CIMT was defined as a mean CIMT ≥ 1.0mm. Logistic regression models were used to examine the independent association of TIR with CIMT.
Patients with abnormal CIMT had significantly lower TIR as compared with those with normal CIMT (P < 0.001). The prevalence of abnormal CIMT progressively decreased across the categories of increasing TIR (P for trend <0.001). Each 10% increase in TIR was observed to be associated with 6.4% lower risk of abnormal CIMT after adjusting for conventional risk factors of CVD. In addition, we found TIR was significantly associated with CIMT in males but not in females. In a subset of patients (n=612) with complete data on diabetic retinopathy and albuminuria, the relationship between TIR and CIMT remained to be significant, regardless the status of microvascular complications.
TIR is associated with CIMT in type 2 diabetes, suggesting a link between TIR and CVD risk.