Characteristics of people with optimally-managed type 1 diabetes

Objective

The aim is to describe the characteristics of people with type 1 diabetes who are meeting all seven glycemic targets set by international consensus.

Research Design & Methods

We analyzed continuous glucose monitoring (CGM) data from 497 participants (aged 18-70 yrs). Time-in-range, time above and below range, co-efficient of variability, and glucose management indicator (GMI) were combined with demographic data, insulin delivery, and exercise.

Results

While 68% of participants achieved a GMI below 7% (53 mmol/mol), 39% met all seven glycemic targets. Older people and those of White ethnicity were more likely to meet these targets. Men and women were equally likely to meet all targets, although men were more likely to experience hypoglycemia while women were more likely to experience hyperglycemia. Hybrid-closed loop (HCL) system users were more likely to meet all targets than people using a standard pump or multiple daily injections.

Conclusions

Only 56% of those with a GMI below 7% (53 mmol/mol) met all seven targets, illustrating how glycemic management involves more than GMI/HbA_1c lowering alone, which has implications for estimates of optimally managed participants in the wider population of people with type 1 diabetes. Demographic inequalities were prevalent. Using a HCL system clearly facilitated the achievement of glycemic targets.