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Improved Time-in-Range over 1 year is Associated with Reduced Albuminuria in Individuals with Sensor-Augmented Insulin Pump-Treated Type 1 Diabetes

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posted on 04.09.2020 by Ajenthen G. Ranjan, Signe V. Rosenlund, Tine W. Hansen, Peter Rossing, Steen Andersen, Kirsten Nørgaard
Aim: To investigate the association between treatment-induced change in continuous glucose monitored (CGM) time-in-range (TIR) and albuminuria in persons with type 1 diabetes (T1D) treated with sensor-augmented-pumps (SAP).

Methods: Twenty-six of fifty-five participants with albuminuria and multiple daily injection-therapy (25% females, 51 (46-63) years, HbA1c 75 (68-88) mmol/mol [9.0 (8.4-10.4)%], UACR 89 (37-250) mg/g) were in a randomized-controlled trial assigned to SAP-therapy for one year. Anthropometrics, CGM-data, blood and urine samples were collected every three months.

Results: Mean change (95%-CI) in %TIR was +13.2 (6.2;20.2)%, HbA1C was -14.4 (-17.4;-10.5) mmol/mol [-1.3 (-1.6;-1.0)%] and urinary albumin-creatinine-ratio (UACR) was -15 (-38;17)%, all p<0.05. UACR decreased with 19 (10;28)% per 10% increase in %TIR (p=0.04), 18 (1;30)% per 10 mmol/mol decrease in HbA1C (p=0.07), and 31% per 10 mmHg decrease in mean arterial pressure (p<0.001).

Conclusion: In this longitudinal study, treatment-induced increase in %TIR was significantly associated with decrease in albuminuria in T1D.

Funding

This work was supported by an unrestricted grant from Medtronic A/S, Denmark. The funder had no role in the study design, data collection, data analysis, interpretation, or writing the manuscript.

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