Endocrine Abstracts

JOINT2617

Introduction: Time in Range (TIR) has emerged as a key therapeutic target in the management of diabetes, reflecting the proportion of time a patient’s glucose levels remain within the recommended range (70–180 mg/dL). Maintaining an adequate TIR is associated with better glycemic control and a lower risk of diabetes-related complications. However, the relationship between TIR and the incidence of severe hypoglycemia remains unclear. Severe hypoglycemia, defined as an event requiring external assistance for recovery, represents a major concern in diabetes management due to its potential to cause cognitive impairment, cardiovascular complications, and increased morbidity. This study examines whether a lower TIR is associated with an increased likelihood of experiencing severe hypoglycemic episodes in patients with type 1 and type 2 diabetes.

Objective: To assess the impact of TIR on the probability of experiencing severe hypoglycemia and to evaluate its potential as a predictor of metabolic safety in diabetes patients.

Methods: A retrospective analysis was conducted using continuous glucose monitoring (CGM) data from a cohort of 70 patients with type 1 and type 2 diabetes treated at a hospital in southern Spain. TIR values, time spent in hypoglycemia (<70 mg/dL and <54 mg/dL), and the occurrence of severe hypoglycemia were compared between patients using non-parametric statistical tests. The primary outcome was the incidence of severe hypoglycemia in relation to different TIR thresholds.

Results: Patients who experienced severe hypoglycemia did not exhibit significantly lower TIR values compared to those without severe episodes. However, a subgroup analysis revealed that individuals with TIR below 60% tended to have a higher incidence of severe hypoglycemia. Although this difference did not reach statistical significance (P = 0.16), a clinically relevant trend was observed. Additionally, a greater percentage of time spent in hypoglycemia was noted in patients with severe episodes, reinforcing the importance of minimizing glucose variability.

Conclusions: While reduced TIR has been linked to poorer overall glycemic control and increased glucose variability, its specific role in predicting severe hypoglycemia remains uncertain. The findings suggest that TIR may be a useful indicator of metabolic instability, but its predictive capacity for severe hypoglycemia requires further validation. Larger prospective studies are needed to establish TIR as a reliable risk stratification tool and to optimize diabetes management strategies aimed at minimizing hypoglycemic events while maintaining optimal glycemic control.