1011-P: Refined Time-in-Range Analysis for Continuous Glucose Monitoring—Mitigating Bias from Missing Data in Inpatient Glycemic Control

• Published in: Diabetes (New York, N.Y.) Vol. 74; no. Supplement_1; p. 1
• Main Authors: YU, QI, UMPIERREZ, GUILLERMO, DAVIS, GEORGIA M., FAYFMAN, MAYA, PENG, LIMIN
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 20.06.2025
• Subjects: Diabetes mellitus; Glucose monitoring; Hypoglycemia; Insulin; Missing data
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db25-1011-P

Introduction and Objective: Continuous glucose monitoring (CGM) is increasingly used in US hospitals for diabetes management, with Time in Range (TIR) as a key glycemic control metric. However, routine TIR analyses overlook missing data in inpatient CGM studies, such as insufficient CGM sampling due to short hospital stays. To address this, a refined TIR analysis approach was developed to mitigate biases from missing data. Methods: We applied the new method to data from 249 subjects in two prospective inpatient CGM studies. We compared TIR outcomes between patients undergoing CGM-guided insulin adjustment and those with capillary point-of-care glucose monitoring. Results: The analyses revealed differences between the new refined mean TIR analysis, which accounts for missing data, and the standard method, which does not (see Table 1). Group comparisons based on the refined analysis showed a notable reduction in the percent time spent in hypoglycemia of <70 mg/dL (0.34 ± 0.14% vs. 0.84 ± 0.15%, p=0.01) while maintaining comparable mean TIR in the target range of 70-180 mg/dL (60.43 ± 3.92% vs. 61.06 ± 2.12%, p=0.89). Conclusion: The refined TIR analyses confirmed significant reductions in hypoglycemia with CGM-guided insulin adjustments. This supports the ongoing integration of CGM into clinical practice to enhance glycemic control while minimizing the risk of hypoglycemia.