Diab
UKPDS 35 confirmed that every 1% reduction in HbA1c significantly reduced the risk of microvascular complications by 37%, myocardial infarction by 14%, stroke by 12%, and diabetes-related death by 21%. Early achievement of HbA1c < 6.5% after diagnosis of type 2 diabetes (T2DM) significantly reduces the risk of long-term complications and mortality.
Compared with traditional HbA1c, metrics derived from fingerstick-calibration-free continuous glucose monitoring (CGM) provide more refined risk assessment.In patients with T2DM, time in range (TIR) is significantly associated with all-cause and cardiovascular mortality — higher TIR correlates with higher survival rates.In patients with type 1 diabetes (T1DM), higher glucose coefficient of variation (CV) is significantly associated with impaired hypoglycemia awareness and increased risk of severe hypoglycemia.
Studies in T1DM further show that reduced TIR and increased time above range (TAR) are independently linked to diabetic retinopathy; elevated glucose management indicator (GMI) is significantly associated with retinopathy and albuminuria.GMI and TAR have predictive power for retinopathy comparable to HbA1c, highlighting the value of CGM metrics in risk evaluation.
CGM offers multiple advantages in clinical practice:it enables visualization and real-time monitoring of glucose variability, helps reduce hypo‑ and hyperglycemia risk, improves patient self-management and quality of life, optimizes treatment quality, and may reduce healthcare costs.
Recommended populations for CGM include:all patients on insulin therapy, those at high risk of hypo‑ or hyperglycemia, those with large glucose fluctuations, individuals motivated to actively optimize glycemic control, and patients requiring data sharing to guide treatment decisions.