Three-Year Glycemic Trajectories in Subgroups With Type 1 Diabetes at Risk for Suboptimal Glycemic Control: A Multicenter Continuous Glucose Monitoring Study.

In adults with type 1 diabetes, older age and chronic kidney disease show longitudinal improvement in time in range over 3 years without worsening hypoglycemia, unlike severe β-cell failure.

• Why it matters: Subgroups at risk for suboptimal CGM metrics may respond differently over time, but longitudinal trajectory data are needed to guide individualized glycemic targets.
• What they did: A multicenter study of 1,028 adults (3,441 longitudinal CGM profiles) used linear mixed-effects models to compare 3-year CGM changes across strata of age, CKD, β-cell function, BMI, and TyG tertile.
• The result: Older adults had comparable TIR improvement (β = 0.110; P = 0.102) with lower TBR maintained (3.5% vs. 1.7%; P < 0.001), while CKD improved TIR (β = 0.228; P = 0.002) without hypoglycemia worsening; severe β-cell failure attenuated TIR gains (β = -0.119; P = 0.025) and reduced TBR (β = 0.046; P < 0.001).

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