Association between continuous glucose monitoring metrics and diabetic retinopathy and albuminuria among Japanese individuals with type 1 diabetes

ABSTRACT Aims/Introduction This study aimed to clarify the relationship between glucose metrics measured by continuous glucose monitoring (CGM) and diabetic retinopathy (DR) and albuminuria among Japanese individuals with type 1 diabetes mellitus. Materials and Methods The study included 294 individuals with type 1 diabetes (68.7% women) who underwent intermittent scanned CGM between March and April 2023. Multivariable logistic regression analysis was performed to examine the cross‐sectional association of each glucose metric (time in range [TIR], time above range [TAR], time below range, glucose management indicator [GMI], and coefficient of variation [CV]) with DR or albuminuria. Results The prevalence of DR and albuminuria was 27.6 and 13.6%, respectively. CGM metrics did not differ between individuals with DR and those without. However, individuals with albuminuria had significantly lower TIR and higher TAR than those without. The presence of DR was significantly associated with higher levels of TAR (odds ratio [OR] = 1.04, P < 0.001), GMI (OR = 2.13, P < 0.001), and HbA1c (OR = 2.07, P < 0.001), and with a lower level of TIR (OR = 0.97, P = 0.005). The presence of albuminuria was significantly associated with higher levels of TAR (OR = 1.05, P = 0.002), GMI (OR = 2.28, P = 0.005), and HbA1c (OR = 2.28, P < 0.001), and with a lower level of TIR (OR = 0.95, P = 0.007). Conclusion Decreased TIR and increased TAR and GMI were independently associated with a higher prevalence of DR and albuminuria in Japanese individuals with type 1 diabetes.