• Sanbao Chai, Shanshan Wu, Sixu Xin, Ning Yuan, Jianbin Sun, Xiaomei Zhang, and Linong Ji.
• Department of Endocrinology and Metabolism, Peking University International Hospital, Beijing 102206, China.
• Chin. Med. J. 2022 May 5; 135 (9): 1052-1056.

BackgroundTime in range (TIR) refers to the time an individual spends within their target glucose range, which now has been popularized as an important metric to classify glycemic management and also recognized as an important outcome of current diabetes therapies. This study aimed to investigate the association between TIR and the severity of the urinary albumin excretion rate (UAER) in patients with type 2 diabetes mellitus (T2DM).MethodsWe retrospectively analyzed the data of 1014 inpatients with T2DM at the Department of Endocrinology and Metabolism of Peking University International Hospital, China. TIR was defined as the percentage of blood glucose within the target range of 3.90-10.00 mmol/L. Urine samples for assessment of UAER were collected for 3 consecutive days from the start of hospitalization.ResultsThe TIR values for patients with normal urine levels of albumin, microalbuminuria, and macroalbuminuria were 70% ± 20%, 50% ± 20%, and 30% ± 20%, respectively (all P   <  0.001). The patients were stratified according to quartiles of TIR as follows: quartile (Q) 1, <55%; Q2, 55%-72%; Q3, 73%-83%; and Q4, >83%. The incidences of microalbuminuria in Q1, Q2, Q3, and Q4 were 41.1%, 21.6%, 7.1%, and 5.5% (all P  < 0.001), respectively. The respective incidences of macroalbuminuria were 24.2%, 1.1%, 1.4%, and 0% (all P  < 0.001). In multinomial logistic regression analyses, TIR was significantly correlated with microalbuminuria (odds ratio [OR] 0.58, 95% confidence interval [CI]: 0.52-0.65, P  < 0.001) and macroalbuminuria (OR 0.26, 95% CI: 0.18-0.38, P  < 0.001) after adjusting for age, sex, body mass index, diabetes duration, systolic blood pressure, and levels of triglycerides, glycosylated hemoglobin A1c, and creatinine.ConclusionThe proportion of blood glucose in TIR is closely related to the severity of UAER in patients with T2DM.Copyright © 2022 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.

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