226-OR: Time in Range Is Associated with Incident Diabetic Retinopathy in Adults with Type 1 Diabetes—A Seven-Year Longitudinal Study

Introduction: Continuous glucose monitoring (CGM) metrics such as time in range (TIR; 70-180 mg/dL) and their goals have been proposed as new metrics to assess diabetes management. However, longitudinal studies validating TIR with diabetes complications are lacking. Methods: We analyzed up to 7 years of retrospective longitudinal CGM data of 90 adults with type 1 diabetes (T1D) without a diagnosis of diabetic retinopathy [DR] (Control group) and 70 adults with new incident diagnosis of DR between June 2018-December 2020 but had normal eye examinations in the past (DR group). Associations between DR and CGM metrics were assessed via linear mixed models adjusting for age and diabetes duration. Results: Baseline characteristics are provided in Figure 1A. A1c was positively associated with development of DR in adults with T1D (Figure 1B). TIR was negatively associated with development of DR (Figure 1C). Time in tight target range (TTIR 70-140 mg/dL) and time above range (TAR>180 mg/dL) were also associated with DR (p<0.001). Conclusion: CGM metrics such as TIR, TTIR and TAR were associated with development of incidental DR in adults with T1D. To our knowledge, this is the first longitudinal study to demonstrate association between CGM metrics and DR. Disclosure V.N.Shah: Advisory Panel; LifeScan Diabetes Institute, Medscape, Consultant; DKSH, Research Support; Novo Nordisk, Tandem Diabetes Care, Inc., Dexcom, Inc., Insulet Corporation, JDRF, National Institutes of Health, Speaker's Bureau; Dexcom, Inc., Insulet Corporation. C.Sakamoto: None. L.Pyle: None. H.K.Akturk: Advisory Panel; Senseonics, MannKind Corporation, Research Support; Medtronic, Tandem Diabetes Care, Inc., Dexcom, Inc., REMD Biotherapeutics, Eli Lilly and Company, IM Therapeutics. S.Polsky: Other Relationship; diaTribe, Research Support; Dexcom, Inc., Medtronic, Hemsley Charitable Trust, JDRF, NIH - National Institutes of Health. G.P.Forlenza: Advisory Panel; Medtronic, Consultant; Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care, Inc., Lilly Diabetes, Research Support; Medtronic, Abbott, Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care, Inc. J.K.Snell-bergeon: None. Funding JDRF (2-SRA-2021-1069-S-B)