EASD 2020 Highlights

Conference summaries


Chronic complications versus glycaemic variability, time in range and HbA1c in people with type 1 diabetes: substudy of the RESCUE-trial

Presented by:

Anass El Malahi, MD

  • In T1D, HbA1c and duration of diabetes are important risk factors for the development of chronic complications.
  • A shorter TIR is associated with several microvascular complications, and especially retinopathy.
  • TIR is also associated with hospitalization for hypoglycaemia or ketoacidosis.

What do we already know about this topic?

  • Self-monitoring of blood glucose provides an incomplete picture of glucose control.1
  • Continuous glucose monitoring (CGM) can give a more comprehensive picture of glycaemic variability (GV) and time spent in range (TIR).2
  • There are few studies examining the relationship between GV or TIR and chronic complications.

How was this study conducted?

  • Parameters that could have a link with diabetes complications were analysed in 515 adults with type 1 diabetes (T1D) who entered the Belgian reimbursement system in terms of real-time CGM, HbA1c, standard deviation (SD), coefficient of variation, TIR (70-180 mg/dL), age, duration of diabetes, BMI and gender.
  • Association between glucometrics from the first 2 weeks of CGM use and presence of diabetes complications were investigated with multiple logistic regression.

What does this study add?

  • Higher TIR was associated with fewer microvascular complications, with no association with macrovascular complications.
  • Diabetes duration (OR = 1.12, p <0.001) and TIR (OR = 0.97, p = 0.005) were independently correlated with composite microvascular complications.
  • For nephropathy, diabetes duration (OR = 0.97, p <0.001) and HbA1c (OR = 1.65, p = 0.12) were independently associated.
  • For retinopathy, diabetes duration (OR = 0.14, p <0.001) and TIR (OR = 0.96, p <0.001) were independently associated.
  • Age (OR = 1.08, p = 0.003) and HbA1c (OR = 1.80, p = 0.44) were independently associated with macrovascular complications.
  • Only TIR (OR = 0.97, p = 0.021) was independently associated with hospitalization for hypoglycaemia or ketoacidosis.


How does this study impact clinical practice?

  • HbA1c and duration of diabetes remain important independent risk factors for chronic complications in T1D.
  • A shorter TIR was associated with the presence of composite microvascular complications, and with retinopathy in particular.
  • A high SD was linked to peripheral and autonomic neuropathy.
  • For hospitalization for hypoglycaemia or ketoacidosis, TIR was the most important factor.



  1. Charleer S, Mathieu C, Nobels F, et al. Effect of continuous glucose monitoring on glycemic control, acute admissions, and quality of life: a real-world study. J Clin Endocrinol Metab. 2018;103(3):1224-32.
  2. Klonoff DC, Ahn D, Drincic A. Continuous glucose monitoring: a review of the technology and clinical use. Diabetes Res Clin Pract. 2017;133:178-92.


Related content


This is a highlights summary of an oral session given at the EASD 2020 Virtual Meeting and presented by:

Anass El Malahi, MD                                                 
Endocrinology-Diabetology, University Hospital of Antwerp, Edegem, Belgium

The presenting authors of the original session had no part in the creation of this conference highlights summary. 

The content is produced by Infomedica. The summary text was drafted by Patrick Moore, PhD, and reviewed by Marco Gallo, MD, an independent external expert, and approved by Florian Toti, MD, the scientific editor of the program.


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