--- title: "Complications of Diabetes and Metrics of Glycemic Management…" description: "Continuous glucose monitoring metrics, especially Time in Range, are associated with diabetes complications and may offer better insights than HbA1c alone." url: "https://magellanlongevity.com/study/x12.md" canonical: "https://magellanlongevity.com/study/x12.html" html: "https://magellanlongevity.com/study/x12.html" type: "study" study_key: "x12" journal: "J Clin Endocrinol Metab" year: 2022 pmid: "35094087" doi: "10.1210/clinem/dgac034" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › Complications of Diabetes and Metrics of Glycemic… **HTML version:** https://magellanlongevity.com/study/x12.html · **In the Magellan app:** https://magellanlongevity.com/#/study/x12 ## Citation | Field | Value | | --- | --- | | Journal | J Clin Endocrinol Metab | | Year | 2022 | | PMID | [35094087](https://pubmed.ncbi.nlm.nih.gov/35094087/) | | DOI | [10.1210/clinem/dgac034](https://doi.org/10.1210/clinem/dgac034) | | Study key | x12 | ## Takeaway Continuous glucose monitoring metrics, especially Time in Range, are associated with diabetes complications and may offer better insights than HbA1c alone. ## The question What is the relationship between continuous glucose monitoring (CGM)-derived metrics of glycemic variability and diabetes-related complications? ## Hypothesis The study implicitly hypothesizes that CGM-derived metrics, beyond HbA1c, are associated with diabetes complications and can provide insight into short-term glucose fluctuations. ## Methods A systematic review was conducted by searching PubMed and Embase databases from January 1, 2010, to August 22, 2020. The search terms included 'type 1 diabetes', 'type 2 diabetes', 'diabetes-related microvascular and macrovascular complications', and 'measures of glycaemic variability'. Studies not using CGM or involving non-diabetic, acutely unwell, pregnant participants, or those using insulin pumps were excluded. The final review included 34 publications out of 1636 identified records, encompassing 20852 participants (663 with T1D and 19909 with T2D). ## Results Glycemic variability and low time in range (TIR) were associated with all studied microvascular and macrovascular complications of diabetes. Higher TIR was specifically linked to a reduced risk of albuminuria, retinopathy, cardiovascular disease mortality, all-cause mortality, and abnormal carotid intima-media thickness. Peripheral neuropathy was primarily associated with the standard deviation of blood glucose levels (SD) and mean amplitude of glycemic excursions (MAGE). ## Conclusion The evidence supports an association between diabetes complications and CGM-derived measures of intraday glycemic variability. Time in range (TIR) was the most consistent measure, suggesting its growing importance in clinical practice. ## Limitations More longitudinal studies and trials are needed to confirm these associations, especially for type 1 diabetes, where data are limited. ## Verbatim from the abstract > higher time in range was associated with reduced cardiovascular and all-cause mortality ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | Continuous Glucose Monitoring (CGM) | Measurement tool | [FreeStyle Libre CGM](https://magellanlongevity.com/p/73.md) | ## Reference 1. **Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring** J Clin Endocrinol Metab 2022 · [PMID 35094087](https://pubmed.ncbi.nlm.nih.gov/35094087/) · [DOI 10.1210/clinem/dgac034](https://doi.org/10.1210/clinem/dgac034) > higher time in range was associated with reduced cardiovascular and all-cause mortality ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/x12.html#page","url":"https://magellanlongevity.com/study/x12.html","name":"Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring","description":"Continuous glucose monitoring metrics, especially Time in Range, are associated with diabetes complications and may offer better insights than HbA1c alone.","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/x12.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"Complications of Diabetes and Metrics of Glycemic…","item":"https://magellanlongevity.com/study/x12.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/x12.html#study","name":"Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring","headline":"Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring","datePublished":"2022","isPartOf":{"@type":"Periodical","name":"J Clin Endocrinol Metab"},"identifier":"PMID:35094087","url":"https://pubmed.ncbi.nlm.nih.gov/35094087/","sameAs":"https://doi.org/10.1210/clinem/dgac034","abstract":"Continuous glucose monitoring metrics, especially Time in Range, are associated with diabetes complications and may offer better insights than HbA1c alone."}]} ``` ## Related on Magellan Longevity - [FreeStyle Libre CGM](https://magellanlongevity.com/p/73.md) — product graded on this and related evidence - [Continuous Glucose Monitoring and Physical Activity](https://magellanlongevity.com/study/cgm.md) - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).