Correlation between time on target and glycated hemoglobin in people with diabetes mellitus: systematic review.
Rafael Aparecido Dias Lima, Daiane Rubinato Fernandes, Rute Aparecida Casas Garcia and 3 others
PMID 38055596WHAT IT FOUND
Across 16 diabetes studies, higher time on target (70-180 mg/dL) tracked with lower HbA1c, often near 7%.
For nurses, this suggests continuous glucose data may complement HbA1c in monitoring and education, not replace it.
Key findings
01All 16 included studies reported a correlation between time on target (70-180 mg/dL) and HbA1c; Spearman coefficients ranged from -0.310 to -0.766 and Pearson coefficients from -0.623 to -0.869.
02One type 1 diabetes study reported that time on target of 70% was associated with HbA1c about 7%, while time on target of 50% was associated with HbA1c about 8%.
03Only one included study used self-monitoring of capillary blood glucose data to calculate time on target.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review synthesised observational studies, mostly cross-sectional, so it shows association and cannot show that increasing time on target causes lower HbA1c. No statistical pooling was possible because the studies used different designs, glucose ranges, data periods and analyses. Only one study used capillary self-monitoring data, so the review cannot tell clinicians whether time on target works the same way with routine fingerstick readings. None of the included studies was conducted in a gestational diabetes population, despite that group being part of the review question. The included studies generally did not identify or address confounding factors, and the cohort studies did not address incomplete follow-up.
Declared interests
The authors declared no conflicts of interest. The study was financed in part by CAPES, Brazil.
The easy way to misread this
Do not read this as proof that time on target can replace HbA1c or that helping a patient spend more time in range will lower HbA1c. The review included mostly cross-sectional studies of people already using continuous glucose monitoring, and only one study used self-monitoring data, so it reports association, not a tested treatment effect.