Children who develop diabetes in their first years of life risk being exposed to many decades of hyperglycemia, hence having a high risk of early complications and premature death. An additional age-dependent risk is that dysglycemia, especially hyperglycemia, negatively affects the developing brain. In evaluating the outcome of insulin treatment at an individual and group level, cutoff thresholds for glucose values are needed. Time in tight range (TITR) was defined as a measurement of time spent in a state of normoglycemia. The International Society of Pediatric and Adolescent Diabetes recommended that for preschoolers with type 1 diabetes (T1D), either >70% of time with glucose in range 70–180 mg/dL (3.9–10 mmol/L) or >50% of time in a tighter range 70–140 mg/dL (TITR) can be used as continuous glucose monitoring targets. In Sweden, over the past two decades, pediatric diabetes teams set glycemic targets to 70–140 mg/dL (3.9–7.8 mmol/L). Swedish registry data show that >50% of children <7 years old have >50% TITR. The purpose of this review is to share and discuss international knowledge and experiences of working with TITR as a health-promoting strategy in preschoolers with T1D on a structural and individual level. We conclude that as insulin treatment improves, a reasonable goal is to strive for as much time in a state of normoglycemia as possible, and this can easily be explained to families of children with diabetes. For children with access to an experienced health care team and diabetes technologies a currently realistic target can be at least half of the time in normoglycemic range, i.e., TITR >50%.

中文翻译：

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在狭窄的血糖范围内使用时间作为 1 型糖尿病学龄前儿童的健康促进策略


在出生后的最初几年患上糖尿病的儿童有可能暴露于数十年的高血糖症中，因此出现早期并发症和过早死亡的风险很高。另一个与年龄相关的风险是血糖异常，尤其是高血糖，会对发育中的大脑产生负面影响。在个体和团体水平评估胰岛素治疗的结果时，需要葡萄糖值的临界阈值。严格范围时间 （TITR） 定义为在正常血糖状态下花费的时间的测量值。国际儿科和青少年糖尿病学会建议，对于患有 1 型糖尿病 （T1D） 的学龄前儿童，血糖在 70-180 mg/dL （3.9-10 mmol/L） 范围内的 >70% 时间或 >50% 的时间在更严格的范围内 70-140 mg/dL （TITR） 可用作连续血糖监测目标。在瑞典，在过去的二十年里，儿科糖尿病团队将血糖目标设定为 70-140 mg/dL （3.9-7.8 mmol/L）。瑞典登记数据显示，>50% 的 <7 岁儿童的 >50% 滴度系数。本综述的目的是分享和讨论在结构和个人层面上将 TITR 作为 T1D 学龄前儿童健康促进策略的国际知识和经验。我们得出的结论是，随着胰岛素治疗的改善，一个合理的目标是尽可能长时间地处于正常血糖状态，这很容易向糖尿病儿童的家庭解释。对于能够获得经验丰富的医疗保健团队和糖尿病技术的儿童，目前现实的目标可能至少有一半的时间处于正常血糖范围内，即 TITR >50%。