{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:53:03Z","timestamp":1793292783597,"version":"4.5.0"},"reference-count":67,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100020192","name":"Medtronic Europe","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100020192","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Medical Research Council","award":["MR\/W030004\/1"],"award-info":[{"award-number":["MR\/W030004\/1"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Time in range (TIR) has emerged as a key target in managing people with type 1 diabetes (PwT1D). The time spent in a glucose range of 70\u2013180 mg\/dL (3.9\u201310.0 mmol\/L; TIR) is recommended to be &gt;70%, which has been linked to reduced complication incidence. While frequently used in evaluating automated insulin delivery, TIR has rarely been applied in health economic assessments. This analysis therefore examined the impact of a 10-percentage point increase in TIR on clinical and economic outcomes for PwT1D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Four baseline TIR levels (50%, 60%, 70%, 80%) and the investigated TIR increase were mapped to glycated hemoglobin (HbA1c) using two published statistical approaches. HbA1c estimates informed the IQVIA CORE Diabetes Model, projecting cumulative complication incidence, life expectancy, quality-adjusted life expectancy (QALE), and costs over 20 years from an English public health care system perspective. Cohort baseline data, complication costs, and utilities were sourced from an economic assessment by the National Institute for Health and Care Excellence. Sensitivity analyses were performed to assess the robustness of results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A 10-percentage point TIR increase reduced the cumulative incidence of complications, by 15.6%\u201353.0%, 8.8%\u201347.1%, 8.1%\u201333.5%, and 10.1%\u201317.6% for ophthalmic, renal, neuropathic, and cardiovascular complications, respectively, when averaged across baseline TIR levels. Fewer complications translated into life expectancy gains of 0.031\u20130.051 years and QALE gains of 0.056\u20130.143 quality-adjusted life-years, with higher gains for lower baseline TIR. Total projected cost reductions versus constant TIR were 7.5%\u20139.9%, driven by reduced complication costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Long-term projections for England suggested that a 10-percentage point increase in TIR reduced diabetic complications in PwT1D, thereby reducing spending on complication treatment. Improvements were seen across baseline TIR levels but were disproportionately accrued in those with lower baseline TIR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15209156251380593","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T07:17:28Z","timestamp":1758266248000},"page":"206-218","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Improving Time-in-Range in Type 1 Diabetes: Projecting the Clinical and Cost Implications of Automated Insulin Delivery"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6611-8245","authenticated-orcid":false,"given":"Sufyan","family":"Hussain","sequence":"first","affiliation":[{"name":"Department of Diabetes, School of Cardiovascular, Metabolic Medicine and Sciences, King\u2019s College London, London, United Kingdom."},{"name":"Department of Diabetes and Endocrinology, Guy\u2019s &amp; St. Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Institute of Diabetes, Endocrinology, and Obesity, King\u2019s Health Partners, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asli Zeynep","family":"Ozdemir Saltik","sequence":"additional","affiliation":[{"name":"Medtronic International Trading SARL, Tolochenaz, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica J.","family":"Yu","sequence":"additional","affiliation":[{"name":"Medtronic International Trading SARL, Tolochenaz, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"de Portu","sequence":"additional","affiliation":[{"name":"Medtronic International Trading SARL, Tolochenaz, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard F.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Covalence Research Ltd., Harpenden, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8065-755X","authenticated-orcid":false,"given":"Johannes","family":"P\u00f6hlmann","sequence":"additional","affiliation":[{"name":"Covalence Research Ltd., Harpenden, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-1795","authenticated-orcid":false,"given":"Ohad","family":"Cohen","sequence":"additional","affiliation":[{"name":"Medtronic International Trading SARL, Tolochenaz, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-022-05744-z"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnac022"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-0504"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06165-w"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0433"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00212-1"},{"key":"e_1_3_3_8_2","first-page":"193229682412423","article-title":"Automated insulin delivery in adults with type 1 diabetes and suboptimal HbA1c during prior use of insulin pump and continuous glucose monitoring: A randomized controlled trial","author":"Christensen MB","year":"2024","unstructured":"Christensen MB, , Ranjan AG, , Rytter K, et al. Automated insulin delivery in adults with type 1 diabetes and suboptimal HbA1c during prior use of insulin pump and continuous glucose monitoring: A randomized controlled trial. J Diabetes Sci Technol, 2024:19322968241242399.","journal-title":"J Diabetes Sci Technol"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968231185348"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-023-01144-4"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13567"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.5114\/pedm.2024.144041"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00319-9"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci19-0028"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0432"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1444"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-023-01219-2"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0486"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3842"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.08.3019"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(22)00186-6"},{"key":"e_1_3_3_22_2","volume-title":"Hybrid Closed Loop Systems for Managing Blood Glucose Levels in Type 1 Diabetes. Technology Appraisal Guidance","author":"NICE","year":"2023","unstructured":"NICE. Hybrid Closed Loop Systems for Managing Blood Glucose Levels in Type 1 Diabetes. Technology Appraisal Guidance. National Institute for Health and Care Excellence: London and Manchester; 2023."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296819839996"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-1217"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0308"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0578"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0438"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296818822496"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2018.0310"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0442"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1185\/030079904X1980"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1185\/030079904X2006"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2014.07.007"},{"key":"e_1_3_3_34_2","volume-title":"NICE Health Technology Evaluations: The Manual. Process and methods","author":"NICE","year":"2023","unstructured":"NICE. NICE Health Technology Evaluations: The Manual. Process and methods. National Institute for Health and Care Excellence: London, UK; 2023."},{"key":"e_1_3_3_35_2","volume-title":"Multiple Technology Appraisal: Hybrid Closed Loop Systems for Managing Blood Glucose Levels in Type 1 Diabetes: Committee Papers. Multiple technology appraisal","author":"NICE","year":"2023","unstructured":"NICE. Multiple Technology Appraisal: Hybrid Closed Loop Systems for Managing Blood Glucose Levels in Type 1 Diabetes: Committee Papers. Multiple technology appraisal. National Institute for Health and Care Excellence: London; 2023."},{"key":"e_1_3_3_36_2","unstructured":"WHO. Lifetables by Country: United Kingdom. World Health Organization; 2020. Available from: https:\/\/apps.who.int\/gho\/data\/view.main.LT62260?lang=en [Last accessed: December5 2024]."},{"key":"e_1_3_3_37_2","volume-title":"Type 1 Diabetes in Adults: Diagnosis and Management. NICE Guideline","author":"NICE","year":"2022","unstructured":"NICE. Type 1 Diabetes in Adults: Diagnosis and Management. NICE Guideline. National Institute for Health and Care Excellence: London; 2022."},{"key":"e_1_3_3_38_2","unstructured":"ONS. CPI Weights 06: Health. 2024. Available from: https:\/\/www.ons.gov.uk\/economy\/inflationandpriceindices\/timeseries\/chzw\/mm23 [Last accessed: December6 2024]."},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2014.03.003"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X16658660"},{"key":"e_1_3_3_41_2","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. 2025."},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24277-4"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16168"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0297"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-021-01157-0"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2021.0443"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2023.22331"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2024.0121"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103190"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-023-01394-5"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14741"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2024.0130"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-1550"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(25)00091-9"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0455"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0602"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16033"},{"key":"e_1_3_3_58_2","first-page":"193229682412888","article-title":"What is the relationship between time in range, time in tight range, and HbA1c in youth and young adults with type 1 diabetes? Results from the German\/Austrian\/Luxembourgian\/Swiss Diabetes Prospective Follow-up registry","author":"Burckhardt M-A","year":"2024","unstructured":"Burckhardt M-A, , Auzanneau M, , Rosenbauer J, et al. What is the relationship between time in range, time in tight range, and HbA1c in youth and young adults with type 1 diabetes? Results from the German\/Austrian\/Luxembourgian\/Swiss Diabetes Prospective Follow-up registry. J Diabetes Sci Technol, 2024:19322968241288870.","journal-title":"J Diabetes Sci Technol"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-1581"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15791"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-024-01656-w"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-024-01572-z"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0482"},{"issue":"7","key":"e_1_3_3_64_2","first-page":"e63947","article-title":"The relationship between hemoglobin a1c, time in range, and glycemic management indicator in patients with type 1 and type 2 diabetes in a tertiary care hospital in Saudi Arabia","volume":"16","author":"Alazmi AA","year":"2024","unstructured":"Alazmi AA, , Brema I, , Alzahrani SH, et al. The relationship between hemoglobin a1c, time in range, and glycemic management indicator in patients with type 1 and type 2 diabetes in a tertiary care hospital in Saudi Arabia. Cureus, 2024; 16(7):e63947.","journal-title":"Cureus"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03396-x"},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.10.046"},{"key":"e_1_3_3_67_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.111087"},{"key":"e_1_3_3_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102852"}],"container-title":["Diabetes Technology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15209156251380593","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15209156251380593","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15209156251380593","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T07:19:36Z","timestamp":1787123976000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15209156251380593"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,19]]},"references-count":67,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,1]]}},"alternative-id":["10.1177\/15209156251380593"],"URL":"https:\/\/doi.org\/10.1177\/15209156251380593","relation":{},"ISSN":["1520-9156","1557-8593"],"issn-type":[{"value":"1520-9156","type":"print"},{"value":"1557-8593","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,19]]}}}