{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:39:27Z","timestamp":1792525167654,"version":"4.5.0"},"reference-count":36,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health and Welfare","award":["RS-2024-00399025"],"award-info":[{"award-number":["RS-2024-00399025"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To examine 3-year longitudinal trajectories of continuous glucose monitoring (CGM) metrics across subgroups at risk for suboptimal glycemic control among adults with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>In this multicenter study, 1,028 individuals contributed 3,441 longitudinal CGM profiles. Participants were stratified on the basis of age, chronic kidney disease (CKD), \u03b2-cell function, BMI, and triglyceride-glucose (TyG) tertile. Linear mixed-effects models were used to estimate subgroup differences in longitudinal changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>At baseline, there was more time spent with glucose above target range (&amp;gt;180 mg\/dL), for the subgroups of older age, CKD, severe \u03b2-cell failure, higher BMI, and highest TyG tertile (all P &amp;lt; 0.05), while severe \u03b2-cell failure was additionally associated with more time spent with glucose below target range (time below range [TBR]) (&amp;lt;70 mg\/dL), along with greater glycemic variability (all P &amp;lt; 0.001). In relation to younger individuals, for older adults, improvement in time spent with glucose in target range (time in range [TIR]) (70\u2013180 mg\/dL) was comparable (\u03b2 = 0.110; P = 0.102) and lower TBR was maintained (3.5% vs. 1.7%, respectively; P &amp;lt; 0.001). Among the CKD group, significant improvement in TIR was seen (\u03b2 = 0.228; P = 0.002) without exacerbation of hypoglycemia. Severe \u03b2-cell failure attenuated TIR improvement (\u03b2 = \u22120.119; P = 0.025) and TBR reduction (\u03b2 = 0.046; P &amp;lt; 0.001). Lower absolute TIR was seen for those with higher BMI and those in the highest TyG tertile. Greater TIR improvement was observed for those in the highest TyG tertile (\u03b2 = 0.083; P = 0.001). CGM metrics varied widely within these subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Older age and CKD were associated with longitudinal glycemic improvement without worsening of hypoglycemia, whereas severe \u03b2-cell failure limited glycemic gains; substantial within-group heterogeneity supports individualized glycemic targets informed by CGM trajectories in type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc26-1039","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:21:37Z","timestamp":1789575697000},"page":"2013-2021","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Three-Year Glycemic Trajectories in Subgroups With Type 1 Diabetes at Risk for Suboptimal Glycemic Control: A Multicenter Continuous Glucose Monitoring Study"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2536-6274","authenticated-orcid":false,"given":"Jee Hee","family":"Yoo","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine 1 , Gwangmyeong, Republic of Korea"},{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University Wonju College of Medicine 2 , Wonju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seohyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine 3 , Seoul, Republic of Korea"},{"name":"Department of Medical Epidemiology and Biostatistics 4 , Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6458-942X","authenticated-orcid":false,"given":"Yeonsoo","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine 5 , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soojin","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine 3 , Seoul, Republic of Korea"},{"name":"Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University 6 , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choon Hee","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University Wonju College of Medicine 2 , Wonju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5001-963X","authenticated-orcid":false,"given":"Jae Hyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine 3 , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1230-0919","authenticated-orcid":false,"given":"Soo Heon","family":"Kwak","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine 5 , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2242-2816","authenticated-orcid":false,"given":"Gyuri","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine 3 , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"2026102014521472800_B1","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1089\/dia.2020.0618","article-title":"The SWEET project 10-year benchmarking in 19 countries worldwide is associated with improved HbA1c and increased use of diabetes technology in youth with type 1 diabetes","volume":"23","author":"Gerhardsson","year":"2021","journal-title":"Diabetes Technol 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