A recent study published in Journal of Diabetes and Its Complications highlighted the association of glycemic risk index (GRI) and time in range with insulin resistance (TIR) and diabetic kidney disease in patients with type 2 diabetes mellitus.

TIR and GRI are two continuous glucose monitoring (CGM)-based metrics. The study aimed to determine the TIR and GRI for islet function impairment in patients with T2DM.

Four hundred twenty-two patients with T2DM were selected, and a retrospective analysis was done. The patients were admitted to Zhuhai People's Hospital from January 2021 to December 2022. To get TIR and GRI, Continuous glucose monitoring (CGM) data were collected. C-peptide release, C-reactive protein (CRP), and random urine biochemistry analysis were done to calculate HOMA-IR, ISIstumvoll index, HOMA-β, Stumvoll 1-phase and 2-phase index, and insulin resistance. As a diagnostic marker of DKD, Urinary Albumin/Creatinine Ratio (UACR) was ascertained.

Significant correlations of HOMA-IR, UACR, and HOMA-β were found with TIR and GRI. CRP exhibited limited correlation with HOMA-IR and UACR. The odds ratios (ORs) for pancreatic β-cell function were: TIR 0.174 and GRI 1.010 after adjusting for potential confounding factors. GRI 1.017 and TIR 0.182 were found for DKD. With a 4.763-fold and 5.079-fold higher risk of insulin resistance, the TIR levels of 71 %–85 % and 41 %–70 % were found to be associated compared with TIR levels more than 85 %. Association of 2.553-fold, 2.597-fold, and 3.394-fold increases in insulin resistance risk was found with GRI levels of 21–30, 31–45, and 46–100 compared with GRI ≤20. Differences in DKD and islet function were significant despite excluding CRP, GRI, and TIR. The differences remained statistically significant in the regression analysis of DKD and islet function, excluding the CRP, GRI, and TIR groups.