Evidence map›Paper›PMID 39778035›Full record

ArticleDiabetes, obesity & metabolism2025

Long-term health benefit and economic return of time in range (TIR) improvement in individuals with type 2 diabetes.

Khalid Alkhuzam, Piaopiao Li, Sumaya Abuloha, Qiaochu Xue, Lizheng Shi, Vivian Fonseca, Yongkang Zhang, Hui Shao

Abstract read
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Khalid AlkhuzamDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Piaopiao LiDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.ORCID 0000-0003-0941-5563
Sumaya AbulohaDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Qiaochu XueHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Lizheng ShiDepartment of Medicine and Pharmacology, School of Medicine, Tulane University, New Orleans, Louisiana, USA.ORCID 0000-0002-7827-6766
Vivian FonsecaDepartment of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA.ORCID 0000-0002-3381-7151
Yongkang ZhangDepartment of Population Health Sciences, Weill Cornell Medical College, New York, New York, USA.
Hui ShaoDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.ORCID 0000-0002-4088-546X

Funding

Translational Research Core - Engagement and Behavior ChangeP30DK111024 · NIDDK · EMORY UNIVERSITY · PI Mohammed Kumail Ali · 2016 to 2026
$13.4M
Supplement of NIDDK R01 newer GLDs and Clinical OutcomesR01DK133465 · NIDDK · UNIVERSITY OF FLORIDA · PI GUO, JINGCHUAN, SHAO, HUI · 2022 to 2025
$2.8M
NIDDK NIH HHS P30 DK111024NIDDK NIH HHS P30DK111024NIDDK NIH HHS R01 DK133465NIDDK NIH HHS R01DK133465
6 · The paper itself

Abstract

objectiveTime in range (TIR) is an important metric to measure variability of blood glucose levels. The aim is to quantify the long-term health benefits and economic return associated with improved TIR for individuals with type 2 diabetes (T2D).

methodA Markov model with three states (T2D, T2D with cardiovascular disease (CVD) and death) estimated 20-year medical costs, quality-adjusted life-years (QALY) gained and CVD risk under four TIR scenarios: >85%, 71%-85%, 51%-70% and ≤50%. The T2D population was identified using the National Health and Nutrition Examination Survey, and model parameters were sourced from literature. Costs were estimated from a healthcare sector perspective and standardized to 2021 US dollars. Cost ceilings were determined using three willingness-to-pay (WTP) thresholds: $100 000/QALY, $50 000/QALY and $0/QALY (cost-saving).

resultsCompared to TIR <50%, improving TIR to 51%-70% resulted in a 0.79 QALY increase and 4.91% CVD risk reduction; to 71%-85%, a 0.95 QALY increase and 6.24% CVD risk reduction; to >85%, a 1.18 QALY increase and 8.75% CVD risk reduction. To be cost-effective at $100 000/QALY, annual costs for TIR improvements from <50% to 51%-70%, 71%-85% and >85% should be <$1148, $4200 and $7252, respectively. To be cost-saving, these costs should be <$612, $2816 and $5021.

conclusionImproving TIR yields significant health benefits. We calculated feasible medical cost allocations for TIR improvements, informing the implementation of interventions like continuous glucose monitoring devices.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Health Care CostsAdultAgedBlood GlucoseCost-Benefit AnalysisFemaleHumansMaleMarkov ChainsMiddle AgedQuality-Adjusted Life YearsUnited StatesBlood Glucosecontinuous glucose monitoringcost‐effectivenessdiabeteseconomic evaluationhealth benefitT2Dtime in range

Identifiers

PMID39778035
PMCPMC12215644

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.