{
  "abstract": "Objective: To evaluate dose‐normalised time in range (dn‐TIR) and its log relative change (Δdn‐TIR) as measures of within‐person glycaemic change relative to total daily insulin exposure following hybrid closed‐loop therapy (HCL/AID).\n\nResearch Design and Methods: We conducted a retrospective two‐cohort study of people with type 1 diabetes commencing hybrid closed‐loop/automated insulin delivery (HCL/AID) therapy in Australia and the United Kingdom (UK). dn‐TIR was calculated as time in range (TIR) 3.9–10.0 mmol/L (70–180 mg/dL) divided by total daily insulin dose (TDD) and Δdn‐TIR as log[(TIR/TDD)post/(TIR/TDD)pre].\n\nResults: The study comprised 86 people living with type 1 diabetes in Australia and 288 in the UK. In the fixed Australian dn‐TIR cohort, TIR increased from 53.2% ± 20.7% to 70.4% ± 14.6% (n = 86; p < 0.001), whereas mean TDD changed from 53.3 to 52.0 units/day (n = 86; p = 0.724). Median Δdn‐TIR was 0.224 [IQR: −0.033, 0.583]. In the UK cohort, TIR increased from a median 54% [34, 68] to 66% [54, 74] (n = 257; p < 0.001), whereas mean TDD changed from 44.1 to 46.3 units/day (n = 242; p = 0.152). Median Δdn‐TIR was 0.194 [IQR: −0.097, 0.541].\n\nConclusions: HCL/AID therapy improved TIR relative to TDD in two real‐world cohorts. dn‐TIR and Δdn‐TIR are not replacements for established CGM metrics or direct measures of insulin sensitivity; they may provide an adjunct longitudinal description of whether glycaemic improvement was accompanied by proportionately greater, similar or lower insulin exposure.",
  "abstract_shown": true,
  "affiliations": [
    "Hull University Teaching Hospitals NHS Trust Hull UK",
    "Hull York Medical School University of Hull Hull UK",
    "College of Medicine and Dentistry James Cook University Townsville Queensland Australia",
    "Gold Coast University Hospital Gold Coast Queensland Australia",
    "Townsville University Hospital Townsville Queensland Australia",
    "Logan Hospital, Metro South Health Logan Queensland Australia",
    "University Hospitals of Derby and Burton NHS Foundation Trust Derby UK",
    "University of Nottingham Nottingham UK"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Jude Wellens‐Mensah"
    },
    {
      "affs": [
        2
      ],
      "name": "Akash Konantambigi"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Keimee Lopez",
      "orcid": "0009-0007-9132-2230"
    },
    {
      "affs": [
        3
      ],
      "name": "Jessica Triay"
    },
    {
      "affs": [
        2,
        4
      ],
      "name": "Vasant Shenoy"
    },
    {
      "affs": [
        5
      ],
      "name": "Gaurav Puri"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Emma Wilmot",
      "orcid": "0000-0002-8698-6207"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Thozhukat Sathyapalan",
      "orcid": "0000-0003-3544-2231"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Harshal Deshmukh",
      "orcid": "0000-0002-3859-3118"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3a5zwpmt23sz4.bib",
  "cited_by": 0,
  "doi": "10.1111/dom.71342",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731000/",
  "id": "3a5zwpmt23sz4",
  "issns": [
    "1462-8902",
    "1463-1326"
  ],
  "landing_url": "https://doi.org/10.1111/dom.71342",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2712|Diabetes Management and Research"
    ]
  ],
  "openalex": "W7212160298",
  "pdf_url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dom.71342",
  "pmcid": "PMC13731000",
  "pmid": "42717560",
  "published": "2026-09-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3a5zwpmt23sz4.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:17Z",
      "native_id": "PMC13731000",
      "source": "pmc",
      "url": "https://doi.org/10.1111/dom.71342"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Management and Research",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Dose‐Normalised Time in Range (dn‐TIR) Improves Following Hybrid Closed‐Loop (HCL) Therapy in Type 1 Diabetes: A Real‐World Cohort Study From Australia and the United Kingdom",
  "title_text": "Dose‐Normalised Time in Range (dn‐TIR) Improves Following Hybrid Closed‐Loop (HCL) Therapy in Type 1 Diabetes: A Real‐World Cohort Study From Australia and the United Kingdom",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:17Z",
  "url": "https://research.draconitic.com/paper/3a5zwpmt23sz4",
  "venue": "Diabetes, Obesity & Metabolism",
  "versions": []
}