{
  "abstract": "BackgroundContinuous glucose monitoring-derived time in range (TIR; glucose 70-180 mg/dL) has emerged as a complementary glycemic metric, but its association with DKD (Diabetic Kidney Disease) has not been systematically quantified. We aimed to synthesize the evidence on the association between CGM-derived TIR and DKD in adults with type 1 or type 2 diabetes by conducting a systematic review and meta-analysis of the current evidence.\n\nMethodsThis systematic review and meta-analysis adhered to PRISMA guidelines. PubMed, Embase, Cochrane CENTRAL, and Scopus were searched through March, 2026. Eligible studies were studies in adults with type 1 and type 2 diabetes that reported an association between CGM-derived TIR and any DKD outcome (albuminuria, eGFR decline, or composite nephropathy) with a quantifiable per-unit effect estimate. Random-effects meta-analysis (REML with Knapp-Hartung adjustment) pooled odds ratios per 10% TIR increment. Risk of bias was assessed using ROBINS-E and certainty of evidence using the GRADE framework. PROSPERO: CRD420261377763.\n\nResultsEleven studies (n = 7,182; seven T2D, four T1D; ten cross-sectional, one retrospective cohort) were included. The pooled OR per 10% TIR was 0.89 (95% CI 0.84-0.95; P = 0.002; I{superscript 2} = 69.6%), and every leave-one-out iteration preserved significance (OR range 0.88-0.91; all P [≤] 0.005). In the four studies adjusting for HbA1c, the association persisted (OR 0.91, 0.86-0.97; P = 0.015) with no detectable residual heterogeneity (I{superscript 2} = 0%), indicating the signal is not fully attributable to average glycemia.\n\nConclusionsHigher CGM-derived TIR may be associated with lower odds of DKD (OR 0.89 per 10% increment). The HbA1c-adjusted subgroup (k = 4; I{superscript 2} = 0%) provided the most internally consistent signal, though its small size limits inference. Prospective studies with standardized CGM protocols and pre-specified hard kidney endpoints are needed to establish causality.",
  "abstract_shown": true,
  "affiliations": [
    "Maulana Azad Medical College"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "S. M. Lodha"
    },
    {
      "name": "S. Kumar"
    },
    {
      "name": "S. Acharya"
    },
    {
      "name": "P. Dhamelia"
    },
    {
      "affs": [
        0
      ],
      "name": "S. Garg"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3epk3zab7r1f9.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.21.26363573",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.21.26363573v1.full",
  "id": "3epk3zab7r1f9",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.21.26363573v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "endocrinology"
    ],
    [
      "openalex",
      "2712|Diabetes Management and Research"
    ]
  ],
  "openalex": "W7214073434",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.21.26363573v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3epk3zab7r1f9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:14Z",
      "native_id": "10.64898/2026.09.21.26363573",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.21.26363573v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:endocrinology",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Association Between Continuous Glucose Monitoring - Derived Time in Range and Diabetic Kidney Disease: A Systematic Review and Meta-Analysis of current evidence",
  "title_text": "Association Between Continuous Glucose Monitoring - Derived Time in Range and Diabetic Kidney Disease: A Systematic Review and Meta-Analysis of current evidence",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:14Z",
  "url": "https://research.draconitic.com/paper/3epk3zab7r1f9",
  "venue": "medRxiv",
  "versions": []
}