葡萄糖目标范围内时间作为2型糖尿病慢性 并发症预测指标的研究进展
Research Progress on Time in Range as a Predictor of Chronic Complications in Type 2 Diabetes Mellitus
摘要: 随着持续葡萄糖监测(Continuous Glucose Monitoring, CGM)技术的临床普及，不仅传统的糖化血红蛋白评价体系得到补充，基于CGM衍生的葡萄糖目标范围内时间(Time in Range, TIR)也日益成为评估血糖控制质量的核心指标。大量循证医学证据表明，TIR不仅能更敏感地反映血糖波动，还与2型糖尿病患者的微血管及大血管并发症风险密切相关。本文旨在就TIR的定义、其引发器官损伤的病理生理机制，及其与糖尿病肾病、视网膜病变、神经病变、心脑血管疾病、认知功能障碍及糖尿病足等并发症相关性的最新研究进展进行综述，并进一步探讨TIR在临床实践中的应用优势、挑战与未来发展方向，为临床优化糖尿病管理策略提供参考。
Abstract: With the increasing clinical application of continuous glucose monitoring (CGM), the traditional evaluation system based on glycated hemoglobin (HbA1c) has been further complemented. Among CGM-derived metrics, time in range (TIR) has emerged as a key indicator for assessing glycemic control. A growing body of evidence-based studies demonstrates that TIR not only reflects glycemic variability more sensitively but is also closely associated with the risk of both microvascular and macrovascular complications in patients with type 2 diabetes mellitus (T2DM). This article aims to review the definition of TIR and the pathophysiological mechanisms by which glycemic fluctuations induce organ damage. It also summarizes the latest research progress regarding the correlation between TIR and specific complications, including diabetic nephropathy, retinopathy, neuropathy, cardiovascular and cerebrovascular diseases, cognitive impairment, and diabetic foot. Furthermore, this review explores the advantages, challenges, and future development directions of applying TIR in clinical practice, aiming to provide a valuable reference for optimizing clinical diabetes management strategies.
文章引用：李晓雨, 李美燕, 闻杰. 葡萄糖目标范围内时间作为2型糖尿病慢性 并发症预测指标的研究进展[J]. 临床医学进展, 2026, 16(5): 2100-2106. https://doi.org/10.12677/acm.2026.1652017

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