The psychological impact of time in tight range in adolescents with type 1 diabetes: insights from real-life clinical practice

Aims: Time in Tight Range (TITR) is an emerging continuous glucose monitoring (CGM) metric assessing time spent in the 70–140 mg/dL range. While TITR is increasingly recognized for reflecting optimal glucose control, its psychological impact remains unexplored. This study assessed the relationship between TITR and psychological outcomes in adolescents with type 1 diabetes (T1D). Methods: This cross-sectional study included 123 adolescents with T1D. Participants completed two validated questionnaires: the PAID-Teen, which measures diabetes-related distress, and the PERMA model, which evaluates psychological well-being. CGM data were analyzed to determine participants’ glucose metrics. Results: Achieving TITR ≥ 50% was associated with higher distress scores (OR = 1.023; 95% CI 1.002–1.044; p = 0.029), while no such association was found with PERMA scores. Conversely, time in range (TIR) ≥ 70% showed no significant relationship with psychological outcomes. Conclusions: These findings suggest TITR may impose additional psychological burden beyond conventional glycemic targets. Further longitudinal studies are needed to evaluate its long-term impact on quality of life and optimize diabetes management strategies for youth with T1D.