Goodhart’s Law in Diabetes Care: The Hidden Drawbacks of Overoptimizing CGM Metrics

Continuous glucose monitoring (CGM) metrics, such as time in range (TIR), have become standard clinical tools for managing type 1 diabetes (T1D), offering substantial benefits in safety, convenience, and patient engagement. However, these metrics, while correlated with glycemic outcomes, are merely proxies for the true objective: minimizing the complications of dysglycemia.