How Good Is Average Diabetic Control?

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MikeyBikey

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I imagine this mainly applies to Type I diabetics on insulin? After I had seen the consultant about my foot on Monday I was asked to see the DSN attached to the clinic. Before I knew it I was whizzing along the corridor being pushed by a really petite nurse (at around 4' 9" probably weighing less than half my weight). I told the DSN that because I had a new phone I only had less than 72 hours information on my Libre. She asked if I would be happy to share my information as a different Health Trust authorized the Libre. I agreed and before I knew it she had all my information going back months. She then played around with the results looking at averages, and peaks and troughs before declaring I was doing better than 80% of their patients on insulin. She also said it was amazing as I am on "peaky" porcine insulin. Considering I do not feel I am doing that well I wonder what the average control is like?
 
MikeyBikey said:
Considering I do not feel I am doing that well I wonder what the average control is like?
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I've only seen fragments. The earlier draft for HCL chose an HbA1c of 64 for the cutoff because that's the average that those using a pump achieve. We know that the most recent information says the cutoff will be 58, and that (together with the other groups who'd qualify) make up about 75% of people with Type 1 (so not just people currently using a pump).

For TIR and things I don't think I've seen figures. The main recommendations (over 70% in range, etc.) seem not to be targets that people routinely meet so I presume people who do meet it really are doing well relatively.
 
Well done! that sounds like you are doing well!
I think it is very difficult to assess average "control" from this forum as most people hereon the forum are probably quite highly motivated compared to the "average diabetic"

Do you know what your Time in Range is over a 90 day period as that is usually a good guide to how well you are doing. Ideally they like you to be over 70% TIR with less than 4% below range. If you are achieving that then I think you may be in the top 10%.
I seem to remember @Bruce Stephens may have some info on that
 
Well I Know they say aim for 70% in range I don't what the a average of people meeting that.
 
The National Diabetes Audit produces figures on how many people meet a level of less than 58 HbA1c. It seems quite low.
They also produce other figures, but its hard to navigate the site, and I haven’t got time at the mo.
I found this page, and screenshotted the bit about Type 1 diabetes getting under 58.
digital.nhs.uk

National Diabetes Audit dashboards - NHS England Digital

Welcome to the National Diabetes Audit dashboard hub. This page provides links to a number of interactive data visualisation tools containing data relating to provision of care and services for people with diabetes.
digital.nhs.uk digital.nhs.uk
IMG_2246.png
 
Robin said:
The National Diabetes Audit produces figures on how many people meet a level of less than 58 HbA1c. It seems quite low.
They also produce other figures, but its hard to navigate the site, and I haven’t got time at the mo.
I found this page, and screenshotted the bit about Type 1 diabetes getting under 58.
digital.nhs.uk

National Diabetes Audit dashboards - NHS England Digital

Welcome to the National Diabetes Audit dashboard hub. This page provides links to a number of interactive data visualisation tools containing data relating to provision of care and services for people with diabetes.
digital.nhs.uk digital.nhs.uk
View attachment 28131
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Oh that's interesting it does seem quite low. But do they know what the average time in range is or is that something that's going to take a bit longer to gather.
 
I recently read a NHS presentation on the demographics of diabetes patients which was quite shocking in regards to the distribution of hba1c levels, I think only 8% were below 48, then another 8% between that and 56. I need to find it again - I can’t remember if that was type 1,2 or both.
The figures were in that range (I might have no remembered 100% correctly) and I found that quite sad.
So @MikeyBikey if you are achieving a decent TIR I could imagine you are in the top 20%.
 

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Of course more people now have Libre so that should have increased the percentage of people who achieve the target levels.
I think the pandemic was either good or bad for people. Some people got more exercise and cooked for themselves more and other people didn't do any exercise and ate comfort food and drank more, so I think it may not have had a significant impact, although for people suffering from the virus there would be increased levels which I guess would impact the stats but also people caught less other bugs because they were not mixing with people, so again, maybe mixed results.

I keep just failing by a whisker to achieve the TIR target. The 70% is no trouble at all but I usually end up 5% below 😡 and more likely than not it is because Libre reads lover than actual FP often by 1mmol, so I don't have as many hypos as it suggests.
 
mitchsi said:
I could imagine peoples control during the pandemic years were worse and not better.
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That would have been my guess, too, but whenever Partha Kar (or the other people in charge) have commented they've said that all the things measured have improved. So I think we're just wrong. I don't know how much the coincidence of the dramatic increase in use of CGMs is responsible.
 
rayray119 said:
But do they know what the average time in range is or is that something that's going to take a bit longer to gather.
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I suspect collecting that kind of data is more awkward. HbA1c is the kind of thing that's easy to get at but I doubt there's anywhere even trying to collect TIR for all of us. There have been occasional studies doing that for Libre users, I think, but not more generally.

I presume it'll happen but I doubt anyone knows right now.
 
I would have TIR cgm data would be quite easy to collate, i mean, we have to share our data with the clinic don't we? Its just there, whereas a1c needs a blood test...of course, it only goes back a couple of years.
I agree, the people on here likely to have better rests because its likely we are the more motivated, and also because of what we learn by posting here.
 
Tdm said:
I would have TIR cgm data would be quite easy to collate, i mean, we have to share our data with the clinic don't we?
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I think that's common but I doubt everyone does it. I doubt it's required any more. And I doubt things are set up to collect together the data. Stuff like HbA1c is easier, if only because they've presumably been aggregating it for years.
 
Also, cgm users are possibly also a more motivated, possibly younger subset of type 1s
 
My anecdotal evidence is that average control is not that good. I took the DAFNE course as part of the requirements to get the Libre, and I was really surprised how low the TIR figures were. Around 60% was the next best to me (my TIR is around 90%, though at the time was more like 80%).

I was concerned that I would be taken off the Libre because of my control being too good.

It brings it home how hard it is to manage stable levels, and that luck more than skill seems to play a large part in how good your levels are.
 
rebrascora said:
I keep just failing by a whisker to achieve the TIR target. The 70% is no trouble at all but I usually end up 5% below 😡 and more likely than not it is because Libre reads lover than actual FP often by 1mmol, so I don't have as many hypos as it suggests
Click to expand...
I get really annoyed by the Libre when it dishes my TIR because a new sensor has taken a while to bed in, I was suddenly 10% below after a particularly slow starter, and it took a couple of weeks to 'erase' the false low figure.
 
rebrascora said:
Well done! that sounds like you are doing well!
I think it is very difficult to assess average "control" from this forum as most people hereon the forum are probably quite highly motivated compared to the "average diabetic"

Do you know what your Time in Range is over a 90 day period as that is usually a good guide to how well you are doing. Ideally they like you to be over 70% TIR with less than 4% below range. If you are achieving that then I think you may be in the top 10%.
I seem to remember @Bruce Stephens may have some info on that
Click to expand...

I am going on memory because of the new phone but if I remember correctly in was 69% in range, 3% lower (the DSN didn't like that!), and 4% very naughty (over 13.9). Maybe more top 15%?!
 
You should be able to access the old data, as the nurse did, via Libreview, but those are pretty good results if you recall them correctly.
 
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