Target range values - what should I use?

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mitchsi

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Type 1
Hi all,

Since coming out of hospitable last month the DSN set limits of 3.9 -> 10.0 as my target range. I’ve been pretty pleased with my % time in range and then realised it’s at the widest range possible!!!
What does everyone use?
The 3.9 I’m ok with but thought the 10.0 might be a little high.
What do you good folk use and recommend pls?

Thanks,
 
3.9-10 is standard and being inside that range 70% of the time is an achievable target for most people. Some of us can consistently do better BUT 70% is good enough. It is important to consider that this range is including post meal spikes and that non diabetic people spike above 10 occasionally so having this range is pretty much aiming for "normality" given the constraints of insulin usage.... ie injecting the wrong insulin, in the wrong amount, in the wrong part of the body at the wrong time. 🙄 If we could do what our pancreas used to do and secrete tiny bits of insulin into the blood stream throughout the day and night to match our needs when we needed it, instead of larger doses of artificial insulin, in doses that need to cover many hours instead of minutes and inject it under our skin where it takes a variable amount of time to be absorbed. I think considering these limitations we do extremely well to manage 3.9-10..... whilst we are also doing all the other things we need to do in life and hopefully spending some time enjoying ourselves too!

You also have to consider that previous guidelines and Type 2 targets were for finger prick results at set times. So the post meal target of 8.5 or whatever is not necessarily the peak that levels went to after a meal but how well they are recovering after the meal. It is likely that levels go higher within the 2 hours and are coming back down at that point, whereas Libre shows the whole spike, so it is quite normal for levels to go above 8.5 in that 2 hour period.

Diabetes burnout is a real condition that affects many people particularly those managing their levels with insulin, so go have to balance what you can reasonably achieve sustainable over the long term and still enjoy life with the very minor risk of levels being a bit higher than normal occasionally. Furthermore you can't get it right all the time and if you continually strive for better and better you will hit a brick wall.

My advice would be to stick with the 3.9-10 and if you can get 70% or more then you are doing well enough and need to find something more enjoyable to occupy your brain and body than reducing that range and trying to improve it further.

Setting a lower range ie 3.9-9 can lead to you having more hypos, even when you maintain 3.9 as the bottom of the range, because you are trying to keep things in a tighter range.

Also important that the consultants are looking at lots of data and only have a very short time to assess that data for any specific individual and make decisions, so if people are changing their range, the consultant may not pick up on this at first glance and that might affect the advice they give, so best all round to stick with that range.
 
Time in tight range is 4 to 7.9. I would only recommend if you are doing really well at the 4 to 10, and you really want to, otherwise it will stress you out too much.
No point risking burn out!
 
Hi mitshi
Like you I was diagnosed in August but Barbara has given you a comprehensive explanation of what to aim fir and some of the considerations.
As we are all individual and this is for life we need to find an optimal way of dealing with it so that it best meets our needs.
The three variables are generally diet,insulin and exercise and using a combination of them to manage our condition is how we do it.In the early days it is about bringing your levels down in a graduated way and if you are getting a good TIR then you have made an excellent start and to me it is about progressing and gradual improvement but also you are going to have challenges/ lapses etc depending on how you want to live your life.
So I find it a lot easier to achieve my “ targets” which will be different for everyone when I am at home rather than out and about and that is my next challenge to get “ stability”.
As tine progresses it us about improving your decision making through experience but equally if you become obsessive about staying in the range you can increase the risk of hypos if you try and go too low without adequate alarms etc and of course you may just miss out on living a normal life.
But at end of the day it is your decision but I do believe that with commitment and common sense you can manage this condition and live a normal life but don’t get alarmed if it suddenly surprises you
ATB
 
mitchsi said:
Hi all,

Since coming out of hospitable last month the DSN set limits of 3.9 -> 10.0 as my target range. I’ve been pretty pleased with my % time in range and then realised it’s at the widest range possible!!!
What does everyone use?
The 3.9 I’m ok with but thought the 10.0 might be a little high.
What do you good folk use and recommend pls?

Thanks,
Click to expand...

10 isn't high, especially for someone new to diabetes, so stick with that target range.

Own upper level is 9, couple of weeks back got 94% TIR over 7 days but that happening is as rare as hens teeth with me, mostly over 70% & occasionally in 80% range but 70% is good as @rebrascora pointed out earlier.
 
mitchsi said:
Hi all,

Since coming out of hospitable last month the DSN set limits of 3.9 -> 10.0 as my target range. I’ve been pretty pleased with my % time in range and then realised it’s at the widest range possible!!!
What does everyone use?
The 3.9 I’m ok with but thought the 10.0 might be a little high.
What do you good folk use and recommend pls?

Thanks,
Click to expand...

Yes, that’s the range to aim for, and if you’re managing to stay in that range 70% of the time or more, you’re doing very well. There’s no need to lower that range IMO. That’s what it’s supposed to be.
 
Well said @helli ! I’d add the loss of hypo awareness to that, which comes with the loss of your driving licence and far more serious potential consequences too.
 
nonethewiser said:
10 isn't high, especially for someone new to diabetes, so stick with that target range.

Own upper level is 9, couple of weeks back got 94% TIR over 7 days but that happening is as rare as hens teeth with me, mostly over 70% & occasionally in 80% range but 70% is good as @rebrascora pointed out earlier.
Click to expand...
That’s great, nicely done. That’s something to aim for!
 
That’s for all the replies, thanks @rebrascora for your lengthy reply.
All good advice. Good to know it’s sound to keep going as I am but I would look to tighten as I become experienced in the future.
Being technically minded and data driven I don’t think I’ll be at risk of burnout chasing my tail but I can see how it can become obsessive. In fact after 5weeks I’m checking the app less and less, just once a minute now ;-)
I’m about 85% for the last 30days, sports is screwing me over a bit in the last week but that’s a different topic.
Appreciate your feedback folks
 
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Being technically minded can be a hinderance in some respects with diabetes because biological systems are messy and give you lots of spurious results for no obvious reason. Plus diabetes is day and night 7 days a week 365 days a year with no holidays, so it is very easy for it to become overwhelming, especially when things start going amiss as they occasionally do.
Just be mindful of your management and reassess it regularly to ensure you are not getting too sucked into it and remember that it is OK to back off from it a bit and drop your standards to basic "tick over" from time to time if necessary.
 
helli said:
I have seen days with 100% in range referred to as "Unicorn days" and would emphasise the point about burn out. It is as important to manage your mental health as well as your diabetes.
Click to expand...

Never heard of that before about Unicorn Days, but your so right that you have to look after your mental health & not get obsessed about numbers.
 
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