Time in range definition

[curlygirl]

Lots of stats from libre and pumps etc include a time in range. Having recently had a conversation that included someone saying time in range should be 3.9 to 10.1 I wondered what other people have their range set to? I do not count 3.9 as in range as it is hypo and having had patches of no warning signals for hypos I would not want to have my in range set that low. I also do not have mine set to 10.1at the higher end and just wondered if time in range should refer to a set range or if each person's is different? Which would then make the percent of time given as in range be different depending on the high and low that is set...

 

[everydayupsanddowns]

I think it’s a personal thing @curlygirl

Probably the suggestion of 3.9-10 comes from the International Consensus statement, see:

Time In Range - useful for Libre / CGM wearers

I've been meaning to post this for ages, but kept forgetting! At the ADA this year the international consensus paper on TIR (time in range) was published by a panel of experts with a huge amount of knowledge and expertise in supporting people to use continuous data to help manage their...

forum.diabetes.org.uk

Personally I tend to use 3.9-9.0 as my running range.

Partly because 9.0 is the recommended 2 hour max reading, and partly because 3.9 is a level non-Ds will hit fairly commonly and is more an ‘alert level’ than clinically significant hypoglycaemia. My personal “steady on now, keep an eye on this / consider action” is 5.2, and I‘d always try to treat by the mid-4s.

 

[Tdm]

I try to run to 'time in tight range' 3.9-7.9.
If i find that demotivating i go back to 3.9-10

 

[Bruce Stephens]

Having recently had a conversation that included someone saying time in range should be 3.9 to 10.

I think there are obvious benefits in using that range (unless you're pregnant or trying to become pregnant). That's what people are talking about when they say >70% in range is a good target.

What alarms you use, and how (and whether) you react to some reading is another question. I think most of us don't wait until we get to 3.9 before doing something, and being too close to 10 feels a bit uncomfortable.

 

[mitchsi]

I see the time in range separate to my target range, the standard TIR allows a general comparison to others and the risk of side effects of if TIR is on a low level. The DSN can then make a better judgement on my management, however, if I had set tight boundaries I’d always have to say it’s because of the tighter range.
Target range is personal for me at least and I adjust alarms for that, depending on what I’m doing, well not that frequently actually because it becomes a pain in the arse!

 

[Inka]

The TIR is 3.9 to 10. What anyone has their alarms set at, or what an individual likes to aim for is separate from the TIR, otherwise we’d all be talking at cross-purposes.

 

[curlygirl]

Good info. I feel that target range is personal to each of us but had begun to feel somewhat lacking, or daunted, when reading about time in range quotes from people of 90 percent etc. So if time in range has a standard of 3.9 to 10.1, but target of any that you set to suit then that is easier to manage. Interesting to think I have been looking at time in range statistic and not wondered if that was a set thing until today. Great to have the forum to come to in order to ask people. Thanks.

 

[Finn]

Good info. I feel that target range is personal to each of us but had begun to feel somewhat lacking, or daunted, when reading about time in range quotes from people of 90 percent etc. So if time in range has a standard of 3.9 to 10.1, but target of any that you set to suit then that is easier to manage. Interesting to think I have been looking at time in range statistic and not wondered if that was a set thing until today. Great to have the forum to come to in order to ask people. Thanks.

I started with the target range at the default. As I got better control, I slowly brought the higher number down, while trying to maintain the same time in range.

My endo looks at the range I have set (not the default), so I make it clear at appointments what my range is set to. It can be easily changed for appointments if needed.

 

[nonethewiser]

Own is set at 4.2 to 9 at present.

 

[mitchsi]

Good info. I feel that target range is personal to each of us but had begun to feel somewhat lacking, or daunted, when reading about time in range quotes from people of 90 percent etc. So if time in range has a standard of 3.9 to 10.1, but target of any that you set to suit then that is easier to manage. Interesting to think I have been looking at time in range statistic and not wondered if that was a set thing until today. Great to have the forum to come to in order to ask people. Thanks.

I had the exact same query when first diagnosed last year, you can catch a lot more nuances of diabetes in this forum compared to infrequent discussions with the DSN’s albeit mine I find are very supportive and helpful.

 

[rebrascora]

My target range is set at the standard 3.9-10 firstly because enables my consultant to see at a glance if I am achieving the guideline % targets and with only a 10 min appointment once a year it seems sensible to make his job as easy as possible to assess how I am doing, but also, this is a range that a normal non diabetic person would normally be mostly within, so I am not setting myself unreasonable targets. Sometimes I think that the Type 2 guidance of no more than 8.5 2hours after meals encourages people to lower their range down to this, but those guidelines don't mean that people don't go above 8.5 but just that they are trying to get back down to that level or below in a timely manner, so they may well spike above that as non diabetic people do too.
My alarms are set at 4.2 and 9.2 and those give me enough time to act to mostly stay in that 3.9-10 range. My response to carbs is generally much quicker than my response to insulin, even with Fiasp, so I give myself a bit more room for manoeuvre at the top end of the range than the bottom.

 

[Inka]

Exactly @rebrascora When a consultant asks your time in range, the 3.9 to 10 is what they mean. Obviously if someone had theirs set at 3.2 to 15 and reported they were 100% time in range that would be daft. When I ask someone their TIR, I mean the 3.9 to 10 not some arbitrary range someone has chosen.

 

[Bruce Stephens]

Obviously if someone had theirs set at 3.2 to 15 and reported they were 100% time in range that would be daft.

Perhaps because of that, the Libre software doesn't let you do that. (You can have alarms over 10 and under 3.9, but the range is constrained to be not outside 3.9-10.)

 

[Lucyr]

Mine is set to 3.9-10, as others say it’s there for drs etc to see if I’m meeting the target of 70%+ in range and under 4% below range

 

[Tdm]

Perhaps i've an awkward attitude, but don't give a stuff about making drs lives a bit easier the one time a year i see them. I beleive the dexcom charts/ reports they see all run of the standard 3.9-10, anyway.
Also makes me chortle when the dr shows me my agp and points out features, like i never look at it myself. I suppose they deal with many people who don't, though

 

[rayray119]

Mine is set as 3.9 to 10,

I do not count 3.9 as in range as it is hypo

Well technically yes but in reality there isn't really any difference between a 3.9 or 4.

 

[mitchsi]

Perhaps because of that, the Libre software doesn't let you do that. (You can have alarms over 10 and under 3.9, but the range is constrained to be not outside 3.9-10.)

I think if you go to settings you can change report levels and that changes the range - haven’t verified that tho

 

[Robin]

I think if you go to settings you can change report levels and that changes the range - haven’t verified that tho

You can change the range to above 3.9 and below 10.0, but not outside those parameters.

 

[rayray119]

You can change the range to above 3.9 and below 10.0, but not outside those parameters.

My dexcom reciver doesn't allow me change my target range at all not that I would want to.

 

[helli]

You can change the range to above 3.9 and below 10.0, but not outside those parameters.

You can change the range on your CGM to what you want. But, I too understand that the “standard” range is 3.9 (or 4) to 10.

I remember the first time I trialled a CGM (the Dexcom G4) and their rep recommended I set the top threshold to 15, “otherwise it will be alarming all the time”. CGMs we’re pretty rare at the time so time in range was not considered as much as getting annoyed.

Whilst you can also set the range narrower, I hope the standard target also considers the mental impact of trying to maintain it. As I have said many times before, we need to think of our overall health, including mental health, rather than just the diabetes part. There’s little point having an amazing TIR with perfect kidneys, cholesterol, liver, etc. but no life because all the time is spent on controlling diabetes,

I am happy to aim for the 4 to 10 range on the grounds people without diabetes see numbers in that range and the impact, both social and career wise, is minimal on my quality of life, whilst having no diabetes complications 20 years after diagnosis (ot which most was with insulin pens and no CGM).