Time in range definition

[rayray119]

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 on my life, social and career wise, is not impacting my quality of life whilst having no diabetes complications 20 years after diagnosis (ot which most was with insulin pens and no CGM).

Oh that's alerms I have my alerm set at 13 athe moment I might set it back to 14(athough I might set in back to 14 at some point. I do delay it for 2 hours) but the target range which I cannot change is set to 3.9 to 10. At least with dexcom one alerms and target range are two separate features 🙂

 

[Bruce Stephens]

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

As @Robin says, you can set the low to above 3.9 and the high to under 10.0 (so you can have a tighter range), but you can't have a range that's outside 3.9-10.0.

 

[mitchsi]

As @Robin says, you can set the low to above 3.9 and the high to under 10.0 (so you can have a tighter range), but you can't have a range that's outside 3.9-10.0.

Yup as I wrote it can be changed I just didn’t detail the directions. I’m only quoting the libre, no idea about other models

 

[everydayupsanddowns]

Oh that's alerms I have my alerm set at 13 athe moment I might set it back to 14(athough I might set in back to 14 at some point. I do delay it for 2 hours) but the target range which I cannot change is set to 3.9 to 10. At least with dexcom one alerms and target range are two separate features 🙂

Interesting that it’s fixed on the reader @rayray119

The iphone Dex G6 Clarity app allows you to adjust TIR as high as 13.8 and as low as 3.1

For my own observations I use 3.9-9.0, but then update the reports to 3.9-10 for appointments 🙂

 

[Inka]

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.

Very true @helli Life is for living not obsessing over blood sugar (and yes, some people do obsess). It’s perfectly possible to live life and have good control too. There’s no need to set an additional tight target range. No only does it affect mental health, it leads to impaired hypo awareness. The pregnancy targets are super-tight and that’s good for that very short part of your life, but it’s not only not necessary to do that when you’re not pregnant, it’s actually detrimental. Every person I know who has an ultra tight range has either no or little hypo awareness.

 

[rayray119]

Interesting that it’s fixed on the reader @rayray119

The iphone Dex G6 Clarity app allows you to adjust TIR as high as 13.8 and as low as 3.1

For my own observations I use 3.9-9.0, but then update the reports to 3.9-10 for appointments 🙂

Ah well perhaps I could change it if had access to Charity I have no laptop. So will need to just let them upload it at next appointment(whenever that is).


Seems odd that it will let you set at 3.1

 

[everydayupsanddowns]

Seems odd that it will let you set at 3.1

Yes I thought so too, though I’m not sure what the suggestions might be for targets during pregnancy in some countries.

 

[Inka]

I hope they’re not as low as 3.1. That would be scary! The U.K. ones are 3.5 to 7.8 if I remember correctly. I don’t think that this is so much that any women should aim to be 3.5 but more to make some allowance for the additional lower sugars that such tight control leads to, and to the pregnancy hypos. You’re supposed to aim for 70% sugars in that range. It’s hard.

I suppose there might also be women with Gestational Diabetes not (yet) on meds but monitoring their blood sugar closely.

The only think that I can think of regarding the 3.1 is that that’s where the Urgent Low triggers?

 

[rayray119]

.

The only think that I can think of regarding the 3.1 is that that’s where the Urgent Low triggers?

I believe it is. I can't say for sure as only on dexcom one which doesn't have those kind of alerts just what I've heard.

 

[Tdm]

I think everyone needs to make their own decisions, keeping in mind impact on their mental health, how easy they find their sugars are to control, etc

 

[rayray119]

I think everyone needs to make their own decisions, keeping in mind impact on their mental health, how easy they find their sugars are to control, etc

The mental health ascept is why I like the dexcom one has a delay first high alert as I don't need to be alerted eveytime Im spiking from food.(of course I meant want to know thar happened later on in the day but I mean right that insant I don't need to know)

 

[Inka]

I believe it is. I can't say for sure as only on dexcom one which doesn't have those kind of alerts just what I've heard.

I have the G7. My question mark referred to the possibility they were using the 3.1 as some kind of boundary marker 🙂

 

[rayray119]

I have the G7. My question mark referred to the possibility they were using the 3.1 as some kind of boundary marker 🙂

Oh right I thought it was genuine question. I did think that you were on the G7 so should have known

 

[lordburnside]

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.

I seem to be beating myself up with my readings.
Most of the day I am under 7 but for breakfast I can jump to 14 but this will reduce now I know what is wrong porridge/weetabix and toast! I can probably keep below 11 if I put my mind to it. Lunch is salad and no problem. Dinner isnt too bad but I walk 4 miles immediately afterwards so BG doesnt exceed 8.5 (usually). So assuming I can keep my breakfasts under control I should be OK with the 70% in range you mentioned (international concensus)?

 

[everydayupsanddowns]

I seem to be beating myself up with my readings.
Most of the day I am under 7 but for breakfast I can jump to 14 but this will reduce now I know what is wrong porridge/weetabix and toast! I can probably keep below 11 if I put my mind to it. Lunch is salad and no problem. Dinner isnt too bad but I walk 4 miles immediately afterwards so BG doesnt exceed 8.5 (usually). So assuming I can keep my breakfasts under control I should be OK with the 70% in range you mentioned (international concensus)?

Sometimes it can help to play with dose timing. If you are consistently seeing a bigger BG bump than you’d like after a particular meal, which then comes down over the next 4-5 hours, it can just be a mismatch between the speed if insulin action and the absorption of the carbs.

Many folks here (me included) find it helps to leave 5, 10, 15, 20 or even more minutes between administering their dose at breakfast/lunch and actually eating the food.

Might be worth some cautious experiments?

 

[lordburnside]

Thanks

 

[Leadinglights]

Thanks

I think time in range mostly refers to people who take insulin rather than those are dietary managed or on oral medication.
You may be getting yourself unnecessarily concerned.
Many people in that situation are either not testing at all or just using finger prick testing before eating and after 2 hours so have no idea what is happening in the interim. They make meal adjustments based on either the difference between before eating and post at the 2 hour point keeping the increase to no more than 3mmol/l or no more than 8-8.5mmol/l and before eating aiming at 4-7mmol/l.

 

[lordburnside]

I think time in range mostly refers to people who take insulin rather than those are dietary managed or on oral medication.
You may be getting yourself unnecessarily concerned.
Many people in that situation are either not testing at all or just using finger prick testing before eating and after 2 hours so have no idea what is happening in the interim. They make meal adjustments based on either the difference between before eating and post at the 2 hour point keeping the increase to no more than 3mmol/l or no more than 8-8.5mmol/l and before eating aiming at 4-7mmol/l.

Yes I maybe getting over concerned. I didnt think diabetes was so complicated and everyone is different.
Just thought I could lose weight, improve my diet and exercise and all is well. It might go OK or it might not.
Watch this space!

 

[rebrascora]

Sometimes it can help to play with dose timing. If you are consistently seeing a bigger BG bump than you’d like after a particular meal, which then comes down over the next 4-5 hours, it can just be a mismatch between the speed if insulin action and the absorption of the carbs.

Many folks here (me included) find it helps to leave 5, 10, 15, 20 or even more minutes between administering their dose at breakfast/lunch and actually eating the food.

Might be worth some cautious experiments?

I may be mistaken but I don't believe @lordburnside is using insulin Mike.

 

[lordburnside]

I may be mistaken but I don't believe @lordburnside is using insulin

I am not yet