"Time in Range" The new gold standard for glucose management

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Thanks Patti, I’ll give it a look.

TIR is certainly getting a lot more traction in the UK since sensor use has grown so much in recent years.

And HbA1c has some shortcomings as we all know.
 
Thanks for the links!
On dafne right now. No mention tir. Its all about the premeal bs being in range, nothing about where it goes between, spikes and how to reduce them, nothing on cgm, or cgm graphs.
I tried to use a graph from my dexcom to explain my issue, and they looked at me as if it was witchcraft (everyone on the course is using cgms so its not like they are avoiding cgm-ery to include eveyone).
I'm all about average bs, time in range, the figure that says how much you fluctuate. A1c feels a bit old hat to me, and more about hcps trying to keep control of the tests
 
Thanks for posting @Pattidevans Just had a quick look and there’s lots of interesting information in those links 😎 I love TIR because a) it’s a dynamic thing you can monitor as you go along; and b) it just makes sense. My Dexcom has allowed me to ‘tidy up’ my range by reducing lows and highs. I also think TIR is more encouraging because you can see it and change things whereas an HbA1C gives limited information. I also think sometimes HbA1Cs encourage people to wander below the (hypo) line too much.
 
Yes, there is a temptation to chase numbers but when your time low/ very low goes up, its a bit of a red flag/hold up moment.

Recently my average bs has gone up, but i can also see time below range is now 0 for last 2 days so happier because can see thsy
 
Thanks @Pattidevans
Very useful inks and lots of useful info.
 
Tdm said:
Thanks for the links!
On dafne right now. No mention tir. Its all about the premeal bs being in range, nothing about where it goes between, spikes and how to reduce them, nothing on cgm, or cgm graphs.
I tried to use a graph from my dexcom to explain my issue, and they looked at me as if it was witchcraft (everyone on the course is using cgms so its not like they are avoiding cgm-ery to include eveyone).
I'm all about average bs, time in range, the figure that says how much you fluctuate. A1c feels a bit old hat to me, and more about hcps trying to keep control of the tests
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I'm a bit shocked that the Dafne educators are not using TIR as a measure of control. This link wuld suggest that Diabetes Educators are the most likely category of HCP to be aware of TIR, but I guess that's in the USA. From what you've posted elsewhere I think your lot are lagging a bit behind. Not good.

FWIW I used to get spectacular Hba1cs at one time (and got told off all the time for being "too low") but Libre has enabled me to tidy my graph up a lot! At the same time my Hba1c has gone up to 51, but I'm not unhappy with that. Clicking on 90 days there's more in the high range but 0% low. Mind, part of that time I had a chest infection.

On the negative side, it's pushed me to the back of the queue for HCL.
 

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Joining you at the back of the queue.
The dafne coursebook we got was published in 2019. I don't think there was any tir info by the end of the course, deffo nothing on libre graphs, nor reading the reports, nor any info on when alarms should be set to
 
Pattidevans said:
I received a newsletter from Diatribe today, it had some amazing info on TIR albeit it's USA centric I do think the links are worth a read

https://www.timeinrange.org/discover-pwd/

https://diatribe.org/time-range-new...il&utm_term=0_22467a8528-8db98f6ebd-150133925

Explore the research
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Evening Patti,
Thanks for posting and makes for interesting reading and I consider TIR a very good indicator of how I am doing in managing my diabetes but understand others may prefer different measures and targets.
I like it as I can readily make adjustments to try and maintain a reasonably steady measure of how well I am managing the condition to prevent long term complications.
Equally I can take appropriate actions to try and reduce any variance by trying to avoid the highs and the lows in a timely manner.
By doing this I think the other measures will look after themselves and you always have the option to fine tune the current TIR limits by stricter adherence to a narrower range of that is what you desire.
Personally I try and avoid the very low levels as much as possible and concentrate on maintaining a BG level in the middle of my targeted range for as much time as possible.
It currently works for me so I can more or less live the lifestyle I want and be within a range I am comfortable with but do appreciate I am still in the honeymoon period so am very likely to find it necessary in the future to considerably increase my insulin dose and/ or find it much more difficult to maintain current TIR.
Anyway a very nice discussion and ATB
 
Inka said:
Thanks for posting @Pattidevans Just had a quick look and there’s lots of interesting information in those links 😎 I love TIR because a) it’s a dynamic thing you can monitor as you go along; and b) it just makes sense. My Dexcom has allowed me to ‘tidy up’ my range by reducing lows and highs. I also think TIR is more encouraging because you can see it and change things whereas an HbA1C gives limited information. I also think sometimes HbA1Cs encourage people to wander below the (hypo) line too much.
Click to expand...
Hi Inka.I did not want to repeat the excellent points you made but very much agree with your comments.
 
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