What Do Endocrinologists Think About Time in Range?

[Northerner]

A survey jointly conducted by diabetes research company dQ&A and The diaTribe Foundation assessed how well endocrinologists understood Time in Range and which diabetes metrics they consider most important for setting treatment goals.

Continuous glucose monitoring (CGM) has significantly changed the way that people manage their diabetes and how healthcare professionals deliver care. CGM users have access to an extensive amount of information – up to 288 glucose readings a day – giving them insight into how their glucose levels respond to certain treatments and behaviors.

Time in Range (TIR) conveniently summarizes all this user data into three percentages: their TIR, Time Above Range (TAR), and Time Below Range (TBR). These percentages can help healthcare professionals and people with diabetes understand the day-to-day fluctuations in diabetes management.

Members of the diabetes community have told us how TIR provides them with a sense of comfort and meaningful information to supplement their A1C. Accomplished researchers and leaders in diabetes care have been advocating for the adoption of TIR in clinical care for several years. You can read and hear from three healthcare providers about the importance of this metric in our “Understanding Your AGP Report” series:

What Do Endocrinologists Think About Time in Range?

A survey jointly conducted by diabetes research company dQ&A and The diaTribe Foundation assessed how well endocrinologists understood Time in Range and which diabetes metrics they consider most important for setting treatment goals.

diatribe.org

 

[nonethewiser]

Own is more interested in TIR than Hba.

 

[barrym]

Yep, mine too. HbA1c is too coarse but it was al that was available back then when dinosaurs roamed😉.

 

[rebrascora]

My consultant seems to be very switched on to TIR.
HbA1c seems to be mentioned more as an afterthought or just as support to the TIR info. I suppose it really just acts as a bit of a calibration for the Libre data in general now.

 

[PattiEvans]

Mine hasn't the slightest interest in TIR. 2+ years ago when I'd had the Libre on prescription for a long time, he was having a go at me for my Hba1c which, according to him "was too low, you must be having a lot of hypos". I pushed my phone across the desk and said "well look at that". He changed tack next sentence. I had hoped he would learn from it but at my next (telephone) appointment in March he was back on about the Hba1c again and didn't even ask about the Libre readings, which I could have made available to him by LibreLink. It actually makes me blooming furious! After all it's his clinic that prescribed Libre for me.

 

[mikeyB]

My consultant’s discussion with me revolves around my LibreLink, and she often discusses time in range, which is easy to reckon given that is basic Libre data. Interestingly, she is happy to accept the estimated HbA1c from the Libre, or at least the Libre 2, which may indicate a preference for TIR as predictor of complications. Indeed, it was she who insisted on me allowing my data to be be viewable by her team.

This all accords with my views on the subject. Anybody can get a decent HbA1c with as many hypers as hypos, but only a look at the TIR and other data from the Libre will reveal how that decent HbA1c was achieved.

 

[Northerner]

This all accords with my views on the subject. Anybody can get a decent HbA1c with as many hypers as hypos, but only a look at the TIR and other data from the Libre will reveal how that decent HbA1c was achieved.

It was only after starting using the Libre regularly on prescription that I realised - despite my own perceptions - that my previous HbA1c numbers were very flattered by the number of lows I was having. Prior to Libre and being able to monitor things properly, my HbA1c was always in the mid- to low-30s (5-5.5%). The first one I had done 6 months after getting the Libre was 48! 😱 There was such a contrast that I thought the blood test must be wrong! However, I now accept that my TIR has improved significantly, and I'm regularly 95% in range over 90 days - I currently have 18 hypos showing over 90 days, and nearly all of those were 'marginal' and brief, and some due to a particular sensor reading on the low side compared to blood tests. My blood sugars have far less variation, which is a good thing, even if they are generally higher.