Subscribe Now

[hb-subscribe]

Trending News

T1D Exchange T1D Exchange T1D Exchange
  • Activity
    • 3 hours, 11 minutes ago
      Phyllis Biederman likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      Its a Tandem. The main issue I have with the phone is the inability to do an extended bolus.
    • 3 hours, 11 minutes ago
      Phyllis Biederman likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I selected “other” because my preference (smart watch, mobile phone, or pump screen) depends on circumstances. Watch for a quick and discrete view; pump if I’m preparing for a profile or activity adjustment or bolus, mobile phone if just a food bolus.
    • 3 hours, 40 minutes ago
      Amy Schneider likes your comment at
      How well do you understand the details of your health insurance coverage?
      At the risk of being overly simplistic, it boils down to: "Heads, you lose. Tails, You lose." ╰── ──╮
    • 12 hours, 2 minutes ago
      Daniel Bestvater likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      There are certain areas on my body where the insulin is more effective than others.
    • 21 hours, 36 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      I oftentimes give myself a little insulin for when I go unplugged while changing pods, depending on what my current sensor reading is.
    • 21 hours, 36 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Always, until I began to increase the "cannula fill" amount. I found I need a good bit more than the (1.3u) to "prime the site" to have the next blood sugars be in goal. Just remember "every body is different". Darn than OmniPod does not let you change that amount, have to use "fake carbs". Something to consider.....
    • 21 hours, 36 minutes ago
      KarenM6 likes your comment at
      How well do you understand the details of your health insurance coverage?
      They change all the time. Generally not in a direction to improve my health, but to increase the money in their wallet.
    • 21 hours, 37 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Sometimes, which makes sense to me. It seems like it takes a while til the new insulin is absorbed.
    • 1 day, 1 hour ago
      KSannie likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      **cannula
    • 1 day, 8 hours ago
      Kathleen Juzenas likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I find a using the T-Connect app I have the main features needed, CMG, bolus, battery level and remaining insulin.
    • 1 day, 12 hours ago
      TEH likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Sometimes, which makes sense to me. It seems like it takes a while til the new insulin is absorbed.
    • 1 day, 12 hours ago
      atr likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Usually the opposite. Fresh insulin sometimes sends me low.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      Mostly pump because I want to quickly see insulin on board. Tandem on IPhone when holding my great-niece while she sleeps since getting my pump out of my pocket always wakes her ☺️. Dexcom app if not in need of insulin.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      usually the pump; sometimes my phone.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump (Tandem X2). Since I have to carry a work phone close to 247, I don't want to deal with two phones (device overload!). As I go about my day, looking at my pump meets my needs, I can decide to bolus etc - and edit the bolus. For more in depth data review and analysis, I use the TConnect.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I read it from my pump.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      On my insulin pump
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump. Keep it simple.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      How much of this is intentionally misleading? My mail order prescription service says that can’t possibly know the cost of a medication until after it’s been shipped, which is too late to cancel or return, of course, and makes it impossible to comparison shop.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      I have an MA in writing and lit, but gobbledegook is gobbledegook. The fancy term is obscurantism.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      They change all the time. Generally not in a direction to improve my health, but to increase the money in their wallet.
    • 1 day, 12 hours ago
      Lawrence S. likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Usually the opposite. Fresh insulin sometimes sends me low.
    • 2 days, 9 hours ago
      Sarah Berry likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump
    • 2 days, 10 hours ago
      Marty likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      One nice thing about a watch for readings is that, while it is normally redundant, you can be separated from your phone. For example, when you are in water.
    • 2 days, 10 hours ago
      Marty likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I use both as you can’t do everything you want in one or the other
    Clear All
Pages
    • T1D Exchange T1D Exchange T1D Exchange
    • Articles
    • Community
      • About
      • Insights
      • T1D Screening
        • T1D Screening How-To
        • T1D Screening Results
        • T1D Screening Resources
      • Donate
      • Join the Community
    • Quality Improvement
      • About
      • Collaborative
        • Leadership
        • Committees
      • Centers
      • Meet the Experts
      • Learning Sessions
      • Resources
        • Change Packages
        • Sick Day Guide
        • FOH Screener
        • T1D Care Plans
      • Portal
      • Health Equity
        • Heal Advisors
    • Registry
      • About
      • Recruit for the Registry
    • Research
      • About
      • Publications
      • COVID-19 Research
      • Our Initiatives
    • Partnerships
      • About
      • Industry Partnerships
      • Academic Partnerships
      • Previous Work
    • About
      • Team
      • Board of Directors
      • Culture & Careers
      • Annual Report
    • Join / Login
    • Search
    • Donate

    How important is the time-in-range measurement to you when assessing your T1D management?

    Home > LC Polls > How important is the time-in-range measurement to you when assessing your T1D management?
    Previous

    For this question, we're re-asking a recent question. Even if you answered before, please answer again. If you use both an insulin pump and CGM, do you currently use any of the following automated insulin delivery (also known as “predictive low glucose suspend” or “hybrid closed loop”) algorithms?

    Next

    Do you usually change the time on your glucose meter and/or insulin pump for Daylight Savings Time?

    Sarah Howard

    Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

    Related Stories

    " At T1D Exchange, we’re proud to announce our Medical and Research Advisory Team — an accomplished group of leaders in endocrinology, research, and quality improvement. Together, they are redefining what’s possible in type 1 diabetes (T1D) care through rigorous data analysis, innovative research approaches, and real-world implementation. Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. By leveraging data to scale best practices, the goal is to drive meaningful, measurable change across clinics and communities.  “Our advisors will help to extend our impact — whether through QI strategy, research innovation, funding opportunities, or new data-driven solutions,” said Walton. “We want to take what’s working at individual centers and spread that as broadly as possible.”   He added, “As a Collaborative, we’re also focused on advanced population health strategies such as exploring predictive data models to identify risks earlier and intervene before complications even begin to happen.”    The power of the T1D Exchange Quality Improvement Collaborative  Central to this work is the T1D Exchange Quality Improvement Collaborative (T1DX-QI) — a nationwide network of clinics working together to improve care through shared data, benchmarking, and evidence-based practices.  “I’m thrilled to serve as a Medical Advisor for T1D Exchange, because I’ve seen firsthand the impact this network can have on patient care,” said Dr. Nestoras Mathioudakis. “T1D Exchange is the premier organization for quality improvement in type 1 diabetes, with unparalleled assets like a large EHR database and robust patient registry.”  He added that he is excited to apply his expertise in EHR research and big data analytics to generate real-world evidence across diagnosis, management, and outcomes.  Dr. Viral Shah echoed that perspective, reflecting on T1DX-QI's evolution: “I have been involved with T1D Exchange since its early days and have had the privilege of witnessing how it has transformed the quality of diabetes care across the United States. I’m delighted to return as a Medical Advisor.”  He emphasized the importance of accelerating impact. “I look forward to working closely with the team to accelerate the evidence generation and to help translate these insights to improve patient care.”   Dr. Jenise Wong highlighted the visible impact of T1DX-QI on the delivery of care. "I’m truly honored and grateful to be working with T1D Exchange as a Medical Advisor. T1DX-QI is a remarkable resource for centers that are using continuous process improvement to improve the quality of care for people living with diabetes.”  “Diabetes centers working with T1DX –QI have done amazing work using QI methodology to make care accessible and equitable for all people with diabetes,” she said. “It’s inspiring to be a part of a collaborative in which centers have been creative and thoughtful with initiatives to address individual and systemic challenges to care, improving clinical outcomes as well as the patient experience."  Looking ahead, Dr. Sherr highlighted the opportunity to build on the existing strong foundation. “I’m very excited to be working as a Medical Advisor for T1D Exchange,” she said. “It’s a privilege to help shape what comes next for a group that’s already doing such impactful work.”  “Sharing what’s happening in clinical practice, benchmarking across centers, and understanding outcomes is how we figure out what’s working, what’s not, and where we go next,” she said.      The future of T1D care   With this team’s vision and expertise, T1D Exchange is positioned to accelerate progress in T1D care — bridging research and real-world practice to drive meaningful, measurable impact.  Together, we look forward to advancing innovation and improving outcomes for everyone affected by type 1 diabetes.   "

    7 days ago  
    Meet the Expert

    Meet the Expert: Improving Diabetes Care Through Precision Medicine 

    Jewels Doskicz, 2 weeks ago 8 min read  
    Meet the Expert

    Meet the Expert: Bridging Research, Technology, and Real-World Care 

    Jewels Doskicz, 2 weeks ago 9 min read  
    Insulin & Meds

    Ask the Expert: Diana Isaacs on Benefits, Risks, and Real-World Use of GLP-1s in T1D 

    Jewels Doskicz, 3 weeks ago 6 min read  
    Meet the Expert

    Meet the Expert: Advancing Equity, Improving Outcomes, and Reducing the Burden of T1D 

    Jewels Doskicz, 1 month ago 8 min read  
    Our team

    Spotlight on T1DX-QI: Clinical Leadership Committee 

    Jewels Doskicz, 2 months ago 6 min read  

    22 Comments

    1. RegMunro

      CGM has made time in range 95+% achievable, but not east. It has enabled me to move focus to variability of blood glucose level. I’m not sure what to aim for in this area! Any practical tips?

      4 years ago Log in to Reply
    2. Larry Martin

      It is the only thing I really care about. A1C is a myth because you can have a very wide range of glucose readings from way too high to way too low and still show a good A1C.

      5
      4 years ago Log in to Reply
    3. Lisa Anderson

      I have long-term gastroparesis treated with propulsid I get through a compassionate need/IND program and dietary restrictions. I frequently go in and out of Auto Mode to use the split/square wave boluses. The only way I can be in range all the time is by eating the same things ate the same times everyday. That’s not a fun or healthy way to live, so I try not to get hung up too much on numbers.

      1
      4 years ago Log in to Reply
    4. connie ker

      My endo apts. always include an A1C either in the lab orders or on the office machine. I understand it is an average but perhaps both TIR and A1C are both informative to the patient and Dr. I feel better without the swings, but that is the nature of this T1D.

      1
      4 years ago Log in to Reply
    5. Lawrence S.

      I answered “Other” because I don’t know where the Time In Range number is to be found. I tried to figure mine out by going onto my TConnect program and crunching the numbers. Between 70 and 180 I am at approximately 85%. Seems that it would be a useful measurement, if I knew how to quickly find it. My numbers go high frequently because I purposely raise my blood sugars so I can run and workout. Also, my gastroparesis doesn’t help my numbers much either.

      1
      4 years ago Log in to Reply
      1. Miriam Gordon

        If you are using Dexccom together with your t:Slim, then download the Dexcom Clarity app and it shows Time in Range right on the home page.

        1
        4 years ago Log in to Reply
      2. TomH

        T:connect includes the TIR if you’re using the current software. Check https://support.tandemdiabetes.com/hc/en-us/articles/1500004088582-How-do-I-get-the-time-in-range-feature-on-the-t-connect-mobile-app-

        4 years ago Log in to Reply
      3. Gerald Oefelein

        In my t:connect app, the Time In Range shows up in large numbers on the bottom of the opening screen – just under the graphs.

        4 years ago Log in to Reply
      4. Lawrence S.

        Thank you all for your responses. I’ll check these out.

        4 years ago Log in to Reply
    6. Emily Meister

      It does not take much ( 1 or 2 highs or lows) to drop the percentage of time in range.

      1
      4 years ago Log in to Reply
    7. Edward Geary

      Good, but not perfect metric. IMO, more discussion vis a vis patient/provider needed relative to agreement on a realistic and therapeutic “range “ planning. Excellent comparative variant but not a substitute for A1C.

      4 years ago Log in to Reply
    8. TomH

      I consider A1c, GMI, and TIR the three legs of the T1D stool. While A1c has the tag of “gold standard,” I don’t believe it’s deserved, as most T1s only get a test every 3-6 months. A1c is backwards focused, so while useful in determining corrective action is needed, its doesn’t provide a what, when, or how factor to consider. Additionally, it can be misleading; you can have a great A1c, but a chart of daily/more often BGs may show constant hypo/hyper swings which may hurt you in the long run. For those with CGMs, GMI and TIR are continuous and relatively current, so of more practical use in treatment decisions. GMI is the replacement name for eA1c and is based on CGM data in an updated algorithm attributed to eA1c (see https://diabetesjournals.org/care/article/41/11/2275/36593/Glucose-Management-Indicator-GMI-A-New-Term-for). It can be based on a different # of days readings to get a feel for improvement or detriment. TIR, takes it step further and reduces or eliminates the negative factors mentioned above by letting you know TIR, TAR, and TBR. Reviewing a chart of these along with a reasonable food/insulin intake chart, you can determine when your TARs/TBRs occur, probable causes (food types, insulin prebolus timing, etc.), and take action to correct them.

      If I had only one of three as choices, I’d choose TIR because it subsumes most of the good features of the others plus some; but I’d prefer being able to set my own range. Vice the often touted 70-180. I’d up the 70 to 80 (when I’m that low, I tend to continue the drop) and drop the 180 to 160 (if not a bit lower), to improve my potential control, while negating significant hypos and hyper.

      5
      4 years ago Log in to Reply
    9. Mark Schweim

      Time in range is significantly more important than the A1c reading since an “ideal” A1c reading can be reached even with a mix of way too high and way too low BG readings intermixed within the time period the A1c test supposedly shows for.

      6
      4 years ago Log in to Reply
      1. n6jax@scinternet.net

        I agree !!

        4 years ago Log in to Reply
    10. Carol Meares

      I watch in on clarity every day which gives me the summary of the previous 2 days. It keeps me informed of any significant changes and I can easily remember what might have caused those changes. Do I need to adjust insulin, behaviors, food, exercise, stress management, sleep…?

      4 years ago Log in to Reply
    11. Janis Senungetuk

      A higher TIR = a more consistent Quality Of Life for me, so I find it very important.

      3
      4 years ago Log in to Reply
    12. mbulzomi@optonline.net

      Weather you know it or not, A1C is not that accurate for people that have been on Insulin for some period of time (Great for people just diagnosed.). An A1C is only an average that supposed to take the last three (3) months of glucose flowing through your body, however, it uses heavily on the last month and as we all learned in school you could have an average blood glucose number in the two hundreds, just slip a couple of lows in the mix and it makes you look great. In range is far more accurate in predicting your Diabetes Management. The Tandem X2 pump, Control IQ program range spread is quite broad, 70-180mg/dl.

      2
      4 years ago Log in to Reply
    13. Marcie Dutton

      Interestingly TIR if very important to me when I am assessing whether my management is good or not–but– not very important at all to my endocrinologist. He has told me not to worry much about it because I have Control IQ on my pump. Doesn’t make sense to me to give myself an excuse to not TRY to stay in range. But…

      4 years ago Log in to Reply
    14. Kelly Wilhelm

      The reason I said “Important” and not “very important” is that TIR can be different. So I have alarms set at 70-130 but, for me, being 100% in range of 70-180 wouldn’t let me know if I’m doing a good job (for me). I want tight range and if I can be a higher percentage with a lower threshold then that’s a fantastic measurement but a higher percentage of a higher range wouldn’t be relevant/important to me. Hoping that makes sense.

      2
      4 years ago Log in to Reply
    15. lis be

      time in range is even more important to me then my A1C. Ive been diabetic for 40 years and was only told this year (for the irst time) that time in range is the best way to protect the eyes.

      4 years ago Log in to Reply
    16. T1D5/1971

      I care far more about TIR than A1c. I had amazing A1cs preCGM while battling multiple extreme hypoglycemic events. Not healthy. Not “good” control.
      Now if only I can find an endo who isn’t stuck in the 1980s…

      4 years ago Log in to Reply
    17. Cheryl Seibert

      T1D for 55 years. Time in Range (TIR) is the most important measurement. Standard Deviation is the other measurement I use to determine how much my highs and lows vary. I’ve always had A1Cs below 6.5, however I previously had rapidly changing BGs that swung very low to very high. It makes the A1C look great, but TIR is terrible. I still have widely swinging BGs, but TIR is 85-95% with a 30-40 SD. I would like to get to 95-100 TIR and no more than 20 SD

      4 years ago Log in to Reply

    How important is the time-in-range measurement to you when assessing your T1D management? Cancel reply

    You must be logged in to post a comment.




    101 Federal Street, Suite 440
    Boston, MA 02110
    Phone: 617-892-6100
    Email: admin@t1dexchange.org

    Privacy Policy

    Terms of Use

    Follow Us

    • facebook
    • twitter
    • linkedin
    • instagram

    © 2024 T1D Exchange.
    All Rights Reserved.

    © 2023 T1D Exchange. All Rights Reserved.
    • Login
    • Register

    Forgot Password

    Registration confirmation will be emailed to you.

    Skip Next Finish

    Account successfully created.

    Please check your inbox and verify your email in the next 24 hours.

    Your Account Type

    Please select all that apply.

    I have type 1 diabetes

    I'm a parent/guardian of a person with type 1 diabetes

    I'm interested in the diabetes community or industry

    Select Topics

    We will customize your stories feed based on what you select here.

    [userselectcat]

    We're preparing your personalized page.

    This will only take a second...

    Search and filter

    [searchandfilter slug="sort-filter-post"]