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    • 7 hours, 52 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.
    • 17 hours, 26 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.
    • 17 hours, 26 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.....
    • 17 hours, 26 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.
    • 17 hours, 27 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.
    • 21 hours, 42 minutes 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, 4 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, 7 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, 8 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, 8 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, 8 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, 8 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, 8 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, 8 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, 8 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, 8 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, 8 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, 8 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, 8 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, 5 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, 6 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, 6 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
    • 2 days, 7 hours ago
      Kathy Hanavan 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.
    • 2 days, 7 hours ago
      John Barbuto 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
    • 2 days, 8 hours ago
      Gerald Oefelein 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
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    How important is the time-in-range measurement to you?

    Home > LC Polls > How important is the time-in-range measurement to you?
    Previous

    Based on your experiences with customer service representatives from insurance companies, do you feel that they understand the needs of people with T1D?

    Next

    If your area observes Daylight Savings Time, do you typically see any impact on your blood sugar?

    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.

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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. 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    16 Comments

    1. Bob Durstenfeld

      I know that Time in Range is new, but it makes a lot more sense than the 3-month HbA1C.

      5 years ago Log in to Reply
    2. connie ker

      The CGMs show time in range with the percent of highs and lows. I use the Abbott Freestyle Libre because I am a senior and think how far we have come with technology to help diabetics. My fingers say thank you each and every scan. I live alone so this CGM helps me feel more confident in doing so. I know when to correct with insulin and when to eat a snack. Because I have a Jitterbug Flip phone without apps and data, this Freestye Libre works for me.

      5 years ago Log in to Reply
    3. Patricia Dalrymple

      I tried the CGMs when they first came out and I could never get them calibrated and they hurt – I am thin. However, they’ve come a long way and while I don’t really want to stick another device in my body, I go low a few times a week and I know I need one. Am waiting two more years until I am on Medicare.

      5 years ago Log in to Reply
    4. Greg Felton

      Taking it one game at a time!

      5 years ago Log in to Reply
    5. Grey Gray

      TIR is much more helpful than a1c for me. A good A1C may have meant I was hypoglycemic alot of the time with super high peaks, from over treating the low bg. Or what I lovingly refer to as yo-yoing. I believe the new gold standard is 70% TIR. MM 670g automode keeps me there or close. A1C of 7.2 Been running automode for about 5 months.

      5 years ago Log in to Reply
    6. Thomas Hatton

      I use TIR more than A1C. The Minimed app shows how much over or under I am. It is a daily indicator. It helps.me have better overall control.

      5 years ago Log in to Reply
    7. Pat Reynolds

      I use the fixed tir of HappyBob to see “at a glance” and 3.9 to 8.9 to see on Clarity (aiming for 70% in range). But also waning to see now “very lows” – would mark that as a fail day even if achieving 70% in range, and minimal “very high”

      5 years ago Log in to Reply
    8. Pat Reynolds

      As important is Standard Deviation. I like to be under 2, over 2.5 something’s wrong … Hba1c is a poor indicator, compared to these three (for, very lows (count) and SD.

      5 years ago Log in to Reply
    9. George Lovelace

      With Dex G6 coupling with Tandem X2 the TIR is the Key number along with SD. I’ve eliminated all Lows.

      5 years ago Log in to Reply
    10. Trina Blake

      TIR is very important to me, I’ve been Dexcom’ing saince 2009 (back when the receiver for the Dexcom 7 was an oval, rather bulky device). As was mentioned above, you could have a great A1C that was the “result” of major highs and major lows offsetting one another (say your goal is an A1C of 5 if your bg’s run 5, 5, and 5, But you also get an A1C of 5 if your bg’s run 0, 5, and 10). Hav ing the TIR info from T-Connect reports allowed me to counter (offensive) comments by an Endo saying it was impossible for someone like me to have such good labs. My health plan wasn’t covering Dexcom so I paid out of pocket since I already was using it and saw the value. Whipping out my reports (and you can’t fake them unless you have a non-D person wear it for you) shut him right up. I set my own desired range, and of course using the “standard” range of 60-160 I am in range 99% of the time. With my own range, perhaps 90% (my range is 60-120).

      5 years ago Log in to Reply
    11. Tb-well

      Time in range is a useful measure, but unless it includes a readout of time frames out of range, it is only part of the picture. It needs to be included with time out of range by time frame and percentage.

      5 years ago Log in to Reply
    12. Mary Ann Sayers

      I’ve only had the TANDEM Basal IQ for less than 2 weeks, but being out of range is more common than in! I’ve used the temp rate a few times to increase my basal to match my needs. I’m looking forward to the Quality IQ which will automatically increase my basal!!! I am thankful for the Basal IQ which suspends my basal when I’m heading below range and resumes it when my graph shows my CGM is heading in the right direction.

      5 years ago Log in to Reply
    13. Patricia Maddix

      Medical professionals really emphasize the value of the time in range and after using it for the last few months I really find it valuable. I have the CLARITY app for my Dexcom and frequently look at this to compare all the way from two days to 90 days to see improvements when I tweak my insulin or food. I find being able to look at the percentage of high and low blood sugars to be great information. I recently switched from hot cooked grits as my standard breakfast to old fashion oatmeal and now have very little rise in blood sugar after breakfast. I was even able to increase my portion and of course increased insulin as well but still I have very little rise after breakfast.

      5 years ago Log in to Reply
    14. Sally Numrich

      I focus on time in range and standard deviation. Those two will tell how I am doing with my treatment plan. Yes, each of us has a different range we shoot for which is why these two numbers are my numbers and can’t really compare them to others. It is my treatment plan, a plan that works for me and my life.

      5 years ago Log in to Reply
    15. ConnieT1D62

      Important. TIR makes much more day to day sense than vague generalization of A1C measurement.

      5 years ago Log in to Reply
    16. Cheryl Seibert

      Time in Range (TIR) is the most important measurement to use as a goal for blood glucose control. A1C is an average so if BGs are wildly ranging from 300+ to under 45 and you have more lows than highs or more time in the low range than the high range, your A1C measurement is not accurate as a measure of control. TIR combined with Standard Deviation (how much your BGs vary from an average of say 110) is the most accurate indicator of good control available today. It is important to remember that a NON-DIABETIC’s BGs also rise and fall with meals and stress, so trying to obtain that “flat line” even after meals is not something a diabetic should obsess about.

      5 years ago Log in to Reply

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