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How important is the time-in-range measurement to you?
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I know that Time in Range is new, but it makes a lot more sense than the 3-month HbA1C.
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.
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.
Taking it one game at a time!
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.
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.
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”
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.
With Dex G6 coupling with Tandem X2 the TIR is the Key number along with SD. I’ve eliminated all Lows.
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).
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.
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.
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.
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.
Important. TIR makes much more day to day sense than vague generalization of A1C measurement.
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.