Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community 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 Manager of Marketing at T1D Exchange.
Time-in-range is important, but since I think many of us want to be in a tighter range than 70-180, time-in-range is only so helpful. Actually looking at our actual numbers in reference to how high or low we go is more important than being “in-range”.
My concern with time in range is that I could be in range 90% but my average could be 170 which to me is way too high. With my previous, Medtronic, pump I was averaging 131 over 90 days, now with control Iq I am averaging 151. Control Iq is not all it is made out to be.
I said, “A little important.” As Derek West said, I could be in range 90% of the time, and still be running too high. I look at my Tiime In Range, but give it value when compared to my A1C, and the numbers of high’s, 180+, and low’s, 70-. My Time in Ranges average in the mid 80%’s. I would like to get them a little higher percentage.
TIR is as important, if not more than, A1C. You can can be all over the map, spending more time high and low than in range and still have an excellent A1C. Before cgm, I was running 35% low, 35% high, and only 30% in range (70-180). A1Cs were always high 5s-low 6s.
I feel that it complements the A1c numbers. I have a friend with great A1c results, but was in range less than half the time. He is on a better path now that he can look at the range and not just the average. Most of us who have the option make changes to the range being measured.
Libre also has a “daily pattern” view that summarizes the time lines for several days. This makes it easier for me to spot a new trend, which might not have been obvious by scrolling back through lists or readings.
The benifit ot TIR is you can see daily or 2 day results. I use it to see how I respond to different or new situations. My responses are all over. I document responses so I can fine tune my response. More carbs, less carbs. More activity less activity.
I never took note of TIR until Tandem introduced the “bolus by phone” feature, which forced me to download the t:connect app, which has the TIR metric on it. However, I find the “range” to be too large to be useful. You could ride at 180 consistently and have “100% TIR”, which is not ideal for me.
I upload my Tandem X2 with Dexcom integration every month. And I print out the reports. I agree that the range is too broad, so I run reports using the default range (60-180) and then run it again for my personal preference (60-130).
As others have pointed out, A1C is an **average**, which means you can have a great number that obscures how much you’ve been roller-coastering to end up there. TIR, with the stats for time above and time below says a lot more about how you’re actually doing. And you can set those parameter values manually in Dexcom if you want to tighten them up.
Worth noting that TIR stats only **exist** because of CGM tech. A1C average was all there was in the bad old days, though you could kinda-sorta get an idea if you were finger-sticking 8 times a day. It’s definitely something all T1s–and T2s for that matter–using CGMs should be attentive to it.
Normal blood glucose for human beings is 83. Standard deviation from that number tells you how consistent your control is. A TIR based on the notion that it is acceptable to get to 180 is hazardous to our health.
I prefer time in range as a measure of T1D management over A1C because I can look at it daily or over specific time ranges and set better targets for myself. Without it, variability is hard to assess.
Essential in tandem with other metrics. No one metric alone is enough to manage BG well. It would be nice to set my own goals for time-in-range though. I’d like tighter control but I have Control IQ.
My A1C has not improved with the TIR available to me. The best way I have found for the last 47 years is by doing a paper chart, with a week’s worth of BG. ‘s on one page. I then see whether the high sugars are consistently right after lunch or right before supper or at night or whatever, and that can determine whether I need to adjust my basal (or, formerly, long acting insulin) or my bolus (or, formerly, short acting insulin). I keep a year’s worth, so I can tell whether the changes are due to the season of the year as well, or whatever. My sugars have gradually gone up with stress for 6 months before the weddings of two of my children, for example. I now know that on wedding day they will plummet precipitously.
TIR is absolutely essential for T1D management. I also use the STDDEV to determine wide swings in BGs. A1C, for me, is inaccurate as I have wide swings in BG (being brittle T1D and Type A personality). The lows distort the A1C. TIR + StdDev shows a more accurate pictures.
Time-in-range is important, but since I think many of us want to be in a tighter range than 70-180, time-in-range is only so helpful. Actually looking at our actual numbers in reference to how high or low we go is more important than being “in-range”.
Time in range is important. Also subtle. It reminds me of the shades and hues of the painter Amy Sherald and her simplified realism. 🤌🏿
Not familiar with how to use it.
I agree that how high and low we are is more important
My concern with time in range is that I could be in range 90% but my average could be 170 which to me is way too high. With my previous, Medtronic, pump I was averaging 131 over 90 days, now with control Iq I am averaging 151. Control Iq is not all it is made out to be.
I said, “A little important.” As Derek West said, I could be in range 90% of the time, and still be running too high. I look at my Tiime In Range, but give it value when compared to my A1C, and the numbers of high’s, 180+, and low’s, 70-. My Time in Ranges average in the mid 80%’s. I would like to get them a little higher percentage.
I put Time in range as extremely important. Since my CGM allows it to be adjusted, I set mine to be 75-150. 180 is just too high.
I personally find the range….70- 180 too expansive. I don’t want to be higher than 130 without an alert going off on my Dexcom.
Absolutely essential. I have mine set at 70-150 with a goal of 90%.
I like the daily results instead of waiting for my A1C results every 6 months.
TIR is as important, if not more than, A1C. You can can be all over the map, spending more time high and low than in range and still have an excellent A1C. Before cgm, I was running 35% low, 35% high, and only 30% in range (70-180). A1Cs were always high 5s-low 6s.
I feel that it complements the A1c numbers. I have a friend with great A1c results, but was in range less than half the time. He is on a better path now that he can look at the range and not just the average. Most of us who have the option make changes to the range being measured.
Libre also has a “daily pattern” view that summarizes the time lines for several days. This makes it easier for me to spot a new trend, which might not have been obvious by scrolling back through lists or readings.
The benifit ot TIR is you can see daily or 2 day results. I use it to see how I respond to different or new situations. My responses are all over. I document responses so I can fine tune my response. More carbs, less carbs. More activity less activity.
I never took note of TIR until Tandem introduced the “bolus by phone” feature, which forced me to download the t:connect app, which has the TIR metric on it. However, I find the “range” to be too large to be useful. You could ride at 180 consistently and have “100% TIR”, which is not ideal for me.
I upload my Tandem X2 with Dexcom integration every month. And I print out the reports. I agree that the range is too broad, so I run reports using the default range (60-180) and then run it again for my personal preference (60-130).
It’s very important, more than 6 month A1c’s, but other lab results are also considered before making any changes.
As others have pointed out, A1C is an **average**, which means you can have a great number that obscures how much you’ve been roller-coastering to end up there. TIR, with the stats for time above and time below says a lot more about how you’re actually doing. And you can set those parameter values manually in Dexcom if you want to tighten them up.
Worth noting that TIR stats only **exist** because of CGM tech. A1C average was all there was in the bad old days, though you could kinda-sorta get an idea if you were finger-sticking 8 times a day. It’s definitely something all T1s–and T2s for that matter–using CGMs should be attentive to it.
Normal blood glucose for human beings is 83. Standard deviation from that number tells you how consistent your control is. A TIR based on the notion that it is acceptable to get to 180 is hazardous to our health.
Agreed.
I prefer time in range as a measure of T1D management over A1C because I can look at it daily or over specific time ranges and set better targets for myself. Without it, variability is hard to assess.
Essential in tandem with other metrics. No one metric alone is enough to manage BG well. It would be nice to set my own goals for time-in-range though. I’d like tighter control but I have Control IQ.
My A1C has not improved with the TIR available to me. The best way I have found for the last 47 years is by doing a paper chart, with a week’s worth of BG. ‘s on one page. I then see whether the high sugars are consistently right after lunch or right before supper or at night or whatever, and that can determine whether I need to adjust my basal (or, formerly, long acting insulin) or my bolus (or, formerly, short acting insulin). I keep a year’s worth, so I can tell whether the changes are due to the season of the year as well, or whatever. My sugars have gradually gone up with stress for 6 months before the weddings of two of my children, for example. I now know that on wedding day they will plummet precipitously.
I do not play that formal game.. So far doing fine without it for 70 years..
It doesn’t help with day to day settings. It only helps with bragging rights, my TIR was 85% oooh wow
TIR is absolutely essential for T1D management. I also use the STDDEV to determine wide swings in BGs. A1C, for me, is inaccurate as I have wide swings in BG (being brittle T1D and Type A personality). The lows distort the A1C. TIR + StdDev shows a more accurate pictures.