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Time in Range: How to Measure It, How to Report It, and Its Practical Application in Clinical Decision-Making
Eugene E Wright1, Kayla Morgan2, Danny K Fu2
1Charlotte Area Health Education Center, Charlotte, NC.
Summary
Glycemic time in range offers a more holistic view of blood sugar control than the traditional A1C test. This new standard, using continuous glucose monitoring, provides a clearer picture of patient glycemic status.
Area of Science:
- Endocrinology
- Metabolic Health
- Diabetes Management
Background:
- Hemoglobin A1C (HbA1c) has long been the standard for assessing long-term glycemic control.
- HbA1c provides an average glucose level, masking glycemic variability and individual fluctuations.
- Limitations of HbA1c include its susceptibility to factors affecting red blood cell turnover and its inability to reflect rapid glucose changes.
Purpose of the Study:
- To review glycemic time in range (TIR) as a superior metric for assessing glycemia.
- To highlight the advantages of TIR over traditional A1C measurements.
- To summarize findings and recommendations from the International Consensus Group on Time in Range.
Main Methods:
- Review of current literature and established guidelines on glycemic monitoring.
- Analysis of data from continuous glucose monitoring (CGM) systems.
- Synthesis of information presented by the International Consensus Group on Time in Range.
Main Results:
- Glycemic time in range (TIR) offers a more comprehensive assessment of glucose control compared to A1C.
- TIR quantifies the percentage of time glucose levels remain within a target range, reflecting glycemic stability.
- CGM data enables the calculation of TIR, providing insights into glucose variability, highs, and lows.
Conclusions:
- Glycemic time in range is emerging as the new gold standard for assessing glycemic control in patients using CGM.
- TIR provides a more dynamic and patient-centered view of diabetes management than A1C.
- Adoption of TIR facilitates more personalized and effective diabetes care strategies.
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