Related Experiment Video
Updated: Sep 18, 2025

Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test
Published on: November 13, 2016
Moving the Goalposts: Do Adults with Type 1 Diabetes Want Time in Tight Range (TITR)?
Molly L Tanenbaum1, Mabelle B Pasmooij2, Rachel Tam3
1Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA, 94304; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA USA, 94304; Stanford Diabetes Research Center, Stanford, CA, USA, 94304.
Objectives:
Our objective was to understand attitudes toward time in tight range (TITR: 70-140 mg/dL) among adults with type 1 diabetes. The perspectives of people with type 1 diabetes on TITR can inform educational approaches to introducing potential new continuous glucose monitoring (CGM) metrics in a way that optimizes glycemic and quality of life outcomes for people with type 1 diabetes.
Methods:
Focus groups with adult CGM users with type 1 diabetes elicited feedback on a potential shift to TITR. Groups were audio-recorded, transcribed, and analyzed using content analysis.
Results:
Participants were 33 adults (age 42.7±16.7 years, 55% female, 91% non-Hispanic White, 23±16 years living with diabetes, HbA1c 6.5±0.6% (48±6 mmol/mol)). Most (88%) used automated insulin delivery (AID). Some approved of TITR for the potential to improve their long-term health. Concerns about TITR included increased management burden; risk of anxiety, hypoglycemia, disordered eating; and feelings of failure. Participants advocated for flexible, personalized clinical targets and better technologies, insulins, and access, to make TITR achievable for more people with type 1 diabetes.
Conclusions:
Results indicate that TITR may be a welcome shift for some who are already using the tighter metric but may add risks and psychosocial and self-management burden even in a group of adults predominantly using AID and achieving current HbA1c goals. Including the perspectives of people with type 1 diabetes in decision-making around CGM metrics will be important for the implementation of new clinical targets to improve patient care.
More Related Videos
Related Concept Videos
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Diabetes: Symptoms, Diagnosis, and Complications
Diabetes Mellitus: Type 2 and Gestational
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...

