Goal levels for most individuals with diabetes are:
- A1C: 7% or lower
- Fingerstick blood glucose:
- Before meals: between 4 and seven mmol/L
- 2 hours after the beginning of meals: between 5 and 10 mmol/L. You and your healthcare team use this information to make changes to your diabetes management to attain goal levels. There are, nevertheless, limitations to those measurements of glucose. A1C measures how you’ve got done during the last 3 months. When changes are made, you need to wait one other 3 months to evaluate the effect of the changes. Fingerstick glucose measures your level for 1 second of the day, on the time the blood sample is taken. It will not be capable of let you know anything outside of that 1 second, resembling the way you arrived at that glucose level. It’ll miss any high glucose (hyperglycemia) or low glucose (hypoglycemia) levels you could have had previously.
With the introduction of continuous glucose monitoring (CGM), all of that is about to alter. CGM measures your glucose level every 1 minute through a sensor inserted under your skin. Every glucose measurement is stored and provides data with the intention to create reports. To make use of any report from a CGM system, the sensor should be worn for no less than 14 days and be lively no less than 70% of the time. A1C levels will at all times remain a component of understanding your diabetes; nevertheless, using the info from CGM, we will now start to make use of different measures of your glucose control.
Let’s discuss ‘time in range’
Recent international guidelines recommend that point in range (TIR) for many adults with type 1 or type 2 diabetes must be 70%. What’s that range? The advice is that glucose must be between 3.9 and 10 mmol/L, as much as possible. This is taken into account to be a standard range for glucose levels in those living with diabetes.
Why is TIR necessary?
Studies have shown that TIR of 70% can prevent or delay complications of diabetes, each for small blood vessels (resembling the eyes) and huge vessels (including the guts). The more time spent within the goal range, the lower the danger of all complications.
Do all individuals with diabetes have the identical TIR targets?
Sometimes TIR goals might change. There could also be a lower TIR for people who find themselves frail, elderly or at higher risk of hypoglycemia, or the next TIR for somebody who’s pregnant.ii
You and your healthcare team can work together to seek out the fitting TIR goal for you.
The time in range report also includes time below range (TBR), which indicates hypoglycemia, and time above range (TAR), which indicates hyperglycemia.
How is TIR helpful for those in danger for hypoglycemia?
It’s a very important a part of diabetes management to avoid hypoglycemia as much as possible to maintain you secure. TBR <3.9 mmol/L is taken into account hypoglycemia. Guidelines suggest that lower than 4% of the day must be spent below 3.9 mmol/L. 1% equals quarter-hour of time.
How is TIR useful for hyperglycemia?
Hyperglycemia is defined as glucose levels above 10.0 mmol/L. Guidelines suggest that lower than 25% of the day must be spent on this range.
Hyperglycemia increases the risk of complications.
Understanding that your blood glucose levels are above your goal can enable you work towards reducing TAR through lifestyle or medication changes.
How do you make sense of TIR measurements from the info that’s collected?
TIR is a very simple report to know. It’s color coded, indicating that green is sweet, red will not be and yellow is caution – similar to a traffic light. When reviewing this report, you should see more green and fewer red. It’s quite simple! Unlike the A1C test, which takes 3 months, you should use your TIR report back to see the advantages of any changes in diabetes management much sooner.
If you’ve got diabetes, speak along with your healthcare team to learn more about the way to measure your TIR.