What is Time In Range and why is it becoming the gold standard in diabetes care?

Time in Range (TIR) is a concept in diabetes care that refers to the amount of time a person’s blood glucose levels remain within a target range throughout the day. The target range typically includes the optimal blood glucose levels to maintain good diabetes management and reduce the risk of long-term complications.

The standard target range for blood glucose levels can vary depending on factors such as age, overall health, and individual treatment plans. However, a commonly used target range for adults with diabetes is usually between 3.9 mmol/L and 9.0 mmol/L or slightly different values depending on the diabetes type and individual recommendations.

 Time in range has become the buzz phrase in Diabetes Care, with the advent of Blood Glucose sensor technology. Continuous streaming of blood glucose levels into an smart phone application, allows both patients and healthcare professionals (HCP`s) to see the, proverbial, bigger picture. No more, guesswork on the actual highs and lows that provide the average HbA1c, but a continuous stream of real time Blood Glucose data. This allows the patient, with guidance from his HCP to maintain blood glucose levels within a rigid target range – called Time in Range.

Time in Range is becoming the “gold standard” in diabetes care for several reasons:

  1. Comprehensive View: Unlike conventional measures such as Haemoglobin A1c (HbA1c), which provide an average blood glucose level over several months, TIR gives a more comprehensive view of a person’s blood glucose fluctuations throughout the day, providing insights into potential high and low blood glucose periods that may go unnoticed by other metrics.
  2. Immediate Feedback: TIR allows individuals with diabetes and their healthcare providers to obtain almost real-time feedback on glucose control. This enables them to make informed decisions about diabetes management, like adjusting insulin doses, dietary habits, or exercise routines promptly.
  3. Reduced Hypoglycaemia and Hyperglycaemia: Focusing on TIR helps minimize the occurrence of both hypoglycaemia (low blood sugar) and hyperglycaemia (high blood sugar), which are associated with acute and chronic complications in diabetes patients. Striking a balance within the target range improves overall quality of life and reduces the risk of complications.
  4. Personalized Care: TIR takes into account individual variations and allows for personalized diabetes management plans. This personalized approach leads to better patient outcomes and improved glycaemic control.
  5. Continuous Glucose Monitoring (CGM) Technology: The widespread use of Continuous Glucose Monitoring devices has made it easier to track TIR efficiently. CGMs provide real-time glucose data, trends, and alarms, making it more convenient for people with diabetes and healthcare professionals to monitor and act upon deviations from the target range.

As the medical community gains a better understanding of the relationship between blood glucose control and long-term health outcomes, TIR is increasingly being recognized as a crucial metric for assessing diabetes management success and guiding treatment decisions. It allows for a more patient-centered approach, focusing on the individual’s daily experiences and helping them achieve better glycaemic control and an improved quality of life. Medical aid funders in South Africa, take heed, funding  sensor technology, for all people with diabetes, is going to be the gold standard you are measured by, in the future.


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Responsible Pharmacist: Imraan Ahmed Bismilla