There’s a New Glucose Gauge in Town: “Time In Range”

You know about A1c levels and daily glucose checks. But, I’d wager you haven’t heard much, if at all, about Time In Range (TIR). TIR is the new kid on the block, with official guidelines released on it in 2019. It’s another layer for understanding how well your diabetes management plan is working.

What is Time In Range?

TIR refers to how often your glucose levels stay in a healthy range (which is defined as 70-180 mg/dl). The goal for most people with diabetes is greater than 70% in range, with less than 4-5% of glucose levels under 70 mg/dl. TIR is typically used for those on a continuous glucose monitor (CGM), although, it can also be used if you check blood sugars with a glucometer.

How do I figure my Time In Range?

Typically a two-week window is used for calculating TIR. Most glucometer apps will calculate it for you. If you use a CGM, you can download TIR information from your device (read your user’s manual or meet with a certified diabetes educator (CDE) if you need help).

If you use a glucometer, get as much information as you can over a two week period (basically check your blood sugars a LOT; fasting, before and after meals, bedtime), to get a better gauge of your TIR. If your glucometer doesn’t have an app, you can calculate your TIR by doing the following:

# of blood sugars in-range* ÷ # of blood sugars checked x 100 = TIR

*Note: In-range blood sugars are any blood sugars between 70-180 mg/dl

Why is Time In Range important?

TIR offers something daily glucose checks and A1c’s cannot, which is a picture of where most blood sugars fall. Daily glucose checks just look at a snapshot of time, although if we zoom out we can see trends. A1cs give an average of your blood sugar levels, which doesn’t account for large swings in your glucose.

A well-rounded view

Most importantly, TIR can give you a more well-rounded view of your diabetes self-care. I often meet people who are terrified of elevated glucose levels. They become obsessed and concerned about what occasional high glucose levels may do to their body. In the medical field, we may give the impression that perfection is necessary for reducing risks and managing care well.

TIR gives perspective. Perspective, in my experience, has given many people peace of mind about their diabetes. It also gives healthcare professionals a more realistic tool to evaluate someone’s diabetes plan.

Remember TIR is still only one piece of the puzzle, another layer of how we can understand and gauge diabetes health. As you slowly get used to hearing, seeing and using it, you’ll become more comfortable in understanding its role in your diabetes self-care.