with diabetes on the rise, it’s time for a different approach to help people live well
talk to your diabetes care team about how time in range can support your diabetes care
oct 31 2022
3 minute read
with more than five million canadians living with diabetes, it's important that individuals are aware of the tools available to help them take control of their health.
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over the last two years, the impact of the covid-19 pandemic has been detrimental for people living with chronic conditions — including those living with diabetes. despite the best efforts of diabetes care teams, ensuring individuals with diabetes had optimal access to the care they needed was challenging. it is known that interruptions in access to comprehensive diabetes care — including regular appointments with health-care providers for education, medication review and renewals, as well as discussing disease management, and the risks and complications associated with having diabetes — can lead to increased morbidity and mortality .
with more than five million canadians currently living with diabetes — a number that is expected to keep rising over the next decade — it’s important that individuals are aware of the tools available to help them take control of their health and better manage their disease so they can live well and help prevent complications.
time in range (tir) is a metric that reflects the amount of time a person with diabetes spends in their target blood glucose (blood sugar) range. while this target varies for different individuals, the goal is to spend as much time in range (achieve a high tir) as possible. tir can be tracked by wearing a continuous glucose monitor (cgm), a device that tracks blood glucose every few minutes throughout the day and night. over the course of 14 days, the thousands of glucose measurements can be summarized in a graphic that shows the time spent in range (tir), above range (tar) and below range (tbr). for most people living with diabetes, the goal is to achieve tir under 70 per cent and tbr over four per cent.
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being responsible for one’s own daily diabetes monitoring and management can often feel isolating and overwhelming. but using a cgm and the data it generates, including tir, can provide the insight to take control of a person’s own diabetes management. by mapping out and recognizing the patterns that impact blood glucose levels, individuals can minimize hypoglycemia and hyperglycemia — both of which can lead to more serious complications, including damage to the blood vessels, neuropathy, retinopathy, nephropathy, heart attack and stroke.
“time in range is a user-friendly tool for people with diabetes that maps the time spent within their recommended target blood glucose levels,” says dr. alice cheng, endocrinologist and associate professor. “their continuous glucose monitor generates cloud-based reports, which their physician can review with them in real-time, whether speaking in person or remotely. it is also possible to compare to previous time periods to see if things are changing in the right direction.”
compared to the traditional a1c blood test, which measures the average amount of glucose in the blood for two- to three-month periods, tir can be measured at home, daily. people living with diabetes experience different energy levels, moods, and overall quality of life when they are ‘in-range’ versus ‘out-of-range.’ tir can capture these differences in a way a1c cannot.
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“time in range and a1c levels are complementary. but while a1c gives you the high-level overview, time in range allows for more granularity,” says dr. cheng. “a1c calculates average blood glucose levels over a longer period, so it doesn’t show whether an individual has had a lot of fluctuations in their levels, or if they’ve been in their target range. this means that someone who has a lot of variability could have the same a1c average as someone who does not.”
it is important for people living with diabetes to speak to their health-care team to establish tir goals personalized to their individual needs and understand how to interpret tir. tir goals are different for different groups of people and may depend on overall health, age, and pregnancy.
once goals are established, it is important to wear a cgm often and focus on making positive daily habits to increase the time spent in range. as someone living with diabetes continues to use the data provided through their cgm, watching and learning trends that impact their in-range time will become second nature.
with the right tools, like tir, people with diabetes can feel empowered to effectively monitor and manage their glucose levels and live well with diabetes.
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to learn more about time in range, speak to your diabetes care team or visit: jdrf.ca
this story was provided by sanofi-aventis canada inc. for commercial purposes.
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