Key TakeawaysLeaders in diabetes care are encouraging people with diabetes to also monitor their “time in range” (TIR)—the percentage of time that their blood glucose remains within set parameters.Some experts say that continuous glucose monitoring can guide the management of diabetes better than spot finger stick blood sugars or hemoglobin A1C.Keeping blood sugar levels within target ranges can help prevent both short-term and long-term complications of diabetes.
Key Takeaways
Leaders in diabetes care are encouraging people with diabetes to also monitor their “time in range” (TIR)—the percentage of time that their blood glucose remains within set parameters.Some experts say that continuous glucose monitoring can guide the management of diabetes better than spot finger stick blood sugars or hemoglobin A1C.Keeping blood sugar levels within target ranges can help prevent both short-term and long-term complications of diabetes.
But now, leaders in diabetes care are encouraging people with diabetes to also monitor their “time in range” (TIR)—the percentage of time that their blood glucose remains within set parameters.
In late June, Dexcom, a company that develops continuous glucose monitoring systems (CGM), along with singer Nick Jonas, who lives with type 1 diabetes and uses a CGM,launched a global campaign to promote TIR.
What Is a Continuous Glucose Monitoring System (CGM)?CGM’s continuously monitor the glucose (sugar) in your blood through an external device that’s attached to your body, giving real-time updates. You can measure your TIR using data from these devices.
What Is a Continuous Glucose Monitoring System (CGM)?
CGM’s continuously monitor the glucose (sugar) in your blood through an external device that’s attached to your body, giving real-time updates. You can measure your TIR using data from these devices.
The Centers for Disease Control’s gold standard for monitoring blood glucose control has long since been the hemoglobin A1C test, which measures average blood sugar control over the past 90 days. However, that means that a person with diabetes can have a normal hemoglobin A1C result even if they are having extreme highs andlows in glucose.
On the other hand, TIR gives people with diabetes different—perhaps even more helpful—insights into their blood sugar levels.
What Is Blood Glucose Monitoring?
How Does Time in Range Monitoring Work?
Dexcom, creators of the Dexcom G6 Continuous Glucose Monitoring (CGM) System, are leading theTime in Rangemovement. The Dexcom G6 CGM is a discreet wearable device that monitors glucose every 5 minutes around the clock.
CGMeliminates the need for routine finger sticksto check blood sugars (which can be painful) and the Dexcom sensor only needs to be replaced once every 10 days.
The monitor sends glucose readings to a mobile app or transmitter and alerts the patient to out-of-range high or low blood sugars. Dexcom also calculates the patient’s total TIR.
Patients can also review their data with caregivers or members of their treatment team using theDexcom mobile appor online interface.
Patients and doctors can customize target ranges, but theInternational Consensus on Time in Rangerecommends keeping blood sugars between 70 mg/dL and 180 mg/DL for 70% of the time or more.
Why Is TIR Important for Diabetes Management?
Steven V. Edelman, MD, clinical professor of medicine at the University of California San Diego School of Medicine, and the founder and director ofTaking Control of Your Diabetes, tells Verywell that using CGM to maintain TIR provides both short-term and long-term benefits.
First, CGM lets people with diabetes take immediate corrective action when they have high and low glucose readings, preventing extreme fluctuations in blood glucose. Real-time action also gets blood sugars back into the target range sooner.
“You’re going to be feeling better and doing better in terms of your overall glycemic control," Edelman, who was diagnosed with type 1 diabetes at the age of 15 and uses the Dexcom CGM, says. “I am alerted when my blood sugar is high, and I can give myself insulin and get back into my target range more quickly.”
On the other end of the spectrum, the Dexcom CGM alerts people about 20 minutes before episodes oflow blood glucose, which can lead to fatigue, irritability, shakiness, confusion, or loss of consciousness.
It’s also the first CGM that is FDA-approved to integrate with other diabetes management tools, includinginsulin pumps. While only a limited number of insulin pumps are fully integrated with the Dexcom CGM, users who do not have an integrated insulin pump can still adjust their insulin dosing based on the CGM’s readings.
The ability to make adjustments gives users more choice about how they want to view and interact with their glucose data, allowing for more customized diabetes management.
Better control of blood sugars can help prevent long-termcomplications of diabetes, including heart disease, kidney disease, and nerve damage.
“Continuous glucose monitoring is the standard of care for people with type 1 diabetes," Edelman says. “It’s the rare person with type 1 diabetes who would not benefit from greatly it.”
Even still, Edelman says that “less than 50% of [people with type 1 diabetes] have a continuous glucose monitor … We have to do better at making CGM accessible.”
What Is a Sensor-Augmented Insulin Pump (SAP)?
“Many folks withtype 2 diabetescould benefit from continuous glucose monitoring, even if they’re not on insulin,” Edelman adds. “People with type 2 diabetes are typically a little more stable and less variable, however, if they have to take insulin they pretty much behave like a person with type 1 diabetes.”
What This Means For YouIf you have diabetes and want to bring up the subject of continuous glucose monitoring with your doctor, the Time in RangeConversation Guideoffers a helpful list of talking points and questions to ask.
What This Means For You
If you have diabetes and want to bring up the subject of continuous glucose monitoring with your doctor, the Time in RangeConversation Guideoffers a helpful list of talking points and questions to ask.
Talking to Your Doctor
CGM is underutilized in diabetes care, according to Edelman, but patients can definitely start the process of changing that.
“If you have diabetes, you should definitely have a discussion with your care team," Edelman says, adding patients should make a specific appointment with their doctor to discuss CGM and be sure to bring up the topic early in the visit.
Empowering patients with data, especially when they can easily share and discuss it with their care team, is an important part of chronic disease management—and one that, ideally, helps them to keep making strides in improving their health.
“When you have information, and you know what you’re treating, you can make a different, more informed decision,” Sayer says.
1 SourceVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Martens T, Beck RW, Bailey R, et al.Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial.JAMA. 2021;325(22):2262. doi:10.1001/jama.2021.7444. Published June, 2021.
1 Source
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Martens T, Beck RW, Bailey R, et al.Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial.JAMA. 2021;325(22):2262. doi:10.1001/jama.2021.7444. Published June, 2021.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Martens T, Beck RW, Bailey R, et al.Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial.JAMA. 2021;325(22):2262. doi:10.1001/jama.2021.7444. Published June, 2021.
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