For many years, the HbA1c was the most important indicator of effective diabetes control. This three-monthly blood test provides a single-percentage snapshot of your blood glucose. The HbA1c, on the other hand, has a flaw in that it isn’t completely accurate. You can have the same HbA1c percentage whether your blood glucose is stable and steady or irregular and rollercoaster. Time on target is a considerably more trustworthy indicator of your diabetes management stability.
Of course, if you’re lucky enough to be wearing a Continuous Glucose Monitor (CGM) or a flash glucose monitor, you’ll be able to see your time in goal.
Understanding Time in a Target Range?
The time in the range refers to the amount of time you stay inside the optimal blood glucose range (TIR). It varies from person to person, but typical guidelines suggest starting at 70 to 180 mg/dl. However, some people prefer to aim for a narrower range, such as 70 to 140 mg/dl, over time.
Time in Range can alternatively be thought of as “hours per day” spent in the range. For example, if you spend 50% of your time in the range (70-180 mg/dl), it implies you spend 12 hours per day in the range. It’s a standard bar graph representation. It shows the proportion of time your blood glucose was high, low, or in the middle of the range. You could get better at it.
Importance of time target range
Blood sugar levels might fluctuate for a variety of causes. As a result, it isn’t something to be concerned about. Your blood sugar levels, on the other hand, should not change dramatically and should return to normal soon. Variations that are substantial enough to put you outside your goal range, on the other hand, may indicate metabolic disorders such as diabetes, PCOS, or some malignancies.
Trying to maintain a stable glucose level may appear to be a difficult undertaking. It is important to note, however, that doing so is not impossible. You may be necessary to make consistent attempts to stay within your target range for longer periods of time. Dietary habits, sleep schedules, drink intake, workout regimens, and other health behaviours are all part of this effort.
Constantly noting and monitoring any ups or downs is a critical aspect of staying in the goal range. To begin, you must recognise patterns and write down the precise target range.
Role of CGM in time in target range
Time in target range may be a relatively new topic in research. However, we know that the longer you stay in range, the less likely you are to acquire diabetes complications.
According to research, utilising a Continuous Glucose Monitoring or CGM System to assess glucose readings is the most accurate and reliable method. CGM devices allow you to track your blood glucose levels in real time. It will also enable you to recognise when your blood sugar level is out of range, such as before an exercise or after nighttime snacks.
Recognizing these peaks and valleys might help you make steps to balance out the highs and lows, such as changing your medication. Maintaining your energy level and temperament is also important.
Who is it for?
Patients with type 2 diabetes and type 1 diabetes who take medication and have strict blood sugar limits will benefit the most from reviewing time in target range statistics. It’s also because they’re more likely to have blood glucose levels that are either above or below their target range.
It’s also for persons who have PCOS, obesity, cardiac problems, high blood pressure, work in stressful environments, or suffer from mental diseases including depression, anxiety, or schizophrenia.
Diabetic individuals have found daily and weekly profiles to be beneficial. You’ll be able to tell how long you’ve been in range if you keep track of your blood sugar levels throughout the day. Finally, time in range values are useless unless they are checked by individuals and their diabetes treatment team. Remember that there is no such thing as an exact time in range target when determining what time in range goal to aim for. Yours will be determined by your blood glucose levels, diabetes severity, lifestyle choices, and eating habits.
Time Range Goals
Every person’s Time in Range objectives are unique. It could be influenced by medications, diabetes type, nutrition (particularly carb intake), age, health, and the risk of hypoglycemia. People with diabetes should try to spend as much time as possible in the target range. This will aid in the prevention of hypoglycemia. Even a 5% difference in Time in Range, according to experts, is advantageous. Going from 60 percent to 65 percent, for example, can be beneficial because it equates to one more hour per day spent in the range.
According to research and large real-world data sets, the average person with diabetes has a Time in Range of 50-60%, while persons without diabetes have a Time in Range of 85 percent or higher. The following graphic can help you comprehend the goals for distinct groups of people during a time in range, above range, and below range.
How to Stay in the Target Range for a Longer Time
Maintaining a constant glucose level is the greatest way to keep your time in the goal range. This also includes food habits, physical activity, and other lifestyle behaviours, such as stress and sleep, which are all very important.
The most major influence on your glucose swings is your diet. High-carbohydrate, high-fat, and high-sugar diets may cause your glucose levels to rise. Refined flour, refined sugar, fried foods, processed snacks, syrups, jams, and candies are just a few examples. It causes our bodies to produce extra insulin in order to move excess glucose from the bloodstream to the cells. Because your body has a big amount of insulin, it may suffer a glucose crash as an overreaction.
Consuming whole grains, pulses, legumes, seeds, nuts, green vegetables, citrus fruits, and dry fruits are also recommended to maintain a steady glucose level. In addition, eat lean meat in moderation, a couple of eggs per day, dairy, and good fats. All of this fibre and high-quality protein will keep you satisfied for longer.
Food should be divided into two categories: main meals and snacks. Carry a variety of nutritious food options with you at all times. Drink plenty of water as well as other liquids such as coconut water, lemon water, mint-infused water, green tea, chamomile tea, and so on.
One of the most effective ways to manage type 2 diabetes is to exercise. It helps you maintain a healthy blood sugar level by improving the way your cells use insulin. It also improves sugar absorption by your cell.
Light walking or simple resistance exercises like squats are beneficial. Strength training, lifting, brisk walking, jogging, cycling, trekking, dancing, swimming, and any other type of outdoor activity are also useful.
Walking after meals, in particular, has been shown to be beneficial. It aids the absorption and use of excess glucose in your bloodstream by performing the function of insulin in the absence of insulin. After meals, 30-45 minutes is the best time to go for a walk.
Inadequate sleep reduces glucose tolerance, and decreased insulin sensitivity disrupts the balance of your appetite-controlling hormones. It can cause blood glucose levels to fluctuate, leading to late-night cravings or morning hunger. As a result, it may have a significant impact on your time in the target range.
At the end of the day, however, time in range data is useless unless both individuals and their diabetes care team check it.
When it comes to deciding what time in range to shoot for, keep in mind that there is no such thing as a universal time in range goal. Yours will be determined by your diabetes care needs and lifestyle, and your doctor will be able to assist you in determining the appropriate range.
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