Time in Range

The American Diabetes Association (ADA) wants to help you understand time in range (TIR) as a new blood glucose management measure and implement it with the appropriate patients today. For many people with diabetes, blood glucose monitoring is key for achieving glycemic targets. Self-monitoring of blood glucose is an integral component of effective therapy of patients taking insulin. In recent years, continuous glucose monitoring (CGM) has emerged as a complementary method for assessing blood glucose levels. CGM accuracy and affordability has evolved rapidly and many patients have these data available to assist with both self-management and assessment by providers. Reports can be generated from CGM that will allow the provider to assess hypoglycemia, hyperglycemia, and glycemic variability plus determine TIR. 

Below are resources to help patients and clinicians use TIR data to make informed treatment and lifestyle decisions that improve health outcomes.

RESOURCES 

Get the latest diabetes technology and time in range guidelines based on the ADA Standards of Care in Diabetes—2023. Watch our webinars, download infographics, and listen to our podcasts and Practice Pearls to help you understand and implement TIR practice recommendations. Get Started Now.

WEBINARS: Available Now

• 2023 ADA Standards of Care: Diabetes Technology Update. The Standards of Care in Diabetes (SOC) includes all of ADA’s current clinical practice recommendations and is intended to provide clinicians, patients, researchers, payers, and others with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. The recommendations are based on an extensive review of the clinical diabetes literature, supplemented with input from ADA staff and the medical community at large. ​This webinar will discuss the latest guidelines that pertain to diabetes technology/ TIR and address how the 2023 recommendations can be implemented in clinic.​ Speaker(s): Viral Shah, MD - Barbara Davis Center for Diabetes​; Grazia Aleppo, MD, FACE, FACP – Northwestern University; Moderator: Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES, FCCP – Cleveland Clinic.    

• Time in Range: WorkflowJoin Anastasia Albanese-O'Neill, ARNP, PhD, CDE, Jennie Votta, DNP, NP-C, and Amanda Sheehan, NP as they discuss workflow and how healthcare teams can efficiently incorporate diabetes technology into their practice to optimize time with patients.

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Time in Range Infographics

Visit our infographic library to view and download resources. 

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Time in Range Initiative

The Time in Range (TIR) initiative aims to encourage patients and clinicians to use TIR data from continuous glucose monitors (CGMs) to inform treatment and lifestyle decisions that improve health outcomes. A consensus document highlighted the type of report that can be generated (1). (See Fig. 6.1 from the ADA’s Standards of Medical Care in Diabetes). Published data suggest a strong correlation between TIR and A1C, with a goal of 70% TIR aligning with an A1C of ∼7% in two prospective studies (2, 3).

Related Programs

Making Diabetes Technology Work. Learn how to incorporate cutting-edge diabetes technologies into your practice by enhancing your knowledge of available diabetes technologies and matching patients to the right technology so that they can reach their targets. *CE Credit Available*. 

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References 

1. Battelino T. et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care 2019;42:1593–1603
2. Vigersky RA, McMahon C. The relationship of hemoglobin A1C to time-in-range in patients with diabetes. Diabetes Technol Ther 2019;21:81–85
3. Beck RW, Bergenstal RM, Cheng P, et al. The relationships between time in range, hyperglycemia metrics, and HbA1c. J Diabetes Sci Technol 2019;13:614–62
4. Diabetes Care 2023;46(Supplement_1):S97–S110

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