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Medical Information | Non-US Health Care Professionals
Time in Range (TIR)
Time in Range (TIR)
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WHY TIME IN RANGE (TIR) MATTERS FOR PEOPLE WITH DIABETES

TIR HCP Educational Content: Time in Range KOL Video of Dr. Bergenstal
(10:39)

Dr Richard Bergenstal, International Diabetes Center, Minneapolis, explains why TIR is becoming an important metric for diabetes management.

Healthcare professional has received a fee from Novo Nordisk Inc. for his participation.

While hemoglobin A1C (HbA1c) and self-monitoring of blood glucose are valuable tools for assessing glucose control, according to the Centers for Disease Control and Prevention (CDC), approximately 50% of adults with diabetes are not achieving the American Diabetes Association (ADA) goal of HbA1c <7%.1 In addition, it has been shown that many people with diabetes spend less than half of their day in target glucose rangea—which is lower than the TIR target of at least 70% of their time in blood glucose range of 70 to 180 mg/dL.2-7

aData from multiple studies using CGM in people with type 1 and type 2 diabetes mostly treated with insulins.2-7

Building a more proactive patient/healthcare professional relationship through data

TIR is a metric that enables people with diabetes to monitor their day-to-day glycemic variability.7,8 Along with food choices, TIR is a critical factor that has been shown to affect the daily life of people with diabetes.9

Using TIR along with other continuous glucose monitoring (CGM) metrics, including Time Below Range (TBR), Time Above Range (TAR), mean glucose levels, and glycemic variability, can help offer deeper insight to help people with diabetes understand their glucose targets and daily glucose profile.7,8

“TIR, together with CGM, is a very powerful metric to make patients’ visits more useful. It puts power in the hands of people with diabetes. Doctors worry, at first, that TIR can increase consultation time, but it saves time.” Dr Alice Cheng, University of Toronto, Canada

TIR HCP Educational Content: Time in Range KOL Video of Dr Cheng
(10:46)

Dr Alice Cheng, University of Toronto, explains how TIR is a useful metric and conversation tool in clinical practice.

Healthcare professional has received a fee from Novo Nordisk Inc. for her participation.

This additional layer of data complements HbA1c to offer insight into the potential drivers behind daily fluctuations in glucose levels and the occurrence of hypoglycemia and hyperglycemia. This may help empower people with diabetes to actively manage their diabetes and adopt positive lifestyle adjustments to improve glucose control.7,8

For healthcare professionals, TIR provides an opportunity to have informed conversations with people with diabetes about factors that may have led to out-of-range readings, such as food choices and physical activity, treatment choice, insulin dosage, and timing of doses.7‑9 When used together, HbA1c and TIR can help people with diabetes and healthcare professionals build realistic and effective management strategies to spend longer periods of time within the recommended target glucose range.7,8

  1. Centers for Disease Control and Prevention. Appendix. Reviewed September 30, 2022. Accessed October 5, 2023. https://www.cdc.gov/diabetes/data/statistics-report/appendix.html
  2. diMeglio LA, Kanapka, LG, DeSalvo, DJ, Anderson BJ, et al. Time spent outside of target glucose range for young children with type 1 diabetes: a continuous glucose monitor study. Diabet Med. 2020;37(8):1308-1315.
  3. Sandig D, Grimsmann J, Reinauer C, et al. Continuous Glucose Monitoring in Adults with Type 1 Diabetes: Real-World Data from the German/Austrian Prospective Diabetes Follow-Up Registry. Diabetes Technol Ther. 2020;22(8):602-612.
  4. Ling J, Poon EWM, Yang A, et al. Glycemic Variability and Time in Range During Self-titration of Once Daily Insulin Glargine 300 U/ml Versus Neutral Protamine Hagedorn Insulin in Insulin-naïve Chinese Type 2 Diabetes Patients. Diabetes Ther. 2021;12(5):1399-1413.
  5. Rodrigues R, Rossi ICB, Rossi BF, et al. New glycemic metrics and traditional clinical and laboratory profiles of children and adolescents with type 1 diabetes mellitus in an outpatient follow-up. Diabetes Res Clin Pract. 2021;173:108680. Epub ahead of print. DOI: 10.1016/j.diabres.2021.108680.
  6. Furler J, O'Neal D, Speight J, et al. Use of professional-mode flash glucose monitoring, at 3-month intervals, in adults with type 2 diabetes in general practice (GP-OSMOTIC): a pragmatic, open-label, 12-month, randomised controlled trial. Lancet Diabetes Endocrinol. 2020;8(1):17-26.
  7. Battelino T, Danne T, Bergenstal RM, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care. 2019;42(8):1593-1603.
  8. American Diabetes Association. Standards of Care in Diabetes—2023. Diabetes Care. 2023;46(suppl 1):S1-S291.
  9. Runge AS, Kennedy L, Brown AS, et al. Does Time-in-Range Matter? Perspectives From People With Diabetes on the Success of Current Therapies and the Drivers of Improved Outcomes. Clin Diabetes. 2018;36(2):112-119.