Diabetes Experts Announce Time-in-Range Consensus at ADA’s 79th Scientific Sessions

Diabetes Experts Announce Time-in-Range Consensus at ADA’s 79th Scientific Sessions

-Shahd Husein

Updated guidelines for Time-in-Range (TIR) targets with continuous glucose monitor (CGM) use were recently presented at the ADA’s 79th Scientific Sessions. Members of the Advanced Technologies & Treatments for Diabetes (ATTD) Congress, a group of international diabetes experts – including people living with diabetes – convened earlier this year to set parameters for CGM blood glucose levels for use in ‘research and clinical settings,’ says the ADA. Tadej Battelino, MD, PhD of the Ljubljana Medical Centre in Slovenia presented these guidelines at the Scientific Sessions.

The Endocrinology Advisor reports the following target ranges from Dr.Battelino’s presentation:

  • Type 1 diabetes & type 2 diabetes: greater than 70% of daily CGM readings falling between 70 mg/dL to 180 mg/dL.
  • Older adults and those considered high-risk with type 1 or type 2 diabetes: greater than 50% of daily CGM readings falling between 70 mg/dL to 180 mg/dL. Healthcare providers are encouraged to minimize this group’s daily time below range (less than 70 mg/dL) to less than 1%.
  • Pregnant individuals with type 1 diabetes: greater than 70% of CGM readings falling between 63 mg/dL to 140 mg/dL.
  • Pregnant individuals with type 2 or gestational diabetes: greater than 90% of CGM readings falling between 63 mg/dL to 140 mg/dL.

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MedPage Today states that an HbA1c of 7% is comparable to 70% of time spent in range, and “spending half the day in range aligned with an HbA1c of 8%, according to an analysis of more than a dozen trials.” For people with type 1 diabetes, especially, Dr. Battelino recommended spending less than 1 hour below and less than 6 hours above the target range.

He argued that measuring TIR is as significant as measuring HbA1c levels when making informed decisions for diabetes treatment. To further assist in this global effort, members of the ATTD suggested using a CGM report similar to the ambulatory glucose profile.

The announcement was received well by the diabetes community. The ATTD’s published manuscript entitled, “Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations from the International Consensus on Time-in-Range,” has already been endorsed by several diabetes organizations, including the American Diabetes Association, the American Association of Clinical Endocrinologists, the European Association for the Study of Diabetes, and JDRF, among others.

The international reach and adoption of these updated guidelines are sure to help with clinical application of CGM, believes Dr. Battelino.

“CGM has the potential to transform diabetes care and our group believes that clear, easy-to-understand and broadly agreed-upon glycemic targets for TIR levels will positively impact short- and long-term diabetes outcomes, particularly if understood and adopted by people with diabetes,” he said in an ADA statement.

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