Expert Recommendations for Using Time-in-Range and Other Continuous Glucose Monitoring Metrics to Achieve Patient-Centered Glycemic Control in People With Diabetes

J Diabetes Sci Technol. 2023 Sep;17(5):1326-1336. doi: 10.1177/19322968221088601. Epub 2022 Apr 26.

Abstract

New metrics for assessing glycemic control beyond HbA1c have recently emerged due to the increasing use of continuous glucose monitoring (CGM) in diabetes clinical practice. Among them, time in range (TIR) has appeared as a simple and intuitive metric that correlates inversely with HbA1c and has also been newly linked to the risk of long-term diabetes complications. The International Consensus on Time in Range established a series of target glucose ranges (TIR, time below range and time above range) and recommendations for time spent within these ranges for different diabetes populations. These parameters should be evaluated together with the ambulatory glucose profile (AGP). Using standardized visual reporting may help people with diabetes and healthcare professionals in the evaluation of glucose control in frequent clinical situations. The objective of the present review is to provide practical insights to quick interpretation of patient-centered metrics based on flash glucose monitoring data, as well as showing some visual examples of common clinical situations and giving practical recommendations for their management.

Keywords: ambulatory glucose profile; continuous glucose monitoring; flash glucose monitoring; glycemic variability; hypoglycemia; time in range.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Benchmarking
  • Blood Glucose Self-Monitoring
  • Blood Glucose*
  • Diabetes Mellitus* / therapy
  • Glycated Hemoglobin
  • Glycemic Control
  • Humans
  • Patient-Centered Care

Substances

  • Blood Glucose
  • Glycated Hemoglobin