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How to read and understand your Time in Range (TiR)

So, you have heard about Time in Range (TiR) and are keen to give it a try? Perhaps you have just started using Time in Range to track your daily blood sugar and are looking forward to using it to improve your diabetes management.1 But does the idea of getting to grips with a new diabetes measure and the thought of lots of data make you feel uneasy? This article will help you. Read on to learn how you can get important round-the-clock blood sugar information with Time in Range, in a one-page report that is easy to read.1  

Wait, what is Time in Range?

Before we go into Time in Range measurements in detail, let’s first get familiar with Time in Range. If you have only just heard of Time in Range or want to refresh your memory, this article will give you a quick overview.

Crunching your diabetes blood sugar numbers

If you are already using a continuous glucose monitoring device (CGM) to check your sugar levels, then you will be familiar with the numbers that you see on your smartphone or on your CGM app. If you are new to digital health monitoring devices, don’t worry, it’s not as complicated as it sounds! 

Time in Range (the amount of time that you spend within your blood sugar range) is measured using the numbers from your CGM.1 This information forms part of your ambulatory glucose profile (AGP) report. 

The AGP is a simple one-page summary of all your 24-hour glucose readings over a period of time – usually 14 days.1 Many CGMs will now allow you to read your AGP report on your glucose monitoring device. You can also download the report onto a computer.2

Breaking down the ambulatory glucose profile (AGP) report

The ambulatory glucose profile (AGP) contains detailed information about your diabetes blood sugar patterns and how much time you spend in your target blood sugar range each day.1 It shows how your blood sugar varies during the day, between different days and across the whole 14 days. It can help you talk with your healthcare professional about what is currently working for you and your diabetes, and what you might like to change.1,2 But what does the AGP look like? 

Here is a helpful breakdown:1

Have a look at the quick-reference guide to understanding the AGP

show me The AGP Guide


 

What questions should I ask when looking at my ambulatory glucose profile (AGP) report?

Even with only a very basic understanding of your ambulatory glucose profile (AGP), you will have more information about your blood sugar patterns to help improve your diabetes management.1,2 This can help you feel more in control and reduce your risk of health complications.1,3,4  When you are measuring your Time in Range, here are some of the extra things you could talk about with your healthcare professional:

  • How much time do I spend in range? 
    Experts recommend most people should spend at least 17 hours (70%) of each day within the target blood sugar range of 70 to 180 mg/dl (3.9–10 mmol/l).1
  • What happens when I eat, take my medication, or do some physical activity?
    Look at your CGM blood sugar readings and try making a note of your usual activities to see how they might affect your blood sugar.
  • Where are my highs and lows?
    Try to think about what you were doing when your blood sugar readings were below range or above range, to see if there may have been a reason why. For example, did you miss your blood sugar medications, had you exercised, or did you eat a carbohydrate-heavy meal? 
  • What would I like to change?
    Seeing the patterns in your blood sugar can help you think about what you can do to increase the time you spend in range. You may have some ideas, and your healthcare professional can help you make a plan that works for you and your diabetes.

Once you are familiar with your ambulatory glucose profile (AGP), reading your Time in Range can be quite simple and, as you get more confident, you and your healthcare professional can discuss your ambulatory glucose profile (AGP) in more detail which can help you to better manage your diabetes. And the better you manage your diabetes, the more you are in control, and the more you could be able to live a healthy life and reduce your risk of long-term complications.1,3,4

Download and keep this free guide for increasing your Time in Range

Download the TiR Top Tips


 

References
  1. 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.
  2. Continuous Glucose Monitoring Guide. International Diabetes Center. http://www.agpreport.org/agp/sites/default/files/CGM_Patient_Guide_AGP.pdf. Accessed October 2022.
  3. Danne T, Nimri R, Battelino T, et al. International Consensus on Use of Continuous Glucose Monitoring. Diabetes Care 2017;40(12):1631-1640.
  4. Lu J, Wang C, Shen Y, et al. Time in Range in Relation to All-Cause and Cardiovascular Mortality in Patients With Type 2 Diabetes: A Prospective Cohort Study. Diabetes Care 2021; 44(2):549-555. 

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