What is Time in the Target Range and How to Maintain it?
The period you remain in the ideal blood glucose range is known as the time in the Target range (TIR). But why is it important?
If you have diabetes or even otherwise, glucose variability is something everyone experiences. It refers to the constant variation in your sugar levels. However, the lower the variations, the better it is for you. Lower glycemic variability also means that you remain in your healthy average range of glucose levels a little longer.
This article would help you learn about time in the target range as a medical term but in simple words. You will also discover ways you could stay longer in your ideal range. Read ahead to understand how you could effectively maintain it through a CGM.
Understanding Time in the Target Range
The period you remain in the ideal blood glucose range is known as the time in the range (TIR). It varies depending on the person, but general guidelines suggest that it starts with a range of 70 to 180 mg/dl. However, over time, some people decide to aim for a tighter range, such as 70 to 140 mg/dl.
You can also understand the Time in Range as “hours per day” spent in the range. For example, 50% Time in Range (70-180 mg/dl) means 12 hours per day spent in the range. It is a typical representation depicted with a bar graph. It represents the percentage of time your blood glucose was high, low, or in range. This information is vital in evaluating which foods and levels of activity cause your sugar levels to spike and fall. In addition, it helps you define patterns of your present health behaviours.
See it as a game of rope balance. The longer you can balance yourself on the rope, the closer to the prize hamper. Here the prize hamper is a stabilised blood sugar level. The task certainly looks complicated, but there are ways you could become better at it.
The Importance of Staying in the Target Range
Blood sugar levels tend to fluctuate because of various reasons. Therefore, it is not naturally something of concern. However, your sugar levels should not vary significantly and should be back to your average range soon. On the other hand, variations significant enough to keep you outside your target range could hint toward metabolic issues like diabetes, PCOS, or certain cancers.
Trying to stabilise your glucose level might seem like a task. However, it is worth knowing that it is not impossible to do so. You may be required to make regular efforts to remain longer in your target range. These efforts include dietary habits, sleep schedule, liquid intake, workout plans, and other health behaviours.
A necessary part of maintaining yourself in the target range is to note and monitor any ups or downs constantly. Firstly, you would be required to notice patterns and note down the specific target range. You could also use a glucose kit for a home check or the HealthifyPRO CGM to know your glucose parameters immediately without pricking. It could help you note the measurable differences quite precisely.
Which is Better: Time in Target Range or A1C?
The A1C test also called the haemoglobin A1C or HbA1 test, measures your average blood sugar over the last three months. It is a widely established, standard metric of diabetes management. It can diagnose diabetes problems and assist you in preventing them.
Knowing your target range and the ups and downs of your blood sugar range gives you a better picture of how you’ll need to regulate your diabetes. In addition, this could assist your doctor in treating you more effectively and precisely, even where medication is concerned.
On the other hand, TIR measurement can assist you even better. A1C is a measurement of the average blood sugar level over months. While your A1C appears normal, you may experience frequent and rapid blood glucose fluctuations that your A1C does not indicate. There may be times during the day when your blood glucose may dangerously fall low or dangerously spike.
Say your sugar levels are already high due to your fruit loops cereal breakfast. You are also excited about the potluck lunch during your work lunch break. A TIR test, in this case, would ping you in, denoting that your glucose levels are spiked enough and that you better go for a brisk walk in the evening.
The Role of CGM in Time in Target Range
The concept of time in target range may be fairly new in research. However, we know that the longer you stay in range, your risk of developing diabetes problems is lower.
According to research, the most accurate and reliable approach for assessing glucose readings is to measure it using a Continuous Glucose Monitoring or a CGM System. CGM devices allow you to monitor your glucose levels each moment in real-time. In addition, it will enable you to identify instances when your blood sugar level is out of range, like before your workout or after your evening snacks.
Recognising these moments helps you make efforts to even out the peaks and low points, such as modifying your medication. In addition, maintaining your level of energy, temperament, and overall well-being is easier when you stay in range.
The HealthifyPro CGM system would give you a daily generated glycemic profile. This profile would show a graph of glucose measurements from 12 am on the previous night to 12 am on a progressive day. As a result, it becomes simple for you to determine which hours of the day you’re in range, over range, or below range. This profile would also be accessible to your fitness and health coach in real-time. Together you could observe patterns, follow suggested dietary and workout suggestions, and form habits for you to function independently and sustainably.
Time in Target Range: Who is it for?
Reviewing time in target range statistics will be most beneficial to patients with type 2 diabetes and type 1 diabetes who use medication and have strict blood sugar limits. It is also because they are more prone to having blood glucose levels over or below their goal range.
It is also for people who have conditions like PCOS, obesity, heart issues, high blood pressure, have stressful occupations, live with mental illnesses like depression, anxiety, schizophrenia, etc.
Profiles available daily and weekly have proven to be helpful to diabetic patients. The more you monitor your blood sugar levels throughout the day, the better you’ll determine how long you’ve been in range. In conclusion, time in range values is pointless unless individuals and their diabetes treatment team check it. When deciding what time in range goal to strive for, remember that there is no such thing as an absolute time in range target. Yours will be a function of your glucose levels, the extent of diabetes, lifestyle choices and food behaviours.
Time in Range Goals
The Time in Range goals are different for every individual. It may depend on medication, type of diabetes, diet (especially carb intake), age, health, and risk of hypoglycemia. People with diabetes should aim to spend as much time in the range (as per their target) as possible. That will help avoid hypoglycemia. Experts emphasise that even a 5% change in Time in Range is beneficial. For example, going from 60% to 65% can benefit because it translates to one more hour per day spent in the range.
As per studies and sizeable real-world data sets, the Time in Range is typically around 50%-60% in the average individual with diabetes and 85% and above in people without diabetes. You can understand the goals for time in-range, above-range, and below-range for various groups of people by the following chart.
Tips to Stay Longer in the Target Range
The best method to maintain your time in the target range is to ensure a stable glucose level. Also, this entails dietary habits, engagement in movement, and other lifestyle habits, including stress and sleep, which are also of great importance.
Your nutrition has the most significant influence on your glucose fluctuations. Consuming foods high in carbohydrates, fats, and sugars might spike your glucose levels. Some examples are refined flour, refined sugar, fried foods, processed snacks, syrups, jams, and candies. It prompts our bodies to release more insulin to transport the excess glucose from the bloodstream and into the cells. Your body might experience a glucose crash as an overreaction because it has a large amount of insulin.
Other dietary suggestions to maintain a stable glucose level include consuming whole grains, pulses, legumes, seeds, nuts, green vegetables, citrus fruits and dry fruits. In addition, eat reasonable quantities of lean meat, a couple of eggs a day, dairy, and quality fats. All this fibre and quality protein would keep you full longer.
Divide your food intake into main meals and snacks. Carry healthy snack options with you. Drink enough water and other fluids like coconut water, lemon water, mint-infused water, green tea, chamomile tea, etc.
Exercise is one of the most effective strategies to handle type 2 diabetes. It improves how your cells utilise insulin and can help you maintain a healthy blood sugar level. It also aids the absorption of sugar by your cells.
Light walking or easy resistance workouts like squats are good for you. In addition, strength training, lifting, brisk walking, jogging, cycling, trekking, dancing, swimming, and any form of outdoor sports are all beneficial.
Walking after meals specifically has been proven to be quite beneficial. It helps your muscle tissues absorb and utilise the excess glucose present in your bloodstream, doing the work of insulin in its absence. The ideal time to walk is around 30- 45 minutes after meals.
Insufficient sleep leads to reduced glucose tolerance, and decreased insulin sensitivity dysregulates your appetite-regulating hormones. It can lead to late-night cravings or morning hunger, causing blood glucose levels to fluctuate. As a result, it could severely affect your time in the target range.
Prolonged stress can spike blood sugar levels. Your body reduces insulin release when cortisol levels are high. Also, insulin aids in transporting sugar from the bloodstream to cells, where it creates energy. Therefore, more sugar stays in the bloodstream if insulin isn’t released correctly, causing blood sugar levels to become unbalanced.
You can reduce your stress levels by having a workout schedule, going for a stroll to clear your head, talking to a friend or a family member, playing a sport, engaging in hobbies, meditating, or listening to music. In addition, research has proven that comparatively less stressed and happier individuals have healthier diets.
Maintaining a detailed record of your sugar readings and their effects will help you maintain a healthy glucose level. Furthermore, maintaining a regular schedule and not skipping a doctor’s visit is critical. To detect any odd changes in your blood sugar levels, you should use blood-glucose monitoring kits or a CGM.
Make use of multiple features of the HealthyfyPro and get real-time glucose readings. First, it will help you find any patterns between sugar spikes or dulls and your behaviour habits. Then, the Pro would immediately connect you with your fitness coach and diet coach to study those patterns, suggest ways to stabilise your glucose and help you form sustainable habits.
There’s no universal standard of time in the target range. It has to be what your target range and the time in the target range is right for you. It is also essential to learn the health behaviours over time for you to practise them independently or with the help of a coach. In addition, personalising the general rules of diabetic care will be perfect for you, which is precisely what PRO aims for you. It is just one of your work training for a skill to help you practise better. For example, using HealthifyPro enables you to learn which food is good for you and which is not. Once you start understanding the pattern, you become independent of wrong food choices, and as a result, you are better enabled to lead a healthy and fulfilling life.