Is it time for ‘Time in Tight Range’?

At a recent ATTD event, diabetes experts discussed the potential benefits of time in tight range, calling for personalized care and education to help achieve tighter blood glucose control.

 In the past decade, many healthcare providers have embraced time in range as a new way to evaluate glyceamic control. However, inventions and discoveries like automated insulin delivery (AID), continuous glucose monitoring (CGM), and GLP-1 receptor agonists are enabling people with diabetes to manage glucose levels with greater precision, leading experts to consider a new metric for glycaemic control: ’time in tight range’. This is defined as glucose levels between 70-140 mg/d, a metric developed based on the recognition that high glucose levels over time may be harmful to different body systems. However, achieving ‘time in tight range’ may be easier said than done: striving for tighter blood sugar control could introduce further diabetes distress and may not necessarily be right for everyone. Furthermore, since ‘time in tight range’ is a new concept, official guidelines regarding this metric have not yet been developed.

The experts at the “Is It Time for Time in Tight Range?” panel discussion at ATTD 2024 explored the potential benefits of time in tight range, how to begin using this metric, and strategies to further optimize glycaemic control.

While panelists generally agreed that 50% time in tight range is a good starting point, they also called for more research to determine the optimal amount of time in tight glycaemic control. They hoped that the concept would incentivise diabetes companies to develop new technologies and medications to help people achieve more glycaemic control and hoed that proper education would also help people with diabetes will be able to attain tighter glucose levels.

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