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Review
. 2021 Jul:177:108917.
doi: 10.1016/j.diabres.2021.108917. Epub 2021 Jun 11.

Time-in-range for monitoring glucose control: Is it time for a change?

Virginia Bellido  1 , Pedro José Pinés-Corrales  2 , Rocío Villar-Taibo  3 , Francisco Javier Ampudia-Blasco  4
Affiliations
Review

Time-in-range for monitoring glucose control: Is it time for a change?

Virginia Bellido et al. Diabetes Res Clin Pract. 2021 Jul.

Abstract

The HbA1c value has been the gold standard for evaluating glucose control for decades. However, it has limitations such as the lack of information on glycemic variability or the risk of hypoglycemia. The increasing use of continuous glucose monitoring has provided patients and healthcare professionals with a range of useful metrics for the management of diabetes. Among them, Time in Range (TIR) is a simple and intuitive metric that gives information regarding the quality of glucose control. It is defined as the time spent in an individual's target glucose range. TIR is strongly correlated with HbA1c, and it has been linked to the risk of developing microvascular and macrovascular complications. The International Consensus on Time in Range has recently set targets for different diabetes populations. For the majority of people with type 1 or type 2 diabetes, a TIR (70-180 mg/dL or 3.9-10.0 mmol/L) of >70%, a time below range (TBR) <70 mg/dL (<3.9 mmol/L) of <4% and a TBR <54 (<3.0 mmol/L) of <1% are recommended. In this review, we address the latest evidence for the use of TIR as an essential parameter in the management of diabetes.

Keywords: Continuous glucose monitoring; Diabetes complications; Glycemic variability; Hyperglycemia; Hypoglycemia; Time in range.

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Conflict of interest statement

Declaration of Competing Interest The authors declared the following potential conflicts of interest with respect to this article: Virginia Bellido has speaker/advisory honoraria from Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Esteve, Janssen, Merck, Mundipharma, Novartis, Novo Nordisk, Roche, Sanofi. Pedro José Pinés-Corrales has received speaker/advisory honoraria from AstraZeneca, Boehringuer Ingelheim, Eli Lilly and Co, Merck Sharp & Dohme, Mundipharma Pharmaceuticals, Novo Nordisk, Sanofi and Medtronic. Rocío Villar-Taibo has received speaker/advisory honoraria from AstraZeneca, Boehringuer Ingelheim, Eli Lilly and Co, Merck Sharp & Dohme, Mundipharma Pharmaceuticals, Novo Nordisk, Sanofi and Janssen. Francisco Javier Ampudia-Blasco — Consultant/advisor: Abbott Diabetes Care, AstraZeneca, Boehringer Ingelheim, Eli Lilly, GlaxoSmithKline, LifeScan, MannKind Co., Medtronic, Menarini, Merck, Novartis, Novo Nordisk, Sanofi; Speaker: Abbott Diabetes Care, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, LifeScan, Eli Lilly, Madaus, Medtronic, Menarini, Merck, Novartis, Novo Nordisk, Sanofi; Grant support: Novo Nordisk, Sanofi.

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