Time in Range

Dr Banshi Saboo explains an innovative concept of monitoring blood sugar levels

- Dr Banshi Saboo

Time-in-range

Time-in-range is a new metric that is fast gaining importance in Diabetes care. Time-in-range is the term used for the time when the blood sugar levels of a person with Diabetes stay within the normal range (70-180 mg/dL). Ideally, a major amount of time or 70 percent of the time the blood sugar levels should remain between 70 and 180 mg/dL, anytime the sugar is checked. For example, if a person has a blood sugar level of 50 mg/dL or 250 mg/dL then s/he is out of range.

Unlike HbA1c, which provides a three-month average of the blood sugar levels, time in range takes note of changes in the blood sugar levels throughout the day owing to changes in diet, stress levels, medications, and other factors. This can only be monitored by continuous glucose monitoring. It allows blood sugar levels to be continuously checked. It then creates a graph of the readings throughout the day, indicating hypoglycemia (low blood sugar level), hyperglycemia (high blood sugar level), and normal blood sugar levels. The graph helps the physician assess how long a person with Diabetes had been within the normal blood sugar range.

While HbA1c that gives only an average of the sugar level, provides a photograph of the sugar levels, time in range is like videography with continuous information throughout the day. It gives a complete picture of blood sugar readings of 24 hours.

Time-in-range goals are different for every person and may depend on medication, type of Diabetes, diet (especially carb intake), age, health, and risk of hypoglycemia. Experts emphasize that even a 5 per cent change in time-in-range i.e. from 60 to 65 per cent translates to one more hour per day spent in-range.

Benefits of time-in-range metric