Hello,
I am a recently diagnosed T2, with a latest A1C of 6.1, in the hope of getting better and often struggling with post prandial highs - which make me anxious. I have therefore been looking at many resources to figure out where I am and where I should be heading.
In this search I have found a lot of information - often conflicting and inconsistent. The latest such find, to my surprise, is from the American Diabetes Association Glycemic Targets page. I am told not to post any links so I wont do it, but a simple google search will take you there. I am comparing Tables 6.2 & 6.3.
Table 6.2 gives the Standardized CGM metrics for clinical care in nonpregnant individuals with type 1 or type 2 diabetes. Note the 6,7 & 8th points there. TIR: % of readings and time 70–180 mg/dL (3.9–10.0 mmol/L). The recommended time (goal) is >70% (most adults);>50% (older adults). Does this not imply that for at least 30% of the time the blood glucose can be >180 mg/dL or <70 mg/dL. I am not saying that it should but the TIR goal does not say 100%
Now look at Table 6.3, which says that the Peak postprandial capillary plasma glucose be <180 mg/dL* (<10.0 mmol/L)
Is this not a contradiction ? If the Peak Goal of <180 mg/dL is met, then TIR, by definition is 100% (ignoring the times when the values are < 70 mg/dL). If on the other hand the TIR goal of 70% - 99% is met then the goal of Peak postprandial capillary plasma glucose be <180 mg/dL* (<10.0 mmol/L) is necessarily not met.
So my question is - Why do we have this seeming conflict ?
Are we expected to see that the safe goal is to go for < 180 for all the 24 hours ? Then why even have the TIR goals ?
I am all confused. Any help is appreciated.
Thanks
I am a recently diagnosed T2, with a latest A1C of 6.1, in the hope of getting better and often struggling with post prandial highs - which make me anxious. I have therefore been looking at many resources to figure out where I am and where I should be heading.
In this search I have found a lot of information - often conflicting and inconsistent. The latest such find, to my surprise, is from the American Diabetes Association Glycemic Targets page. I am told not to post any links so I wont do it, but a simple google search will take you there. I am comparing Tables 6.2 & 6.3.
Table 6.2 gives the Standardized CGM metrics for clinical care in nonpregnant individuals with type 1 or type 2 diabetes. Note the 6,7 & 8th points there. TIR: % of readings and time 70–180 mg/dL (3.9–10.0 mmol/L). The recommended time (goal) is >70% (most adults);>50% (older adults). Does this not imply that for at least 30% of the time the blood glucose can be >180 mg/dL or <70 mg/dL. I am not saying that it should but the TIR goal does not say 100%
Now look at Table 6.3, which says that the Peak postprandial capillary plasma glucose be <180 mg/dL* (<10.0 mmol/L)
Is this not a contradiction ? If the Peak Goal of <180 mg/dL is met, then TIR, by definition is 100% (ignoring the times when the values are < 70 mg/dL). If on the other hand the TIR goal of 70% - 99% is met then the goal of Peak postprandial capillary plasma glucose be <180 mg/dL* (<10.0 mmol/L) is necessarily not met.
So my question is - Why do we have this seeming conflict ?
Are we expected to see that the safe goal is to go for < 180 for all the 24 hours ? Then why even have the TIR goals ?
I am all confused. Any help is appreciated.
Thanks
