Recommended time in range targets T1D

[Mitchsi]

Hi all,

Since coming out of hospitable last month the DSN set limits of 3.9 -> 10.0 as my target range. I’ve been pretty pleased with my % time in range and then realised it’s at the widest range possible
What does everyone use?
The 3.9 I’m ok with but thought the 10.0 might be a little high.
What do you good folk use and recommend pls?

Thanks,

 

[Westley]

I guess it depends on how you're considering targets.
I aim to stay between 4 and 7. Realistically I very frequently go outside this ideal.

Duration also matters - I'm not going to stress about spiking up to 9 for a bit after a meal, but I'd feel differently about coasting there for multiple hours of the day for months.

It's a personal balance between how much time/effort/lifestyle change you're realistically willing to trade for reducing risk of complications down the line.

You say you've just come out of hospital, are you newly diagnosed?

It's also normal for priorities to change. At first it might be more about just avoiding real extremes and getting used to everything, whereas as time goes by you might want to dial it in more tightly. Stressing too much about perfect control from the start risks burning out or letting it take over your life. With experience it gets easier to achieve the same level of control with less effort.

 

[eventhorizon]

I aim for a TIR of 70% between 4.1 to 9.0.

 

[Antje77]

You can change the range as often as you like, even just for a minute to see how much time you spend in range if you lower the upper bar.

I change it depending on how I'm doing at the moment. I like to see the graph have a reasonable TIR, say 80%.
That way it's easy to spot where I can do better, but it's also enough time in range to look nice.
A graph showing 100% in range won't tell me much, and one saying I'm only 20% in range isn't helpful either.

 

[Rokaab]

My target range is 4-10, but then the target on my pump with its auto-mode is to aim for 6.7 so that's about half way between 4 and 10 (and I cant change that whilst using automode - the pump does not let you change it, it is set in stone for automode), and its wont let me correct unless above 8.3 anyways (well not without me pretending I've had carbs anyways), so setting myself a target range of 4-8 even would require a lot of lying to my pump about having carbs and would make its automode a lot less auto .....

 

[Fenn]

When I’m motivated 4-10 and I aim for 99%

Other times 4-20 and I aim for 80% in range lol

I don’t know why but my endo and dietician only seem to care about % time in range so I try harder leading up to appointments so I don’t get told off, they never tell me off but at least I try harder for a few months of the year.

 

[Deleted member 527103]

I believe there was a study which concluded that the target should be 70% TIR with a range of 3.9 to 10.0 where no more than 5% of the time is below 3.9.
This is the target I work to.

 

[Zhnyaka]

most of the time I have a range set from 4.5 to 9, simply because if my bg drops to 4.5, then most likely it will drop even more

 

[Deleted member 527103]

most of the time I have a range set from 4.5 to 9, simply because if my bg drops to 4.5, then most likely it will drop even more

There should be a difference between your target range and the alarm thresholds.
My target range is 3.9 to 10.0. My alarm thresholds are 5.0 and 9.5.

 

[Jaylee]

When I’m motivated 4-10 and I aim for 99%

Other times 4-20 and I aim for 80% in range lol

I don’t know why but my endo and dietician only seem to care about % time in range so I try harder leading up to appointments so I don’t get told off, they never tell me off but at least I try harder for a few months of the year.

I don’t know about yours..
But my endo tends to only look at TIR & daily patterns from the last 30 days…?

There should be a difference between your target range and the alarm thresholds.
My target range is 3.9 to 10.0. My alarm thresholds are 5.0 and 9.5.

If I set my alarm threshold at 5mmol, I would be doing nothing but beeping like R2D2.. Although fully hypo aware I can cruise for hours at 4.9 with my activity. (Pending on insulin onboard & tailing off of basal.) Set for 3.9 I personally get a 10/15 minute heads up before the symptom even knocks the door. With my CGM set up.)

Even with the “mask” of alcohol, I know I’m low..

Everyone is different….

Been doing this for many years. The recent advent for me with sensors confirm. (On the trends.back in the day I peed in a cup for a vague reading.) Thus improving my management. I could still improve further with a pump but somehow your comments always seem to dissuade, making this pump aspect for me unobtainable..

But I digress.

“Don't try this at home, kids.”

 

[RoughcutAU]

Libreview reports default to 3.9-10 as an internationally recognised standard anyway.

Personally I set my goal at 3.9-8.0 at which I’m currently TIR of 75% in the last 90 days. I’m trying to achieve 80% or better in this range however I like carbs too much.

 

[SherwoodT1]

If you're newly diagnosed, I would personally stick with the advised target of your dsn. By all means aim for a tighter range on an informal basis. But don't be too hard on yourself. You're still going to be learning how to manage everything at this stage, god knows I certainly still am!

As you get more used to things, then start honing in on a tighter range.

From my personal experience, take it easy on setting targets so early into diagnosis. Particularly if you still have some insulin production (honeymooning). Being too restrictive early on can get very disheartening as your insulin requirements change and you don't have the tools to handle it as well as you'd like. T1DM is unfortunately a long game, and it's all too easy to get disheartened if your time in range slips away from you.

 

[Mitchsi]

I guess it depends on how you're considering targets.
I aim to stay between 4 and 7. Realistically I very frequently go outside this ideal.

Duration also matters - I'm not going to stress about spiking up to 9 for a bit after a meal, but I'd feel differently about coasting there for multiple hours of the day for months.

It's a personal balance between how much time/effort/lifestyle change you're realistically willing to trade for reducing risk of complications down the line.

You say you've just come out of hospital, are you newly diagnosed?

It's also normal for priorities to change. At first it might be more about just avoiding real extremes and getting used to everything, whereas as time goes by you might want to dial it in more tightly. Stressing too much about perfect control from the start risks burning out or letting it take over your life. With experience it gets easier to achieve the same level of control with less effort.

Wow quite impressive to stay that tight - something to aim for! In time.

Yes newly diagnosed, I’m not getting stressed about it just interested in a general concensus here.

I’m putting in quite a bit of time and effort early on so that with experience the management of this barely registers in the day.

 

[Mitchsi]

Libreview reports default to 3.9-10 as an internationally recognised standard anyway.

Personally I set my goal at 3.9-8.0 at which I’m currently TIR of 75% in the last 90 days. I’m trying to achieve 80% or better in this range however I like carbs too much.

That’s really good going, do you try and stay low carb say below 120g or further?
I don’t usually eat breakfast but as I have high cholesterol I’m having oats in the morning so it’s adding to my carbs per day. I’ll drop it next month sometime as I’m seeing my weight slowly creep up. (Also exercising most days so not inactive).

 

[Mitchsi]

That’s for all the replies.
All good advice. Good to know it’s sound to keep going as I am but I would look to tighten as I become experienced in the future.
Being technically minded and data driven I don’t think I’ll be at risk of burnout chasing my tail but I can see how it can become obsessive. In fact after 5weeks I’m checking the app less and less, just once a minute now ;-)
I’m about 85% for the last 30days, sports is screwing me over a bit in the last week but that’s a different topic.
Appreciate your feedback folks

 

[RoughcutAU]

That’s really good going, do you try and stay low carb say below 120g or further?
I don’t usually eat breakfast but as I have high cholesterol I’m having oats in the morning so it’s adding to my carbs per day. I’ll drop it next month sometime as I’m seeing my weight slowly creep up. (Also exercising most days so not inactive).

Thank you. Definitely not a low carber here … my average is more like 200g a day - though this can vary considerably. I wasn’t a breakfast person either (unless you count a very carby grande latte) before diagnosis but the hospital dietitian and DNE both pushed the benefits in blood glucose control. Breakfast certainly helps sort my DP.

 

[Mitchsi]

Thank you. Definitely not a low carber here … my average is more like 200g a day - though this can vary considerably. I wasn’t a breakfast person either (unless you count a very carby grande latte) before diagnosis but the hospital dietitian and DNE both pushed the benefits in blood glucose control. Breakfast certainly helps sort my DP.

Ok 200g is a decent amount, I’ve been a bit above that having had breakfast but I will stop but might still land at about 200g. I’m not going to go back down the low carb route for a while - I want to concentrate on getting back into a good fitness level, say half marathon level.
I have my 1st dietitian appointment and carb course next month so I’ll have to argue against the breakfast but I have to say no breakfast keeps my levels pretty well flat.