TIR vs Hba1c

[Zinadane]

Just a random question.
Which set of numbers would you prefer:
1. Hab1c 45 with TIR of 70% and 7% lows
2. Hba1c 50 with TIR of 80% and <5% lows

 

[EllieM]

Is that 45 accompanied by a high number of hypos? If so, I think I'd prefer no 2 , as I lose hypo awareness if I have too many lows....

 

[Zinadane]

Is that 45 accompanied by a high number of hypos? If so, I think I'd prefer no 2 , as I lose hypo awareness if I have too many lows....

Ah yes, good point, I have edited the post.
For me I tend to accept around 7% lows without any known issues (of course they moan at me)
Problem is I can be 3.8 for eg (low) which if stable or rising i conside ok.
Of course completely different to being 2.8% and yet both scenarios are classed as 'low'

 

[Nicola M]

Option 2 for me, my clinic goes more on TIR rather than HbA1c anyway and although I know the 50 is very slightly above the recommended 48 I wouldn’t be happy with 7% lows. I rarely if ever go above 3% so that’s far too high a percentage for my liking

 

[sgm14]

The TIR report on LibreView.com includes `percentage low` and `percentage very low` which might affect my preference, but without knowing more I would probably go with Option 2. (and I'd pretend I was an American where the recommendation is below 53 rather than 48)

 

[CheeseSeaker]

Option 2 - TIR increased is safer overall.

Was never a fan of Hba1c as a gauge since CGMS have been about#

The way its monitored is weighed to the last 7 days - and the assumption (by lots of us and medical professionals) is its even over the whole 2-4 weeks its supposed to monitor

 

[Juicyj]

Your DSN would prefer your 80% TIR as said above it's considered safer - we are being told to use TIR now for this reason, however it's changing your mindset from HbA1C which takes some doing as we still see it as a benchmark.

 

[becca59]

Definitely option 2. Have worked hard the past year to avoid lows and highs and maintain a steadier line. My HbA1c has risen to 52 as a result, but my TIR is 87-90% between 3.9 and 10. Am now working on getting it between 3.9 and 8.5. Which is about 73% at the moment.

 

[Ushthetaff]

To be perfectly honest I think either is good I would say if you had either as a long term control you would keep complications risk at quite a low percentage .

 

[Antje77]

For me it would depend a lot on how low the lows are in time below range. Anything 3.6 or above I'm not impressed with, it's what non diabetics see on a regular basis and it's even within the recommended range for pregnant women on insulin.
I would be worried if I was more than 2% below that, and I don't like to be more than 4% below 3.9.

I like my hba1c as low as I can get it as long as I can keep my time below range within the above numbers.

 

[Zhnyaka]

in principle, I would like less fluctuations between values regardless of TIR and HBA1. Changes of 5-7 units per hour bother me more than both hba1 and tir

 

[ausGeoff]

As a T2 newbie, I have to admit I didn't even know
what the term TIR meant, so looked it up. I apologise
if my comments as a newbie disrupts the flow of this
thread Zinadane. (Please let me know guys.)

My figure two weeks ago at T2 diagnosis was 10.9% and the path
report range is 4% to 6% in Australia. So I still can't interpret what this
bar chart implies for my condition.

 

[Antje77]

As a T2 newbie, I have to admit I didn't even know
what the term TIR meant, so looked it up. I apologise
if my comments as a newbie disrupts the flow of this
thread Zinadane. (Please let me know guys.)

T1's often use a CGM, a sensor which continuously measures blood glucose. Because it measures continuously, it can tell you what % of time you were in a pre-set range.
Because we regulate our blood glucose with injected insulin around meals (and lots of other variables), we always walk a tightrope from hour to hour with regulating our BG.

So a 'good' hba1c can either be a result of highs and lows, averaging a reasonable number, or a result of stable management.
While a lowish hba1c is wonderful, it isn't as wonderful if it's accompanied by many hypos (time below range).

Does this help?

 

[Zinadane]

Definitely option 2. Have worked hard the past year to avoid lows and highs and maintain a steadier line. My HbA1c has risen to 52 as a result, but my TIR is 87-90% between 3.9 and 10. Am now working on getting it between 3.9 and 8.5. Which is about 73% at the moment.

A very impressive TIR!
My problem is, I binge a bit too much, always thinking that I will be able to deal with any spike via dosing.
The biggest problem though is when bg hits teen values, insulin resistance changes so much!
I know, I need more self discipline

 

[Tony337]

Hi
As usual i'm at variance with experts and specialists.
I'm 91% in range with a hba1c of 39.
My 4% below 3.9 is debatable as if i start dropping into the 4s i pop a freddo bar in which brings me back into the 5s but because of the delay with the libre i can drop into the 3s quite easily however if i eat a freddo bar i only have background insulin on board so i'm rarely troubled doing it this way.

It works for me and i want to be in the 5s and not just in the green which is an expression i hear alot these days and it gets on my nerves a bit as its a bit too vague for my liking.

I've been type 1 for 50 years and never been hospitalized and fear i have become a pompous smug old git lol.

My 91% is only over the last 3 weeks as i had to wipe the data as i now have a smart watch that shows my levels which i'm excited about.
I've just looked at my watch and i'm 5.6 and done 4500 steps.....modern technology is fantastic.

@Zinadane to answer your original post i aim for the 5s all the time as thats what a non diabetic would be and do not fear a low so 45 is preferable.

I wish you all well

Tony

 

[Fairygodmother]

Like Tony, my ideal is to be in the fives, I feel so much better there, I’m happier and more energetic. I’ve set a personal range of four point six to eight point nine as I know from experience that’s not easy, plus the fifteen min CGM delay needs an early warning system.
It’s the bigger drops and higher rises that are more important to me than the TIR

 

[Fairygodmother]

Oh ******, that number thing’s hit again. Time to edit!

 

[CheeseSeaker]

If we can get a higher TIR (between 4 and 10mmol in the UK) - the UK health service aims for 70% or higher TIR as a target.

The nearer we get to 100% TIR, the better, but thats not realistic with current Tech and medication without major work and impact to lifestyle (for most of us).

as @Fairygodmother says - avoid the highs and lows is key - TIR gives an idea how well its going over time (say 14 days etc) to see whats happening.

On the system I use it gives me a summary over 14 days (very low - below 3.1, low 3.1-3.9, in range 4-10, high 10-13.9 and very high 14 and above) - a nice way of gauging what's happening, and more useful than hba1c which just gives me '38' over 2-4 weeks

 

[searley]

Just a random question.
Which set of numbers would you prefer:
1. Hab1c 45 with TIR of 70% and 7% lows
2. Hba1c 50 with TIR of 80% and QUOTE]

Depends how low the lows are lows can be very dangerous not only to you but those around you

So I’d prefer option 2 to be safe