Introducing Time in Range (TiR) – a new approach to diabetes
What if there was a way to find out how your diabetes control is
going, without waiting for your next HbA1c test? Time in Range (TiR)
is an up-and-coming diabetes measure that lets you do just that. With
Time in Range, you get regular access to detailed summaries of your
blood glucose levels. Time in Range lets you see all the peaks and
dips during each day and night, and it shows you exactly what your
medication, food and exercise do to your blood sugar levels.1
If you use a continuous
glucose monitor (CGM), you will know that it allows you to
measure your ‘interstitial’ glucose throughout the day and
night.1 Interstitial glucose sounds complicated but all it
means is that the monitor measures the sugar level in the fluid under
your skin rather than directly from your blood.2 You may
also have heard of Time in Range, a term often used by the medical
profession. Time in Range is an up-and-coming diabetes measure that
could help you manage your blood sugar and talk to your healthcare
professional about your diabetes management, using the numbers from
Read on and find out more about Time in Range and how
this measurement can help you and your healthcare professional improve
your diabetes management.1
This free CGM Cheat Sheet gives you the basics about starting with
a CGM and TiR
The Time in Range diabetes measure shows how much time you spend in
your target blood sugar range, using the numbers from your
CGM.1 You can use other CGM measures alongside TiR as a
guide to managing your diabetes, such as how long you spend above
(Time Above Range) or below (Time Below Range) your range. Together
they show you how much your blood sugars vary during the day and
For most people, blood sugar is
‘in range’ when it is between 70 and 180 mg/dl (3.9–10 mmol/l).
Experts recommend that if you have type 1 or type 2 diabetes, most
people should spend at least 17 hours (70%) of their day within this
target range.1 Check with your doctor what your personal
target range is.
What are the recommended targets for Time in Range, Time
Above Range, and Time Below Range?
Time in Range + HbA1c = a more complete picture of your diabetes blood
You will be familiar with using HbA1c to manage your diabetes. Time
in Range does not replace HbA1c but can provide extra information and
greater insight, because it shows you the peaks and dips in your blood
sugar levels each day and night.1,3
HbA1c is a helpful way to look at your average blood
sugar levels for the previous three months and it helps to predict
your risk of diabetes complications.1 But it cannot show
you the daily patterns in your sugar levels so you cannot see any
highs and lows you might be having.1 In fact, people with
the same HbA1c values could have very different blood sugar
patterns.5 A quick look at this article will help explain
between TiR and HbA1c.
Two people with the same HbA1c levels can have different blood
24-hour blood sugars of a person with type 1 diabetes
HbA1c result = 7.0% High blood sugar variability – an episode of hypoglycaemia and
a couple of episodes of hyperglycaemia
24-hour blood sugars of a different person with type 1
diabetes HbA1c result = 7.0% Low blood sugar variability and no hypo- or hyperglycaemia
By adding Time in Range to your diabetes management, you can get a
more complete picture of your blood sugar levels. It can also help you
spot any patterns in low blood sugar (hypoglycaemia) and high blood
sugar (hyperglycaemia) during the day and night, and between different
days. By using Time in Range with HbA1c, you get a personalised story
about your blood sugar levels, helping you understand how they
fluctuate daily and what might be causing the peaks and
“Time in Range makes it possible to plan ahead. If I’m going out, if
I’m doing something that’s active, if I’m making a food choice, if I’m
taking my medicine, I have that real-time data that helps me plan
A diabetes expert explains how Time in Range is helping people with diabetes
Time in Range can help you reduce the risk of health problems
Living with diabetes means an increased risk of certain health
complications, but the good news is that increasing time spent in your
target blood sugar range may help to reduce this risk.6,7
The more you know about your health, the greater your
chance of regulating and promoting it. Time in Range can help you to
better understand the daily patterns in your blood sugar levels, your
blood sugar management and your blood sugar targets.1 A
survey of people with diabetes found that Time in Range came second
only to food as the most important factor affecting their daily
Getting the most out of your blood sugar monitor
Continuous glucose monitoring and Time in Range can also help you
have more detailed discussions with your healthcare professional about
your diabetes, and better understand the advice you are given.
Together you can discuss your eating habits and physical activity as
well as your treatment choices, insulin dosage and the timing of your
doses to improve your diabetes management.1,8
Battelino T, Danne T, Bergenstal RM, et al. Clinical Targets
for Continuous Glucose Monitoring Data Interpretation:
Recommendations from the International Consensus on Time in Range.
Diabetes Care 2019;42(8):1593–1603.
Association. Choosing a CGM. Available at :
Accessed October 2022.
Danne T, Nimri R, Battelino T, et
al. International Consensus on Use of Continuous Glucose Monitoring.
Diabetes Care 2017;40(12):1631-1640.
Association. Glycemic Targets: Standards of Medical Care in Diabetes
2022. Diabetes Care 2022;45(Supplement 1):S1-S264.
Hayter GA, Doniger KJ, et al. Development of the Likelihood of Low
Glucose (LLG) algorithm for evaluating risk of hypoglycemia: a new
approach for using continuous glucose data to guide therapeutic
decision making. J Diabetes Sci Technol 2014; 8(4):720–730.
Lu J, Ma X, Zhou J, et al. Association of Time in Range, as
Assessed by Continuous Glucose Monitoring, With Diabetic Retinopathy
in Type 2 Diabetes. Diabetes Care 2018; 41(11):2370-2376.
Mayeda L, Katz R, Ahmad I, et al. Glucose Time in Range and
peripheral neuropathy in type 2 diabetes mellitus and chronic kidney
disease. BMJ Open Diabetes Research and Care 2020;
Runge AS, Kennedy L, Brown AS, et al. Does
Time-in-Range Matter? Perspectives From People With Diabetes on the
Success of Current Therapies and the Drivers of Improved Outcomes.
Clin Diabetes 2018; 36(2):112-119.
3 min. read
TiR vs HbA1c
Find out how you can use both these blood sugar measurements together to
get a better grip on your diabetes.