October 2024
Here’s a number to keep in mind: 15 minutes. Every 1% of the day equals about 15 minutes. If you spend 30% of the day out-of-range, that equates to about 7½ hours a day when diabetes is holding you back! 24%=6 hours, 20%=5 hours, 16%=4 hours, and so on. So I ask you this: How much of your day do you really want to spend out-of-range? If the answer is “less than I’m spending now,” then give us a call. Chances are, there are things we can do to reduce your time out-of-range and help you feel, function and perform your best. The columns in this month’s edition of Diabetes Bites focus a great deal on optimizing technology – a key aspect of improving time in-range. Let us know what you think! To help you select the devices that will best meet your personal needs, you can also read our product reviews in the Thinking Like A Pancreas Blog. As always, please reach out if there is anything we can do to assist you in reaching your personal goals. Call 610-642-6055 or send an email to info@integrateddiabetes.com.
Gary Scheiner MS, CDCES
Owner, Clinical Director
How Much Is Too Much?
First off, thank you to everyone who wrote in to respond to last month’s article and share their stories about their struggles with frozen shoulder. There is something comforting about going through the battle together.This month, I’d like to discuss something that applies to just about all of us: TIME IN-RANGE (TIR).
It’s a term that has gained popularity in both patient and clinical circles with the widespread use of continuous glucose monitors (CGMs). TIR refers to the percentage of time we spend within a desirable glucose range each day. For most people, that range is somewhere in the neighborhood of 70-180 mg/dl (3.9-10 mmol/l). The reason for this range is obvious: Below 70 is when symptoms of hypoglycemia tend to appear, and above 180 is when the kidneys start to dump sugar into the urine, causing dehydration and a loss of energy. TIR has made the A1c somewhat obsolete. TIR correlates closely with the risk for long-term diabetes complications, as does A1c. But unlike the A1c, TIR conveys something about the quality of one’s glucose management. Lots of highs and lows can result in a decent A1c, but TIR also reflects the stability of one’s glucose levels. And stability does matter.The way we feel, function and perform on a moment-to-moment basis is affected by our immediate glucose levels.The American Diabetes Association, in its professional guidelines, recommends that most people strive for a TIR of at least 70%. For most people using an automated insulin delivery (AID) system, this isn’t that hard to achieve. But here’s the catch: Time not spent in range is time spent out-of-range (above or below your target zone). And any time we’re out of range, we don’t feel, function or perform as well as we should.
Here’s a number to keep in mind: 15 minutes. Every 1% of the day equals about 15 minutes. If you spend 30% of the day out-of-range, that equates to about 7½ hours a day when diabetes is holding you back! 24%=6 hours, 20%=5 hours, 16%=4 hours, and so on. So I ask you this: How much of your day do you really want to spend out-of-range? If the answer is “less than I’m spending now,” then give us a call. Chances are, there are things we can do to reduce your time out-of-range and help you feel, function and perform your best. The columns in this month’s edition of Diabetes Bites focus a great deal on optimizing technology – a key aspect of improving time in-range. Let us know what you think! To help you select the devices that will best meet your personal needs, you can also read our product reviews in the Thinking Like A Pancreas Blog. As always, please reach out if there is anything we can do to assist you in reaching your personal goals. Call 610-642-6055 or send an email to info@integrateddiabetes.com.See You In The Range!
Gary Scheiner MS, CDCES
Owner, Clinical Director
