You may have heard people talking about time in target – or time in range – lately. Read on as we unpack it!
What is time in target, and how can it help your blood glucose control?
For many years, the most important indicator of good diabetes control was the HbA1c. This three-monthly blood test gives a snapshot of your blood glucose in a single percentage (find out more about the HbA1c here). The problem with the HbA1c, though, is that it’s not entirely accurate. You can get the same HbA1c percentage by having constant steady blood glucose, or by having erratic, rollercoaster blood glucose. Time in target is a far more reliable measure of how stable your diabetes control is.
Of course, you can only really see your time in target if you’re lucky enough to be using a Continuous Glucose Monitor (CGM) or flash glucose monitor. Here’s an explanation of CGMs and flash glucose monitors. Did you know that Discovery now offers a CGM Benefit? Find out your options here.
What is time in target?
Time in target (also called time in range) is a measurement of how long you spend in a pre-defined target range. This can be changed according to your preferences – the standard measurement is 3.9mmol/l to 10.0mmol/l, but some prefer a tighter range. Time in target literally tells you how many hours a day you are spending with your blood glucose where you want it to be.
Why is time in target important?
The obvious answer is that the more time you spend in your target range, the less chance you have of long-term complications, and the less risk you face of dangerous consequences as a result of low blood glucose. But the deeper answer is that it vastly improves your quality of life to spend more time in target. If you think of the way you feel when you’re high – impatient, headachey, thirsty, emotional – and the way you feel when you’re low – spinny, light-headed, confused, anxious – you can see how having more time in range would be good for your daily life.
Think of your energy levels, mood and mental space on ‘unicorn’ days – when your blood glucose is in the target you set all day (if this hasn’t happened recently, imagine how lovely it would feel!) Now think of your energy levels, mood and mental space on days when you’re on the diabetes rollercoaster, either high or low, hardly ever in between. Which day would you prefer?
What are time in target goals?
Your time in target goal is a personal matter: it depends on your age, health, diet, medication, and risk of hypoglycemia (low blood glucose). There are general guidelines though:
- 70% of the day in target: 3.9mmol/l to 10mmol/l
- Less than 4% of the day below 3.9mmol/l
- Minimise the time spent above 10mmol/l
You can set your own time in target goals with your doctor so that they are specific to you.
How do you choose what’s motivating for you?
We asked psychologist and Type 1 diabetic Daniel Sher to share some tips for how to find a meaningful (and motivating!) time in target goal:
1. Ensure that the goals are realistic.
It’s better to set small achievable goals than broad unachievable goals. If you keep failing at something, you’ll lose motivation quickly – but if you succeed at small goals you’ll be motivated to continue.
2. Set SMART goals.
Don’t set yourself up for failure! SMART goals are Specific, Measurable, Achievable, Relevant and Time-based.
3. Start with small incremental goals and take it one step at a time.
You can’t eat an elephant with one bite. If you’re trying to lower your HbA1c, aim for lowering it half a percentage in 3 months. If you want to improve your time in range, aim for 5% in a month. That translates to one more hour spent in range each day.
4. Be accountable.
Accountability is really important. If you want to set a goal that’s appropriate for you, do it with your doctor or coach so that you know it’s a safe goal, and you can set out steps to achieve it.
It’s helpful to look at time in target as something that you build on, rather than a grade you are being given for your diabetes ‘performance’. It’s a way to actively engage with your diabetes control so that you don’t have to be surprised by an HbA1c result, but can be involved in your daily management. If you’re able to use a device like the FreeStyle Libre, you can also track your time in target and share those results with your doctor every two weeks. Here’s how the system works.
Remember that quality of life is the big goal when living with Type 1 diabetes. Much of that quality of life comes from having balanced blood glucose, it’s true. But it’s also important to balance how much space diabetes takes up in your life – and how much freedom it gives you. Somewhere in the middle of that is the magic target range for you.
What to read next?
What is a CGM? Flash glucose monitoring and CGM: Not sure what the difference is, or what these words mean? Read this article.
Your options on the Discovery CGM Benefit: There are 3 CGM / flash glucose monitors available in South Africa. Here’s what they are, and how much they cost.
Everything you need to know about the FreeStyle Libre: We gathered all your questions and answered them – here’s all you need to know about the Libre.