I sincerely believe healthcare should not be one size fits all, but our healthcare system does believe one size fits all. In all fairness, I’m curious to know what the norm is considered to be. My brother recently started using the G7 & he hasn’t gone to his provider since he started. What does America’s healthcare system deem a good % In Range to be? Different providers probably have a different % in mind. I’m just curious to know the numbers you have been told. My brother’s provider is truly exceptional & I think she’ll think he’s doing well. But I’d love to get the feedback you’ve been given.
That’s gonna differ a lot, Doc to Doc and patient to patient. I’ve had a Doctor who was really risk adverse about lows. If she saw any readings below 80, she would circle them with a big red pen and wanted them all eliminated.
70% TIR is recommended, I think.
But you gotta kinda look at the data because if your coasting along overnight at a bloodsugar of 75 for 8 hours, that’s gonna screw the TIR and make it look much worse than it might actually be.
ADA says 70%. CGM & Time in Range | American Diabetes Association
Time in Range 70-180 mg/dL (4.0-10.0 mmol/L) at 70% seems to be the standard for most doctors. In general, these providers are much more concerned about avoiding any hypoglycemia.
I think most providers miss impressing on their patients the importance of glucose variability. CGM data like standard deviation and Coefficient of Variation can be followed to track variability.
I follow a much tighter range than my doctors often see. With all the CGM data that I provide, quarter after quarter, demonstrates by my low SD and CoV that a tighter range with lower variability does not compromise my health and safety.
I believe that most doctors in the US follow and recommend 70% TIR 70-180 but that many are willing to make adjustments based on their patients needs. They are not very flexible, however, when it comes to % of time in hypoglycemia.
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Both the patient and the doctor have ongoing knowledge about diabetes management.
The doctor generally knows more about the medical side of the equation than the patient would ever care to learn and the patient knows typically more about the day-to-day effects of diabetes on their body than the doctor would ever have time to learn.
Hence, the answer is for the doctor and the patient to arrive at the best compromise that falls between acceptable medical tolerances and what the patient can realistically reach and maintain. Each patient is different from other patients so the point or range of compromise needs to be specifically tailored to each patient. Furthermore, life happens, and the best compromise today, may need to be periodically tweaked as circumstances change.
My doctor tells me 80% or better is good control. I like to be in the 90s and since I use a pump w algorithm I average 95
I think 70% TIR 70-180 is where the researchers started to see a meaningful decrease in the rate of complications in all people with diabetes. For people who show interest in caring for themselves most docs will move the goals up, 75, 80, 85 etc as the patient successfully learns how to manage their blood glucose. The 2024 version of the ADA Standards of Care emphasizes the need to tailor a care plan to each patient. It also states a patient’s healthcare team must work together. I imagine your brother has more than a few docs on his care team, they all need to contribute and agree to a plan. You’re part of that care team so you get to have input too.
I just found out my CDE isn’t faxing chart notes to my PCP. Next time I see the CDE I have to remind them they are on my team and I expect my team to work together.
Everyone, thank you for your feedback. My brother has been on an insulin pump for 9 years, and we’ve done very well with it. The pump isn’t new to us, but the G7 is new. My brother had G6 before G7. I was just curious to know what other providers were saying. My brother’s provider has always been supportive.