Time in range (TIR) vs. glycated hemoglobin type A1c (HbA1c): a patient-centered approach Continuous glucose monitoring metrics in daily practice

The use of continuous glucose monitoring (CGM) systems and CGM-based metrics has increased massively in recent years in clinical care. However, HbA(1c) remains the most widely used parameter to assess glycemic control. Even despite its limitations, HbA(1c) is still the most commonly used parameter for glycemic control and outcome in clinical trials. Time in range (TIR) as a measure of CGM has many advantages over HbA(1c), since it provides deeper insights into glucose variability and detection of hypoglycemia. In addition, individual TIRs can be applied, for example, in pregnant women or patients with comorbidities. TIR is a powerful tool to evaluate clinical outcomes in diabetes trials; however, standardized methods are still lacking. Changes in TIR furthermore predict the risk of diabetes complications based on the achievement of TIR-based targets. Use of CGM has improved quality of life in people living with diabetes. In recent years people living with diabetes are more familiar with the importance of TIR-based metrics as parameters of glucose control.