What is Time in Range? The #1 Metric for Diabetes Control

If you have diabetes, you've probably tracked your HbA1c levels religiously. But there's a newer, more powerful metric that better reflects your day-to-day glucose control: Time in Range (TIR).

Time in Range has revolutionized how we understand diabetes management. Instead of looking at a 3-month average (like HbA1c), TIR shows you the percentage of time your glucose levels stay within a healthy target range each day. This single number can tell you more about your diabetes control than any other metric.

In this comprehensive guide, we'll explore what Time in Range is, why leading diabetes organizations now consider it the #1 metric for glucose control, and most importantly—how you can improve your TIR starting today.

What is Time in Range (TIR)?

Time in Range (TIR) is the percentage of time your blood glucose levels stay within a target range over a specific period (usually 24 hours or longer).

The standard target range recommended by the American Diabetes Association is:

For example, if your glucose levels were in the 70-180 mg/dL range for 18 out of 24 hours yesterday, your Time in Range would be 75%.

TIR is typically measured using Continuous Glucose Monitors (CGMs) that check your glucose levels every 5-15 minutes throughout the day and night. However, you can also estimate TIR using frequent finger-prick tests, though this is less accurate.

Why Time in Range Matters More Than HbA1c

For decades, HbA1c has been the gold standard for diabetes management. So why is TIR now considered more important?

The Problem with HbA1c

HbA1c measures your average blood glucose over the past 2-3 months. While useful, it has significant limitations:

• Hides variability: Two people with the same HbA1c can have completely different glucose patterns. One might have stable glucose levels, while another experiences dangerous highs and lows that average out to the same number.
• Delayed feedback: It takes 3 months to see if your changes are working. That's a long time to wait when making lifestyle adjustments.
• Doesn't show hypoglycemia: An HbA1c of 6.5% could mean excellent control OR frequent dangerous lows that bring down the average.
• Tested infrequently: Most people check HbA1c only 2-4 times per year, missing important trends.

The Advantages of Time in Range

Time in Range addresses all these limitations:

• Shows the full picture: TIR captures both highs and lows, giving you a complete view of your glucose control.
• Immediate feedback: You can see your TIR improve within days of making lifestyle changes, not months.
• Prevents complications: Research shows that higher TIR is directly linked to lower risk of diabetes complications like retinopathy, neuropathy, and kidney disease.
• Daily tracking: With a CGM, you can monitor your TIR every single day and adjust accordingly.
• More motivating: Seeing daily improvements in TIR is far more encouraging than waiting 3 months for an HbA1c result.

Target Time in Range Percentages

The American Diabetes Association and International Consensus on Time in Range recommend the following targets:

Gold Standard Goal: Aim for at least 70% Time in Range. This means your glucose should be in the 70-180 mg/dL range for at least 16 hours and 48 minutes per day.

Additional Important Metrics

Along with TIR, you should also monitor:

• Time Below Range (TBR): Target <4% below 70 mg/dL (less than 1 hour/day)
• Time Above Range (TAR): Target <25% above 180 mg/dL (less than 6 hours/day)
• Time in Very Low Range: Target <1% below 54 mg/dL (less than 15 minutes/day)

How to Calculate Time in Range

Method 1: Continuous Glucose Monitor (CGM)

The most accurate way to measure TIR is with a CGM device. Popular CGM systems include:

• Dexcom G6/G7
• Abbott FreeStyle Libre
• Medtronic Guardian
• Eversense CGM

These devices automatically calculate your TIR and display it in their companion apps. You can also export the data as CSV files for further analysis.

Method 2: Manual Calculation (Finger Pricks)

If you're using a standard glucometer with finger-prick tests, you can estimate TIR:

1. Test at regular intervals throughout the day (e.g., before meals, 2 hours after meals, bedtime)
2. Record all readings over 24 hours
3. Count how many readings fall within 70-180 mg/dL
4. Divide by total readings and multiply by 100

Example: You tested 8 times in 24 hours. 6 readings were in range (70-180 mg/dL). TIR = (6/8) × 100 = 75%

Note: This method is less accurate than CGM because it only captures snapshots, missing overnight trends and between-meal variations.

7 Proven Ways to Improve Your Time in Range

Improving your Time in Range doesn't require drastic lifestyle changes. Small, consistent adjustments can make a significant difference. Here are 7 evidence-based strategies:

1. Maintain Consistent Meal Timing

Eating at roughly the same times each day helps stabilize your glucose levels. Your body develops a rhythm, making insulin dosing (if applicable) more predictable.

Action step: Set meal times and stick to them within a 1-hour window daily.

2. Pre-Bolus Insulin (Type 1 Diabetes)

For Type 1 patients using insulin, taking your mealtime insulin 15-20 minutes before eating can significantly reduce post-meal spikes.

Action step: Set a timer reminder to take insulin 15 minutes before meals.

3. Exercise Regularly (But Strategically)

Regular physical activity improves insulin sensitivity and helps keep glucose stable. However, timing matters:

• After meals: A 15-minute walk after eating can prevent post-meal spikes
• Consistent timing: Exercise at the same time daily for predictable effects
• Monitor carefully: Check glucose before, during, and after exercise to avoid lows

Action step: Start with 10-minute walks after dinner, gradually increasing duration.

4. Prioritize Quality Sleep (7-9 Hours)

Poor sleep directly impacts insulin resistance and glucose control. Studies show that sleeping less than 6 hours per night can increase blood sugar levels by 20-30 mg/dL.

Action step: Establish a consistent bedtime routine and aim for 7-9 hours of sleep nightly.

Read more: How Sleep Affects Your Blood Sugar (And What to Do About It)

5. Improve Carb Counting Accuracy

Accurate carbohydrate counting is crucial for insulin dosing and preventing glucose swings.

Action steps:

• Use a food scale to measure portions
• Read nutrition labels carefully
• Learn to estimate carbs in common foods
• Consider a diabetes nutrition app for tracking

6. Manage Stress Effectively

Stress hormones like cortisol can raise blood glucose levels. Chronic stress makes diabetes management much harder.

Action steps:

• Practice daily meditation or deep breathing (even 5 minutes helps)
• Engage in hobbies you enjoy
• Maintain social connections
• Consider professional counseling if stress is overwhelming

7. Review and Adjust Medication Timing

Work with your healthcare provider to optimize when you take diabetes medications. Sometimes small timing adjustments can significantly improve TIR.

Action step: Schedule a medication review with your doctor, bringing your CGM data or glucose logs.

How My Health Gheware™ (MHG™) Tracks TIR Automatically

Tracking Time in Range manually can be tedious and time-consuming. That's where My Health Gheware™ comes in.

Automated TIR Calculation

MHG™ automatically calculates your Time in Range from your CGM data:

• CSV Import: Upload CSV files from Dexcom, FreeStyle Libre, or any CGM device
• Instant Analysis: Get your TIR, TAR, and TBR calculated in seconds
• Historical Trends: View TIR trends over 7, 14, or 30 days
• Visual AGP Charts: See your glucose patterns with Ambulatory Glucose Profile visualization

Multi-Factor Correlation Analysis

What sets My Health Gheware™ apart is its ability to correlate TIR with other health factors:

• Sleep Impact: See how sleep duration and quality affect your TIR
• Activity Correlation: Understand how exercise timing impacts glucose control
• Meal Timing: Identify which meals consistently cause spikes
• AI Insights: Get personalized recommendations to improve TIR based on your data patterns

Professional Reports for Your Doctor

Generate comprehensive TIR reports to share with your healthcare team:

• 14-day glucose summary
• TIR trends and patterns
• Identified problem areas (overnight lows, post-breakfast spikes, etc.)
• Suggested adjustments based on AI analysis

Conclusion: TIR is Your Daily Diabetes Report Card

Time in Range has transformed diabetes management from a guessing game into a data-driven science. Unlike HbA1c, which only updates every 3 months, TIR gives you immediate, actionable feedback every single day.

Key Takeaways:

• Aim for at least 70% Time in Range (16+ hours daily in 70-180 mg/dL)
• TIR provides more complete information than HbA1c alone
• Small, consistent changes (meal timing, sleep, exercise) can significantly improve TIR
• Use technology (CGM + MHG™) to automate tracking and get personalized insights

Remember, improving your Time in Range isn't about perfection—it's about progress. Even increasing your TIR by 5-10% can reduce your risk of diabetes complications and improve your quality of life.

Start tracking your TIR today, and you'll be amazed at how empowering data-driven diabetes management can be.