ADA 2019: International Panel Recommends CGM Targets for Time in Range

SAN FRANCISCO — Convened in February 2019, the International Consensus on Time-in-Range (TIR) panel proposed evidence-based clinical targets for routine continuous glucose monitoring (CGM) aimed at improving diabetes management. These recommendations were presented at the American Diabetes Association 79th Scientific Sessions, held June 7 to 11, 2019, in San Francisco, California.

Use of CGM is expanding due to increased accuracy, better reimbursement, and longer-lasting glucose sensors. To enhance the effectiveness of CGM, a panel of experts proposed clear targets for metrics that care teams and patients with diabetes can work to achieve. The International Consensus on TIR proposed the following targets:

• For patients with type 1 and type 2 diabetes, >70% of CGM readings should fall within a target range of 70 to 180 mg/dL each day.
• For patients who are medically frail with type 1 or type 2 diabetes, >50% of CGM readings should fall within a target range of 70 to 180 mg/dL each day. Clinicians should focus on reducing time below range (<70 mg/dL) to <1% each day in this population.
• For pregnant patients with type 1 diabetes, >70% of CGM readings should fall within a target range of 63 to 140 mg/dL.
• For pregnant patients with type 2 or gestational diabetes, >90% of CGM readings should fall within a target range of 63 to 140 mg/dL.

The panel recommends using a standardized CGM report that incorporates key metrics and targets, as well as a 14-day composite glucose profile as a component in clinical decision making. The ambulatory glucose profile is representative of a standard CGM report.

When patients — particularly adolescents and children — are working toward these proposed TIR targets, care teams should emphasize that every 5% increase in TIR is clinically beneficial.

The panel concluded that “[t]he CGM targets and standardized profile proposed by the International TIR Consensus may facilitate the routine use of CGM and improve clinical outcomes of diabetes management.”

Disclosures: Several authors disclosed associations with pharmaceutical companies. Please see the original reference for a full list of disclosures.

Reference

Battelino T, Danne T, Phillip M; for the International Consensus on TIR Targets. CGM-based clinical targets: recommendations from the International Consensus on Time-in-Range (TIR). Presented at: American Diabetes Association 79th Scientific Sessions; June 7-11, 2019; San Francisco, CA. Poster 2-LB.