Recent upswings in the use of continuous glucose monitoring (CGM) technologies have given people with diabetes and healthcare professionals unprecedented access to a range of new indicators of glucose control. Some of these metrics are useful research tools and others have been welcomed by patient groups for providing insights into the quality of glucose control not captured by conventional laboratory testing. Among the latter, time in range (TIR) is an intuitive metric that denotes the proportion of time that a person's glucose level is within a desired target range (usually 3.9-10.0 mmol/l [3.5-7.8 mmol/l in pregnancy]). For individuals choosing to use CGM technology, TIR is now often part of the expected conversation between patient and healthcare professional, and consensus recommendations have recently been produced to facilitate the adoption of standardised TIR targets. At a regulatory level, emerging evidence linking TIR to risk of complications may see TIR being more widely accepted as a valid endpoint in future clinical trials. However, given the skewed distribution of possible glucose values outside of the target range, TIR (on its own) is a poor indicator of the frequency or severity of hypoglycaemia. Here, the state-of-the-art linking TIR with complications risk in diabetes and the inverse association between TIR and HbA1c are reviewed. Moreover, the importance of including the amount and severity of time below range (TBR) in any discussions around TIR and, by inference, time above range (TAR) is discussed. This review also summarises recent guidance in setting 'time in ranges' goals for individuals with diabetes who wish to make use of these metrics. For most people with type 1 or type 2 diabetes, a TIR >70%, a TBR <3.9 mmol/l of <4%, and a TBR <3.0 mmol/l of <1% are recommended targets, with less stringent targets for older or high-risk individuals and for those under 25 years of age. As always though, glycaemic targets should be individualised and rarely is that more applicable than in the personal use of CGM and the data it provides.

中文翻译：

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在糖尿病管理中的定位时间。

最近，连续血糖监测（CGM）技术的使用使糖尿病患者和医疗保健专业人员获得了前所未有的一系列血糖控制新指标。这些指标中的一些是有用的研究工具，而其他一些则受到患者群体的欢迎，以提供对常规实验室测试无法捕获的血糖控制质量的见解。在后者中，时间范围（TIR）是一种直观的指标，表示一个人的葡萄糖水平在所需目标范围内的时间比例（通常为3.9-10.0 mmol / l [怀孕时为3.5-7.8 mmol / l]） 。对于选择使用CGM技术的个人来说，TIR现在通常是患者与医疗保健专业人员之间预期对话的一部分，最近已经产生了共识性建议，以促进采用标准化的TIR目标。在监管层面，将TIR与并发症风险联系在一起的新证据可能表明TIR在未来的临床试验中被更广泛地接受为有效终点。但是，考虑到可能的葡萄糖值在目标范围之外的偏斜分布，TIR（单独）不能很好地指示低血糖的发生频率或严重程度。在此，我们综述了TIR与糖尿病并发症风险之间的最新联系以及TIR与HbA1c之间的负相关关系。此外，还讨论了在有关TIR的任何讨论中包括低于范围的时间量（TBR）和严重性的重要性，并据此推断出高于范围的时间（TAR）。该评论还总结了设置“范围内的时间”的最新指南 希望利用这些指标的糖尿病患者的目标。对于大多数1型或2型糖尿病患者，推荐的目标是TIR> 70％，TBR <3.9 mmol / l <4％和TBR <3.0 mmol / l <1％。年龄较大或高风险的人群以及25岁以下的人群。一如既往，血糖目标应个体化，并且很少比个人使用CGM及其提供的数据更适用。