As pɔrsin wae gɛt shuga, aw yu kin tink bɔt yu blɔd shuga lɛvɛl ɔl di de? Aw dɛn kin de na mɔnin, aw dɛn kin de afta dɛn dɔn it, aw dɛn kin bi bifo dɛn slip, ɛn ɔda tin dɛn. Wan pan di tin dɛm we yu kin yɛri bɔku we yu de tɔk to yu dɔktɔ na di wɔd ‘A1C’. Bɔrku tɛm dɛn kin yuse am fɔ no if yu dɔn kɔntrol yu shuga. Bɔt na A1C na di wan ol stori? Tide wi go tɔk bɔt wan nyu ɛn bɔku yusful we we go gi yu dip ɔndastandin bɔt yu dayabitis pas A1C. Wi de kɔl am ‘Time in Range’ ɔ ‘TIR’.
Wetin na Taym in Rɛnj (TIR)?
Fɔ tɔk am simpul wan, Time in Range (TIR) na di tɛm we yu blɔd shuga lɛvɛl de insay di de we yu de insay yu "target range." Bɔku tɛm, dɛn kin mɛzhɔ dis as pasɛnt.
Naw yu kin de wɔnda wetin na dis "target range". Fɔ bɔku big pipul dɛn we gɛt Tayp 1 ɔ Tayp 2 dayabitis, bɔt nɔto ɔl, dis target rɛnj na di blɔd glukɔs lɛvɛl bitwin 70 mg/dL ɛn 180 mg/dL .
Dɔktɔ dɛn kin se yu fɔ kip yu TIR pas 70% . Dis jɔs min se yu shuga lɛvɛl fɔ de insay da rɛnj de fɔ at le 17 awa pan 24 awa ɛvride.
Aw wi kin mɛzhɔ dis TIR?
Di bɛst ɛn izi we fɔ mɛzhɔ yu TIR kɔrɛkt wan na fɔ yuz wan tin we dɛn kɔl Kɔntinyu Glukɔs Monitor (CGM) . Dis na smɔl tin we yu kin wɛr na yu bɔdi. i de mכsu εn rεkכd di glukכs lεvεl dεm na di intastitial fכluid כnda yu skin 24 awa insay di de. Dɔn yu kin dawnlod da data de to wan ap ɔ softwe fɔ si di rayt tin we yu TIR bi.
Fɔ tru, di we aw dɛn kin tek blɔd frɔm finga kin gi sɔm aidia bak bɔt di TIR. Bɔt fɔ dat yu fɔ chɛk yu shuga bɔku tɛm insay di de. Bɔt di bɔku data we dɛn kin gɛt frɔm CGM pas dat fa fawe. So, di TIR valyu we dɛn gɛt bak rili kɔrɛkt.
Wit dis CGM teknɔlɔji, bɔku pipul dɛm wae gɛt shuga ɛn dɛn dɔktɔ naw de luk dis TIR valyu fɔ asɛs aw dɛn dayabitis mɛnejɛmɛnt de wok fayn fayn wan. Wit dis data, yu ɛn yu dɔktɔ kin sɛt nyu gol ɛn mek chenj dɛn we nid fɔ apin to yu tritmɛnt plan.
Aw a kin si wan ripɔt we dɛn kɔl Time in Range?
If yu yuz CGM, di TIR ripɔt kin sho yu wan vertikal bar we gɛt kɔlɔ. Dis na tin we izi fɔ ɔndastand. Grin de sho we yu blɔd shuga lɛvɛl bin de in-rɛnj. Ɔda kɔlɔ dɛn (yɔlɔ, ɔrɛnj, rɛd) de sho we yu blɔd shuga nɔ bin de (lɔ ɔ ay).
Lɛ wi luk aw wan tipik CGM ripɔt de sho infɔmeshɔn.
| Shuga lεvεl (mg/dL) . | Di minin (status) . |
|---|---|
| I nɔ rich 54 (< 54) . | Rili Lɔw / Blɔ-rɛnj |
| 54 to 69 | Lɔw / Dɔŋ-rɛnj |
| 70 to 180 | In-range - dɛn kin sho am wit grɛn. |
| 181 to 250 | Ay / Abov-rɛnj |
| I pas 250 (> 250) | Rili Ay / Abov-rɛnj |
Yu CGM ripɔt kin sho dis infɔmeshɔn difrɛn we. If yu gɛt ɛni kwɛstyɔn bɔt dis, aks yu dɔktɔ fɔ mek i klarify.
Aw lɔng mi Taym in Rɛnj fɔ bi?
dis rili imכtant: yu glukכs tכgεt rεnj εn TIR tכgεt na yunik fכ yu. Dis min se dɛn kin difrɛn frɔm ɔda pipul dɛn gol.
Yu ɛn yu dɔktɔ go disayd togɛda us gol dɛn we bɛtɛ fɔ yu. Dɔn bak, dɛn gol ya nɔ kin de di sem ɔlsay na yu layf ɛn dɛn kin chenj as tɛm de go.
Tin dɛn lɛk dɛn tin ya kin apin we yu de disayd wetin yu want fɔ du:
- Aw lɔng yu dɔn gɛt dayabitis?
- Yu ej ɛn aw yu go liv yu layf.
- Yu gɛt ɔda sik dɛn we de afɛkt yu blɔd shuga? (e.g., di kidni dεm we de wok fayn, gastroparesis)
- Yu gɛt sik we de mek yu at ɛn blɔd?
- Yu gɛt haypoglycemia unawareness, wan kɔndishɔn wae yu nɔr de fil di sayn dɛm fɔ low blood sugar (hypo)?
- Yu gɛt bɛlɛ ɔ yu op fɔ gɛt bɛlɛ?
Okay, so lɛ wi luk sɔm TIR gol dɛm we pipul dɛn kin aksept. Agen, dis na jɔs jenɛral rɛkɛmɔndeshɔn dɛn. Yu gol kin difrɛn frɔm dis.
| Kɔmɔn gol fɔ bɔku big pipul dɛn we gɛt Tayp 1 ɔ Tayp 2 dayabitis | |
|---|---|
| Pozishɔn | Target (pasɛnt ɔf tɛm insay di de) . |
| Insay di rεnj we dεn prεskrib (70-180 mg/dL) . | At least 70% . |
| Lɔw lɛvɛl (54-69 mg/dL) . | I nɔ rich 4% . |
| Rili lכw lεvεl (< 54 mg/dL) . | I nɔ rich 1% . |
| Ay lεvεl (181-250 mg/dL) . | I nɔ rich 25% . |
| Rili ay lεvεl (> 250 mg/dL) . | I nɔ rich 5% . |
| I de tɔch di wan dɛn we gɛt ay risk fɔ gɛt haypoglycemia | |
|---|---|
| Insay di rεnj we dεn prεskrib (70-180 mg/dL) . | At least 50% . |
| Lכw lεvεl (< 70 mg/dL) . | I nɔ rich 1% . |
| Rili ay lεvεl (> 250 mg/dL) . | I nɔ rich 10% . |
| Target fɔ pipul dɛm we gɛt Tayp 1 dayabitis we dɛn gɛt bɛlɛ | |
|---|---|
| Insay di nɔmal rɛnj (63-140 mg/dL) . | At least 70% . |
| Lכw lεvεl (< 63 mg/dL) . | I nɔ rich 4% . |
| Hεy lεvεl (> 140 mg/dL) . | I nɔ rich 25% . |
Di gol dɛm fɔ gɛt gestational diabetes ɛn tayp 2 dayabitis we yu gɛt bɛlɛ kin difrɛn, so i impɔtant fɔ tɔk to yu dɔktɔ us gol dɛm we go ɛp yu pas ɔl ɛn we yu go rili ebul fɔ du.
Wetin na di rilayshɔn bitwin A1C ɛn TIR?
I rili impɔtant fɔ ɔndastand di difrɛns bitwin dɛn tu tin ya.
- TIR (Time in Range) na wan we fɔ mɛzhɔ we de gi infɔmeshɔn bɔt di chenj we yu shuga lɛvɛl kin chenj fɔ sɔm awa ɔ dez.
- A1C na blɔd tɛst we de sho yu avɛrej blɔd shuga lɛvɛl fɔ di pas 2-3 mɔnt .
Tink bɔt A1C lɛk se yu de rid sɔmari fɔ wan chapta na buk. I de gi yu smɔl aidia. Bɔt TIR tan lɛk fɔ rid di wan ol chapta, ɛvri wɔd, ɛvri sɛntɛns. Yu get evri ditel klia wan. A1C nɔ de gi yu ɛni infɔmeshɔn bɔt aw yu shuga ay ɔ smɔl.
Wetin mek A1C kin mek pipul dɛn nɔ no di tru?
Tink bɔt dɛn tu pipul ya.
1. Fɔs pɔsin: In blɔd shuga de chenj ɔl di de. Sɔntɛnde dɛn kin rili smɔl (hypo), sɔmtɛm dɛn kin rili ay.
2. Sεkכn pכsin: in bכdi shuga lεvεl de stil fayn fayn wan כl di de, arawnd 154 mg/dL.
Dɛn tu pipul ya kin gɛt A1C we na 7%. Bikɔs A1C na jɔs avrej. Bɔt dɛn TIR valyu dɛn rili difrɛn. Di fɔs pɔsin in TIR kin smɔl pasmak. Dat min se dɛn bɔdi de pan ay risk fɔ gɛt di sayd ɛfɛkt dɛm we dayabitis kin gɛt.
Dɔn bak, pipul dɛm wae gɛt dɛn kɔndishɔn ya kin gɛt A1C valyu dɛm wae nɔr kɔrɛkt:
- Anemia we nɔ gɛt bɛtɛ blɔd
- Di we dɛn we dɛn kin yuz fɔ mek ɛmoglobin
- Ayɔn we nɔ de wok fayn
- We uman gɛt bɛlɛ
- Liva sik
Fɔ naw, TIR nɔ go kɔmplit wan fɔ riples di A1C tɛst. Bɔku bɔku risach dɔn sho se di A1C lɛvɛl kin prɛdikt yu risk fɔ gɛt dayabitis kɔmplikeshɔn. Na dat mek dɔktɔ dɛn kin yuz ɔl tu di A1C ɛn TIR togɛda fɔ gɛt mɔ kɔmplit ɛn kɔrɛkt pikchɔ bɔt yu dayabitis mɛnejɛmɛnt.
Wetin mek Taym in Rɛnj (TIR) impɔtant?
TIR de gi yu wan klia pikchɔ bɔt di chenj na di blɔd shuga lɛvɛl we kin kam wit dayabitis. Tin dɛn lɛk di it we wi de it, di ɛksesaiz we wi de du, di mɛrɛsin dɛn we wi de tek, ɛn di we aw wi de strɛs, ɔl de afɛkt di shuga we de na di blɔd. We yu luk yu TIR data, yu kin ɔndastand aw ɛni wan pan dɛn tin ya kin afɛkt yu blɔd shuga lɛvɛl dairekt wan.
Fɔ ɛgzampul, imajin se yu bin gɛt fiva fɔ wan wik. We yu luk yu TIR ripɔt da wik de, yu si se yu TIR valyu dɔn drɔp bad bad wan. Dɔn, di nɛks tɛm we yu sik, yu kin tɔk to yu dɔktɔ bɔt aw fɔ pripia fɔ am ɛn aw fɔ kɔntrol yu dayabitis bifo tɛm.
TIR ɛn di prɔblɛm dɛn we kin apin to pɔsin we gɛt dayabitis
Risach dɔn sho se link de bitwin di lɔw TIR valyu ɛn di kɔmplikeshɔn dɛn we dayabitis kin kam wit.
di glycemic variability kin inkrεs di oksidativ strεs εn inflameshn na di bכdi, we kin damej di sεl dεm na di bכdi. Risach dɔn sho se dis ay chenj we de apin na di blɔd shuga lɛvɛl de mek di risk fɔ:
- Inkris insidɛns fɔ haypoglycemia.
- Di risk fɔ gɛt sik dɛn we de ambɔg di at ɛn di blɔd.
- di impεryans pan di mεntal εn intellektual fכnshכn (cognitive function).
- Di kwaliti fɔ layf we de go dɔŋ.
Dɔn bak, wan stɔdi dɔn sho se di wan dɛn we gɛt Tayp 2 dayabitis we gɛt smɔl TIR ɛn we gɛt ay blɔd shuga we kin chenj, kin gɛt siriɔs kes dɛn we gɛt fɔ du wit dayabitis we gɛt fɔ du wit retinopathy. Wan ɔda stεdi fכn wan strכng כsכshieshכn bitwin lכw TIR εn kכdivaskyul כtכnomik nyuropathy.
Ɔl dis de sho aw i impɔtant fɔ kip yu TIR valyu na di maksimal lɛvɛl.
Aw a go ebul fɔ mek mi Taym in Rɛnj bɛtɛ?
Di men we fɔ mek yu TIR bɛtɛ na fɔ no ustɛm di tin dɛn we de afɛkt yu shuga lɛvɛl. Dis kin tek sɔm tɛm. I kin rili fil lɛk sayɛns ɛkspiriɛns we nɔ gɛt ɛnd.
So, bi gud to yusɛf . Nɔ tray fɔ chenj ɔltin wan tɛm, pe atɛnshɔn pan wan tin wan tɛm.
Imajin se yu notis se yu blɔd shuga kin jɔs kɔmɔt na di rɛnj afta yu it brɛf ɛvride. So, pe atɛnshɔn to di tin dɛn we yu de du ɛn di tin dɛn we yu de du da tɛm de.
Fɔ ɛgzampul, tin dɛn lɛk dis kin mek di blɔd shuga go ɔp afta dɛn dɔn it brɛf:
- Na tɛm fɔ tek yu dayabitis mɛrɛsin (lɛk insulin).
- Di doz fɔ di mɛrɛsin.
- di bεlε fכ di it dεm we yu de it εn di nyutriεnt dεm we de insay (kabohaydret, fεt, protin dεm).
- Ɔda mɛrɛsin dɛn fɔ tek na mɔnin.
- Fɔ drink sɔntin we gɛt kafin, lɛk kɔfi, na mɔnin.
Dis na jɔs wan ɛgzampul. Dayabitis na wan sik we rili kɔmpleks. Bɔrku we de fɔ ɛp fɔ mek yu TIR bɛtɛ. Mɛmba ɔltɛm, bifo yu mek ɛni chenj na yu tritmɛnt plan, tɔk to pɔsin we spɛshal pan dayabitis, lɛk ɛndokrinɔlɔjis ɔ sɛtifiket dayabitis kia ɛn ɛdyukeshɔn spɛshal pɔsin (CDCES), ɔ at ɔl yu rɛgyula dɔktɔ.
Taym in Rεnj (TIR) na nyu εn rili yusful mεtrik fכ mεzj dayabεtis mεnejmεnt. Fɔs, i kin tan lɛk se i at smɔl fɔ ɔndastand ɔl dis TIR infɔmeshɔn ɛn data. Bɔt nɔ wɔri. Yu dɔktɔ go ɛksplen ɔltin ɛn ɛp yu fɔ yuz dis TIR valyu fɔ yu bɛnifit. Tugeda, una kin trak aw yu TIR de chenj as tɛm de go ɛn ajɔst yu manejmɛnt plan akɔdin to dat.
Mɛsej we dɛn kin kɛr go na os
- ‘Taym in Rεnj’ (TIR) na di pasεnshכn tεm we yu bכdi shuga lεvεl de insay di tכgεt rεnj.
- dis de gi yu bכku klia εn mכr ditayl pikchכ fכ aw yu shuga lεvεl de chenj כl di de pas di A1C tεst.
- Yu pasɔnal TIR target na yu ɛn yu dɔktɔ de disayd togɛda. Nɔto di sem tin fɔ ɔlman.
- If yu yuz TIR data, yu ɛn yu dɔktɔ kin disayd fɔ du bɛtɛ tin bɔt tritmɛnt.
- If yu impɔtant yu TIR mak, yu kin ridyus di risk fɔ gɛt lɔng tɛm kɔmplikeshɔn dɛn we dayabitis kin kam wit.
- Dis na wan joyn. Nɔto ɔltin go wok wantɛm wantɛm. Bi gud to yusɛf, smɔl chenj dɛn kin mek big difrɛns.
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