Wetin "Time in Range (TIR)" min fɔ yu we gɛt dayabitis? Mek wi no di rayt tin!

Yu gɛt dayabitis? Ɔ sɔmbɔdi na yu famili ɔ yu padi gɛt dayabitis? Dɔn yu kin dɔn yɛri, ɔ sɔntɛm yu dɔktɔ dɔn tɔk bɔt dis tin we dɛn kɔl ‘Time in Range’. So, lɛ wi tɔk bɔt am simpul ɛn klia wan tide. Pan ɔl we dis na nyu tin smɔl, na sɔntin we kin ɛp bɔku fɔ kɔntrol dayabitis.

Wetin na dis "Taym in Rɛnj" (TIR)?

Fɔ tɔk am simpul wan, “Time in Range” (TIR) ​​na di tɛm we pɔsin we gɛt dayabitis kin kip in blɔd shuga (glucose) lɛvɛl insay wan patikyula target rɛnj . Imajin se yu dɔktɔ tɛl yu fɔ kip yu blɔd shuga lɛvɛl bitwin dis rɛnj ɛn dis rɛnj. Dis de mɛzhɔ aw lɔng yu de insay da rɛnj de.

Fɔ bɔku pipul dɛm wae gɛt shuga, ɔl tu di wan dɛm wae gɛt Tayp 1 Dayabitis ɛn big pipul dɛm wae gɛt Tayp 2 Dayabitis, dis target rɛnj kin de bitwin 70 ɛn 180 miligram pan wan dɛsilita (mg/dL) . Bɔt dis nɔto di sem tin fɔ ɔlman, ɛn i kin difrɛn frɔm wan pɔsin to ɔda pɔsin. Dɛn kin mɛzhɔ TIR as pasɛnt . Dɔktɔ dɛn kin se fɔ tray fɔ mek yu TIR pas 70% . Dat min se yu blɔd shuga fɔ de na da rɛnj de fɔ at le 17 awa pan 24 awa ɛvride. Na da tɛm de yu kin tink se yu dɔn kɔntrol yu dayabitis fayn fayn wan.

Aw yu kin mɛzhɔ dis TIR kɔrɛkt wan?

Di izi ɛn kɔrɛkt we fɔ no yu TIR na fɔ yuz wan Kɔntinyu Glukɔs Monitor (CGM) . Sɔntɛm yu dɔn yɛri bɔt dis divays bifo. Fɔ tru na smɔl tin we pɔsin kin wɛr we dɛn kin put ɔnda di skin na yu an ɔ yu bɛlɛ . we yu de wɛr am, i de kɔntinyu fɔ mɛzhɔ ɛn rikodɔ di glukɔs lɛvɛl na di intastitial fluid ɔnda yu skin 24 awa insay di de. I tan lɛk smɔl ditektiv we de luk fɔ yu shuga. Dɔn yu kin dawnlod dis glukɔs data yuz sɔftwɛl we kɔnɛkt to di CGM divays ɔ wan ap na yu fon ɛn trak yu TIR.

Fɔ tru, yu kin gɛt wan rɔf aidia bɔt yu TIR bay we yu du manual finga prik . Bɔt if yu du dat, yu fɔ chɛk yu blɔd shuga bɔku tɛm insay di de . Ivin da tɛm de, i nɔ de gi bɔku ditayl data lɛk `CGM`. Tink bɔt am lɛk we yu de flip di pej dɛn na buk. Bɔt wan `CGM` tan lɛk fɔ rid di wan ol buk! I de gi yu wan kɔmplit pikchɔ bɔt yu blɔd shuga lɛvɛl.

Bikɔs ɔf dɛn `CGM` mashin ya, bɔku pipul dɛn we gɛt dayabitis ɛn dɛn dɔktɔ dɛn de yuz dis TIR naw fɔ ɛp dɛn fɔ manej dɛn dayabitis.Asɛs yu TIR data kɔrɛkt wan. We yu luk yu TIR data, yu ɛn yu dɔktɔ kin sɛt nyu gol ɛn mek chenj dɛn we nid fɔ apin to yu tritmɛnt plan.

Aw dis TIR ripɔt tan lɛk?

Insay dɛn TIR ripɔt ya, we kɔmɔt frɔm di softwe we de na CGM mashin dɛn, dɛn kin sho di difrɛn difrɛn say dɛn we yu shuga gɛt lɛk wan vertikal bar we gɛt kɔlɔ . I rili izi fɔ ɔndastand.

• Di tɛm we yu shuga lɛvɛl bin de in-rɛnj, dɛn sho am wit grɛn . Dis na wetin wi ɔl de tray fɔ du mɔ.
• Ɔda rɛnj dɛn, we min di tɛm dɛn we di shuga nɔ bɔku ɔ bɔku, dɛn kin sho dɛn wit ɔda kɔlɔ dɛn lɛk yɔlɔ, ɔrɛnj, ɛn rɛd .

Na dis na aw dɛn de sho dɛn rɛnj ya pan wan tipik `CGM` ripɔt (frɔm dɔŋ to ɔp):

• lεs dan 54 mg/dL (< 54 mg/dL) — Vεri lכw (dכn tכgεt). Dis go apia rɛd. Dis kin bi sɔntin we denja.
• Bitwin 54 mg/dL εn 69 mg/dL — Lכw (dכn tכgεt). Dis kin luk ɔrɛnj. Dis na eria bak we yu fɔ pe atɛnshɔn to.
• Bitwin 70 mg/dL ɛn 180 mg/dL — in-rɛnj. Na dat de insay grɛn . Wi ɔl de tray fɔ mek dis grɔn pat big!
• Bitwin 181 mg/dL εn 250 mg/dL — hכy (abov tכgεt). Dis luk lɛk yɔlɔ.
• big pas 250 mg/dL (> 250 mg/dL) — I rili ay (abov di target). Dis kin sho bak as wan rɛd kɔlɔ. If dis kɔntinyu, i nɔ fayn.

Bɔt mɛmba se sɔm CGM ripɔt dɛn kin sho dis data difrɛn we. If yu gɛt prɔblɛm fɔ ɔndastand dis infɔmeshɔn, i go rili fayn fɔ tɔk to yu dɔktɔ . Dɛn kin ɛksplen am to yu.

Aw bɔku mi TIR fɔ bi?

If yu gɛt dayabitis, di target rɛnj fɔ yu blɔd shuga lɛvɛl na yu yon . Dat min se yu target range nɔto di sem wit mi yon. Yu ɛn yu dɔktɔ go disayd togɛda us target rɛnj bɛtɛ fɔ yu ɛn ɔmɔs pan da rɛnj de yu fɔ aim fɔ de insay.Dɛn gol ya kin chenj ɔlsay na yu layf.

difrεn tin dεm de we kin afekt di glukכs tכgεt dεm:

• Aw lɔng yu dɔn gɛt dayabitis ?
• Yu ej ɛn yu jenɛral wɛlbɔdi .
• Yu gɛt ɔda sik dɛn we de afɛkt yu blɔd shuga, lɛk we yu kidni nɔ de wok fayn ɔ we yu gɛt gastroparesis .
• If yu gɛt sik we de mek yu at ɛn blɔd .
• Wan sik wae yu nɔr no bɔt de sayn dɛm wae de sho se yu gɛt smɔl shuga na yu blɔd (hypoglycemia unawareness) .If i de. Dat min se if yu nɔ fil di diziz ɛn swet we yu kin fil we yu shuga lɛvɛl go dɔŋ, i kin mek yu gɛt prɔblɛm smɔl.
• If yu gɛt bɛlɛ ɔ yu de tray fɔ gɛt bɛlɛ , yu gol dɛn kin chenj bɔku pan dɛn tɛm ya.

Okay, naw lɛ wi si wetin na di jenɛral kɔmɛnt dɛn we dɛn kin gi.

TIR target fɔ bɔku big pipul dɛn we gɛt tayp 1 ɔ tayp 2 dayabitis:

• at le 70% pan di tεm bitwin 70 εn 180 mg/dL (insay di rεnj we dεn prεskrib).
• di tεm we i de dכn 54 mg/dL fכ less dan 1%.
• di tεm bitwin 54 εn 69 mg/dL fכ less dan 4%.
• di tεm bitwin 181 εn 250 mg/dL fכ less dan 25%.
• di tεm we i de oba 250 mg/dL fכ less dan 5%.

TIR target fɔ pipul dɛm we gɛt ay pas avɛrej risk fɔ gɛt lɔw blɔd shuga (haypoglycemia):

Dis na fɔ di wan dɛn we kin gɛt smɔl shuga na dɛn blɔd bɔku tɛm.

• atכs 50% pan di tεm bitwin 70 εn 180 mg/dL (insay di nכmal rεnj).
• di tεm we dεn spεnd dכn 70 mg/dL fכ less dan 1%.
• di tεm we i de oba 250 mg/dL fכ less dan 10%.

TIR target fɔ big pipul dɛn we gɛt tayp 1 dayabitis we dɛn gɛt bɛlɛ:

Dis rili impɔtant, bikɔs i kin afɛkt di pikin.

• at le 70% pan di tεm, i de bitwin 63 εn 140 mg/dL (insay di nכmal rεnj). Di range ya difrɛn smɔl, yu si? I rili impɔtant fɔ kɔntrol yu shuga lɛvɛl we yu gɛt bɛlɛ.
• di tεm we i de dכn 63 mg/dL fכ less dan 4%.
• di tεm we i de oba 140 mg/dL fכ less dan 25%.

Di gaydlain fɔ gestational dayabitis ɛn tayp 2 dayabitis we uman gɛt bɛlɛ kin difrɛn. Bak, dis na jenɛral gaydlain. I impɔtant fɔ tɔk to yu dɔktɔ bɔt wetin na di glukɔs we yu want fɔ du we go ɛp yu pas ɔl ɛn we rili rial fɔ yu. Dɛn go advays yu bɔt di bɛst we fɔ du tin fɔ yu sityueshɔn.

Wetin na di rilayshɔn bitwin dis TIR ɛn A1C?

Yu go mɔs dɔn yɛri bɔt dis A1C tɛst . Bɔku dɔktɔ dɛn kin yuz am fɔ si aw dɛn de kɔntrol yu dayabitis fayn fayn wan. So, na TIR en A1C na di sem tin? Yɛs, smɔl smɔl.

TIR de mכsu di rεnj fכ yu glukכs lεvεl fכ wan tεm, frכm fכ awa to fכ de, we yu de wɛr CGM. I tan lɛk se na shɔt tɛm snɛpsho . Yu kin si di rayt we aw yu shuga kin chenj frɔm wan de to di ɔda.

Bɔt A1C na blɔd tɛst we dɛn kin du na lab . I de mɛzhɔ yu avrej glukɔs lɛvɛl fɔ di pas 8 to 12 wik . A1C tɛst nɔ go ebul fɔ tɛl yu aw yu blɔd shuga de chenj. I jɔs de gi wan avrej valyu.

Fɔ tɔk am simpul wan:

Tink bɔt am dis we: A1C tan lɛk we yu de rid sɔm chapta sɔmari na buk.. Bɔt fɔ yuz `CGM` ɛn luk di TIR tan lɛk fɔ rid di wan ol chapta . Dɔn yu kin ɔndastand am mɔ dip, mɔ nyuans . Yu ɔndastand? Di TIR de sho klia wan aw shuga de biev difrɛn tɛm dɛn na di de, afta it, afta ɛksɛsayz.

Frɔm di 1960 dɛm, dɔktɔ ɛn pipul dɛm wae gɛt shuga dɔn de abop mɔ pan A1C fɔ no aw dɛn de mɛn dayabitis de go fayn. Bɔt frɔm we dɛn bigin fɔ yuz CGM mashin dɛn, dɔktɔ dɛn ɛn di wan dɛn we sik dɔn kam fɔ no se dis TIR de mek dɛn gɛt mɔ yusful ɛn kɔrɛkt pikchɔ bɔt aw fɔ mɛn dayabitis .

Ɛspɛshali fɔ pipul dɛn we gɛt Tayp 1 Dayabitis , di blɔd shuga kin chenj bad bad wan fɔ sɔm dez, wik, ɛn mɔnt. So, di avrej A1C valyu nɔto ɔltɛm na kɔrɛkt mɛzhɔ fɔ dɛn manejmɛnt.

Fɔ ɛgzampul, tink bɔt:

Sɔmbɔdi de we in blɔd shuga lɛvɛl de go rili smɔl ɔltɛm ɛn rili ay bak. Bɔt dɛn A1C kin bi 7%.

כda pכsin de we in bכdi shuga lεvεl de stebul na arawnd 154 mg/dL mכst tεm. In A1C kin bi 7% bak.

Si? Ivin if dεn A1C na di sem, dεn TIR valyu kin rili difrεnt. di fכs pכsin in TIR de lכs biכs i de כltεm ausayd di tכgεt rεnj. I de pan ay risk fɔ gɛt haypoglycemia.

Dɔn bak, di A1C tɛst nɔ kin kɔrɛkt pan pipul dɛn we gɛt dɛn sik ya:

• Anemia (blɔd we nɔ de wok fayn).
• Di we dɛn we dɛn kin yuz fɔ mek ɛmoglobin.
• Ayɔn we nɔ de wok fayn.
• We uman gɛt bɛlɛ.
• Liva sik.

di akkuracy fכ A1C valyu dεm kin difrεn bak bitwin difrεn populeshכn dεm.

Bɔt as tin de apin, we TIR kam nɔ min se A1C tɛst nɔ go de igen . Bɔku bɔku risach dɔn sho se di A1C lɛvɛl kin prɛdikt di divɛlɔpmɛnt ɔ prɛvɛnshɔn fɔ di prɔblɛm dɛn we gɛt fɔ du wit dayabitis. So, dכkta dεm de kכmbayn כl tu di TIR εn A1C tεst dεm f כ gεt mכr komplit pikch כ fכ glukכs mεnejmεnt.

Wetin mek dis TIR impɔtant so?

TIR de gi yu mɔ akchual pikchɔ bɔt di chenj we de chenj na di glukɔs lɛvɛl we kin kam wit dayabitis. Tink bɔt aw bɔku tin dɛn kin afɛkt yu shuga, lɛk di it we yu de it, di ɛksesaiz we yu de du, di mɛrɛsin dɛn we yu de tek, ɛn di we aw yu de strɛs ! So, we yu luk yu TIR data (especially wen yu de yuz `CGM`) kin gi yu bεtε כndastandin aw dεn difrεn tin ya de afekt yu glukכs lεvεl dεm dεn wan dεm .

Fɔ ɛgzampul, yu kin notis se yu TIR dɔn go dɔŋ we yu gɛt fiva fɔ wan wik. Ɔ, yu kin notis se yu blɔd shuga dɔn go ɔp bad bad wan afta yu it wan patikyula it, ɛn yu TIR dɔn go dɔŋ. We yu si sɔntin lɛk dat, yu kin aks yu dɔktɔ se, ‘Aw a go bɛtɛ rɛdi fɔ kɔntrol mi dayabitis di nɛks tɛm we a sik?’ Ɔ, yu go tink se, ‘Aw da kayn it de afɛkt mi, ɛn a fɔ chenj di we aw a de it am?’ In ɔda wɔd, TIR kin ɛp yu fɔ kɔntrol yu dayabitis di we we go fayn fɔ yu layf .

Yu tink se prɔblɛm dɛn we gɛt fɔ du wit dayabitis kin apin if TIR dɔn go dɔŋ?

Risach bɔt dis stil de go bifo, bɔt di stɔdi dɛn we dɛn dɔn du naw dɔn sho se as di TIR lɛvɛl de go dɔŋ, di risk fɔ gɛt prɔblɛm dɛn we gɛt fɔ du wit dayabitis de go ɔp .

stכdi dεm sho se big chenj na di bכdi shuga lεvεl (dεn kכl am glycemic variability) kin inkrεs כ ksidεtiv strεs εn inflameshn na di bכdi. Dɛn tin ya kin pwɛl di sɛl dɛn . Sɔm stɔdi dɛn dɔn sho se dɛn big big glukɔs chenj ya gɛt sɔntin fɔ du wit:

• Di risk fɔ mek yu blɔd shuga nɔ bɔku (haypoglycemia).
• Di risk fɔ gɛt sik dɛn we de ambɔg di at ɛn di blɔd.
• Impairment of di kognitiv fכnshכn.
• Di kwaliti fɔ layf we dɔn go dɔŋ.

Dɔn bak, wan stɔdi sho se pipul dɛn we gɛt tayp 2 dayabitis we gɛt smɔl TIR ɛn ay glycemic variability bin gɛt ay risk fɔ gɛt dayabitis-rilayt retinopathy, we na wan kɔmplikeshɔn fɔ dayabitis we kin afɛkt di yay . Wan ɔda stɔdi sho se di lɔw TIR bin rili gɛt fɔ du wit di ay risk fɔ gɛt kadiovaskular ɔtonomik nyuropathy, we na wan nerve disorder we de afɛkt di kadiovaskular sistɛm .

So, dɛn stɔdi ya sho di impɔtant tin fɔ kip yu TIR as ay as yu ebul . As di wan dɛn we de du risach de lan mɔ, di wan dɛn we sabi bɔt dayabitis kin chenj dɛn TIR target ya tumara bambay.

Aw a go inkrisayz mi TIR?

Di men tin fɔ mek yu TIR bɛtɛ na fɔ no di rayt tin we de afɛkt yu glukɔs lɛvɛl . Dis kin tek sɔm tɛm. Infakt, i kin fil lɛk sayɛns ɛkspiriɛns we nɔ de dɔn. So, i impɔtant fɔ pe atɛnshɔn pan wan tin wan tɛm ɛn du gud to yusɛf . Nɔ panik, ɛn tray fɔ no dɛn tin ya smɔl smɔl.

If yu notis se yu glukɔs lɛvɛl de kɔntinyu fɔ go ɔp ɔ dɔŋ sɔm ​​tɛm dɛn na di de, tek tɛm luk yu abit ɛn tin dɛn we yu de du arawnd da tɛm de.

Fɔ ɛgzampul, yu go notis se yu glukɔs lɛvɛl de kɔntinyu fɔ go ɔp afta yu it brɛf. Bɔku rizin dɛn de we mek dis kin apin:

• Nɔto di rayt tɛm fɔ tek yu dayabitis mɛrɛsin (e.g. insulin ).
• Nɔ inɔf ɔ pasmak doz fɔ mɛrɛsin.
• Di balans we di it dɛn we yu de it ɛn di men tin dɛn we de insay de gɛt (kabɔhaydrɛt, fat, ɛn prɔtin) . Sɔntɛm yu de it bɔku bɔku tin dɛn we gɛt kabɔhaydrɛt.
• Ɔda mɛrɛsin fɔ tek na mɔnin (sɔm mɛrɛsin kin afɛkt di blɔd shuga lɛvɛl).
• Fɔ drink tin dɛn we gɛt kafinɛ lɛk kɔfi na mɔnin (dis kin afɛkt sɔm pipul dɛn).

Dis na jɔs wan ɛgzampul. Dayabitis na wan sik we rili kɔmpleks . Bɔrku strateji de wae kin ɛp yu fɔ mek yu TIR bɛtɛ. As ɔltɛm, we yu de tink bɔt fɔ chenj yu manejmɛnt plan, i bɛtɛ fɔ wok wit dayabitis spɛshal pɔsin (e.g., ɛndokrinɔlɔjis) ɔ wan sɛtifiket dayabitis kia ɛn ɛdyukeshɔn spɛshal pɔsin (CDCES) . Dɛn kin gayd yu fɔ du di wok ɛn ansa yu kwɛstyɔn dɛn.

Mɛsej we dɛn kin kɛr go na os

So, dis “Time in Range” (TIR) ​​na nyu ɛn rili yusful we fɔ pipul dɛm wae gɛt dayabitis fɔ mɛzhɔ dɛn glukɔs mɛnejɛmɛnt. Fɔ ɔndastand di TIR infɔmeshɔn ɛn yu glukɔs data kin fil smɔl sɔmtɛm. Nɔ wɔri, yu kin yus to am smɔl smɔl.

Mɛmba se yu dɔktɔ de ɔltɛm fɔ ɛp yu fɔ ɔndastand yu TIR ɛn yuz am fɔ yu bɛnifit. Tugeda, una kin trak aw yu TIR de chenj ova tɛm ɛn ajɔst yu manejmɛnt strateji dɛn akɔdin to dat. Fɔ liv wit dayabitis na prɔblɛm, bɔt wit nyu tin dɛn lɛk dis, i kin izi smɔl. Nɔto yu wan de, ɛn bɔku pipul dɛn de we go ɛp yu fɔ du dis waka.

`Dayabitis, Taym in Rεnj, TIR, Glukɔs, Blɔd Shuga Lεvεl, CGM, A1C