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A new consensus report provides "time in range" targets for people with diabetes who use continuous glucose monitoring (CGM).

The recommendations were also presented June 9 at the American Diabetes Association (ADA) 2019 Scientific Sessions and published online June 8 in Diabetes Care.

In a late-breaking poster, Tadej Battelino, MD, PhD, head of the department of pediatric and adolescent endocrinology at Ljubljana University Medical Centre, Slovenia, detailed the document entitled, Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range.

The report was developed by a panel convened by the Advanced Technologies & Treatments for Diabetes (ATTD) Congress.

The recommendations are endorsed by the ADA, American Association of Clinical Endocrinologists (AACE), American Association of Diabetes Educators (AADE), European Association for the Study of Diabetes (EASD), Foundation of European Nurses in Diabetes, International Society for Pediatric and Adolescent Diabetes, JDRF, and Pediatric Endocrine Society.

Time in range targets are provided for most people with type 1 and type 2 diabetes, for those who are older or at high risk for severe hypoglycemia, and for pregnant women. Recommendations are given for upper and lower blood glucose targets and for time spent in both target and out-of-target ranges. 

"CGM use continues to expand in many countries...However, glycemic control remains suboptimal and successful use of CGM in clinical practices remains low. This may be due in part to the lack of clear and agreed-upon targets for this new way of monitoring and making decisions in diabetes," Battelino said during a press briefing at ADA. 

The targets aren't meant to replace but to complement HbA1c measurement, he said in response to a question from Medscape Medical News.

"The evidence behind HbA1c is immense, so that stays. Time in range is more a day-to-day target...It's supplementing HbA1c and meant to be used mainly by people with diabetes."

Asked to comment, Steven Russell, MD, of Massachusetts General Hospital, Boston, told Medscape Medical News, "I am not necessarily a believer that time in range is the best metric."

"Personally, I think we're better off using mean glucose and time in hypoglycemia as the two criteria. Mean glucose is more closely correlated to HbA1c, and HbA1c is what we have this long-time connection to regarding risk of complications." 

Time in Range Recommendations 

In the document, the recommendations for most people with type 1 or type 2 diabetes are:

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