02/11/2025

Time in Range: Your Personal Guide to Setting Better Blood Sugar Goals

Have you ever wondered if your blood sugar targets are actually right for you? If you’re living with diabetes, you’ve probably been given standard numbers to aim for – but here’s something that might surprise you: your ideal glucose goals could be quite different from your neighbor’s, even if you both have diabetes.

Managing diabetes isn’t a one-size-fits-all approach, and that’s especially true when it comes to time in range targets. Your age, health conditions, and personal circumstances all play important roles in determining what your blood sugar goals should be. Let’s explore how you can work with your healthcare team to create personalized glucose goals that make sense for your unique situation.

Understanding Time in Range and Why It Matters

Time in Range, or TIR, measures how much time your blood glucose stays within your target range during a specific period, usually 24 hours or two weeks. Think of it as a report card for your diabetes management – but instead of just looking at your average grade, it shows you how consistently you’re hitting your targets.

For most adults with diabetes, the standard target range is 70-180 mg/dL (3.9-10.0 mmol/L), and the goal is to spend at least 70% of your time in this range. That translates to about 16 hours and 48 minutes of every day. However, this standard might not be appropriate for everyone.

The beauty of focusing on time in range is that it gives you and your healthcare team a more complete picture of your glucose control. Traditional measures like A1C provide an average over 2-3 months, but they don’t show the daily ups and downs that can significantly impact how you feel and your long-term health outcomes.

How Age Changes Your Glucose Goals

Your age plays a crucial role in determining what your personalized glucose goals should look like. As we get older, our bodies change, our risk factors shift, and our priorities often evolve too.

Young Adults with Diabetes

If you’re a young adult with diabetes, your healthcare team might recommend more aggressive targets. This is because you likely have decades ahead of you, and tighter control now can help prevent complications later. Young adults often have:

More flexibility to manage low blood sugar episodes
Better ability to recognize and treat hypoglycemia
Longer life expectancy, making long-term complication prevention a priority
More energy and motivation to maintain intensive management

For younger people, aiming for 70% or even higher time in range might be appropriate, with a target range of 70-180 mg/dL or potentially even tighter ranges in some cases.

Middle-Aged Adults

Middle-aged adults with diabetes often face unique challenges. You might be juggling career demands, family responsibilities, and the beginning of age-related health changes. Your personalized glucose goals need to account for:

Work stress and irregular schedules
Hormonal changes that can affect blood sugar
The onset of other health conditions
Balancing diabetes management with other life priorities

The standard 70% time in range goal often works well for this age group, but adjustments might be needed based on your specific circumstances and other health conditions.

Older Adults and Seniors

If you’re over 65, your diabetes management approach should be quite different from someone in their 20s or 30s. Older adults face unique risks and considerations that require more individualized glucose goals:

Higher risk of severe hypoglycemia and its complications
Presence of multiple health conditions
Potential cognitive changes that affect diabetes self-management
Shorter life expectancy, which changes the benefit-risk balance of tight control

For many older adults, a more relaxed target range might be appropriate – perhaps 70-200 mg/dL (3.9-11.1 mmol/L) or even broader ranges in some cases. The time in range goal might also be adjusted to 50-60% instead of the standard 70%.

When Other Health Conditions Change the Game

Diabetes rarely travels alone. Many people with diabetes also have other health conditions, called comorbidities, that can significantly impact what their glucose goals should be. Let’s look at how common comorbidities affect personalized glucose goals.

Heart Disease and Diabetes

If you have both diabetes and heart disease, your glucose management becomes more complex. Heart disease can make severe hypoglycemia more dangerous, as low blood sugar can stress your cardiovascular system. At the same time, high blood sugar levels can worsen heart disease.

Your healthcare team might recommend:

A slightly higher low-end target to reduce hypoglycemia risk
Careful monitoring during exercise and physical activity
Coordination between your diabetes care team and cardiologist
Adjusted medications that consider both conditions

Kidney Disease Considerations

Kidney disease, or diabetic nephropathy, affects how your body processes glucose and diabetes medications. If you have kidney disease along with diabetes, your personalized glucose goals might include:

Modified target ranges based on kidney function
Different time in range goals to account for medication limitations
More frequent monitoring due to unpredictable glucose patterns
Careful coordination with your kidney specialist

Living with Diabetes and High Blood Pressure

High blood pressure is incredibly common among people with diabetes. When you have both conditions, your glucose goals need to consider:

How certain blood pressure medications affect blood sugar
The importance of avoiding both very high and very low glucose levels
Lifestyle modifications that benefit both conditions
Regular monitoring of both conditions together

Creating Your Personal Glucose Management Plan

Working with your healthcare team to develop personalized glucose goals is a collaborative process. It’s not just about the numbers – it’s about creating a plan that works for your real life.

Factors Your Healthcare Team Considers

When developing your personalized glucose goals, your healthcare team looks at many factors beyond just your A1C or current blood sugar levels:

Your age and overall health status
How long you’ve had diabetes
Your history with hypoglycemia
Other medications you’re taking
Your lifestyle, work schedule, and daily routines
Your personal preferences and quality of life goals
Your support system and resources

The Conversation You Should Have

Don’t be afraid to have an open conversation with your healthcare team about your goals and concerns. Some important questions to discuss include:

What time in range goal makes sense for my specific situation?
How should my other health conditions affect my glucose targets?
What are the risks and benefits of tighter versus more relaxed control for me?
How often should we reassess and potentially adjust my goals?
What warning signs should I watch for that might indicate my goals need to change?

Technology Tools for Personalized Monitoring

Modern diabetes technology has made it much easier to track time in range and work toward personalized glucose goals. Continuous glucose monitors (CGMs) provide real-time data that helps you and your healthcare team see patterns and make informed decisions.

Making the Most of Your Data

If you use a CGM or regularly check your blood sugar, you’re generating valuable data that can help refine your personalized glucose goals. Look for patterns like:

Times of day when you’re most likely to be out of range
How different foods, activities, or stressors affect your glucose
Whether your current targets feel achievable and sustainable
How your time in range relates to how you feel day-to-day

Beyond the Numbers

Remember that your glucose data is just one piece of the puzzle. Your personalized glucose goals should also consider:

How you feel when your glucose is in different ranges
Your energy levels and ability to function normally
Your sleep quality and mood
Your overall quality of life and well-being

Adjusting Goals Over Time

Your personalized glucose goals aren’t set in stone. As your life changes, your health evolves, and new treatments become available, your goals should be reassessed and potentially adjusted.

When to Reassess Your Goals

Consider talking to your healthcare team about adjusting your personalized glucose goals when:

You develop new health conditions
Your current goals feel too difficult or too easy to achieve
You experience changes in your ability to recognize low blood sugar
Your life circumstances change significantly
New diabetes technologies or treatments become available to you

The Importance of Regular Check-ins

Schedule regular appointments with your healthcare team to review your progress and discuss whether your current goals are still appropriate. These check-ins are opportunities to:

Review your time in range data and trends
Discuss any challenges you’re facing
Adjust medications or management strategies
Set new goals for the coming months
Address any concerns or questions you have

Living Successfully with Personalized Goals

Having personalized glucose goals that make sense for your situation can make diabetes management feel more achievable and less overwhelming. Remember that the “perfect” numbers on paper aren’t always the right numbers for you as an individual.

Your diabetes management plan should support your overall health and well-being, not create additional stress or unrealistic expectations. Work with your healthcare team to find the sweet spot where your glucose goals are ambitious enough to protect your long-term health but realistic enough to maintain your quality of life.

The key to success with personalized glucose goals is finding the approach that you can stick with long-term. Small, consistent improvements in your time in range can add up to significant benefits for your health and how you feel every day.

Managing diabetes is a marathon, not a sprint. Your personalized glucose goals should support you in running that marathon successfully, taking into account not just where you want to go, but also where you’re starting from and what resources you have for the journey. With the right goals and support, you can achieve better glucose control while living the life you want to live.

Dr Sagar Kajbaje