Critical Reappraisal of the Time-in-Range: Alternative or Useful Addition to Glycated Hemoglobin?

The HbA1c value is a well-established parameter used to characterize glucose control. Continuous glucose monitoring (CGM)-derived parameters calculated using daily glucose profiles such as Time-in-Range (TiR) have increasingly been gaining interest for assessing a patient’s current therapy. The question has arisen as to whether TiR could replace HbA1c? Because TiR focuses on the current quality of glucose control during a minimum of 10 to 14 days of CGM use and reflects the variability of glucose concentrations. Time-in-Range could be considered an attractive option for improving diabetes control in patients with diabetes. Due to the lack of established standards for glucose measurements with CGM systems, results from different CGM systems can deviate from each other. Time-in-Range should not be viewed as a replacement for HbA1c, but should be used to deliver valuable additional information.