Strengths

Key considerations

%TIR is a dynamic measure of short‐term and medium‐term glycaemia. Easy to track. Can be visualized in a meaningful way. Can be personalized. Provides information that is directly actionable. Responsive to changes in diabetes management that can be viewed in real‐time. Allows SMART objectives to be agreed when goal setting. Can be visualized and interpreted either as a % figure or as an absolute number of hours/minutes per day. Better reflects the day‐to‐day experience of living with diabetes than HbA1c. Provides for different and more‐positive messaging for people with diabetes.

Limited data to link improved %TIR with reduced risk of microvascular and macrovascular complications of diabetes. It is important to acknowledge that small improvements of 5–10% in TIR can deliver significant glycaemic benefits. Women with type 1 diabetes who are pregnant or planning a pregnancy must be supported to reach %TIR targets as early as possible during pregnancy. During pregnancy the %TIR should be considered in conjunction with mean daily glucose, aiming for a mean glucose of 6.0–6.5 mmol/l. %TIR should be used in conjunction with AGP data for a fuller picture of glycaemic health and as a basis for managing therapy and making treatment decisions. Achieving a good %TIR outcome for 3.9–10 mmol/l should not come at the cost of an increase in %TBR.