Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

Established clinical targets should be used to individualize glycemic targets and adjust therapy based on each individual’s overall health status, concomitant medical condition (eg, pregnancy, frailty), and risk for hypoglycemia:

• Number of days of active CGM use: 14 days preferred
• Percentage of data available from active CGM use: >70% of data from 14 days
• Mean glucose: Individualized to targets
• Glucose management indicator (GMI): Individualized to targets
• Glycemic variability, percent coefficient of variation (%CV [coefficient of variation]): 36%

• Percentage of time in range (%TIR) 70 to 180 mg/dL: >70%
• Percentage of time below range (%TBR) <70 mg/dl: <4%
• %TBR <54 mg/dL: <1%
• Percentage of time above range (%TAR) >180 mg/dL: <25%
• %TAR >250 mg/dL: <5%

• %TIR 70 to 180 mg/dL: >50%
• %TBR 250 mg/dL: 70%: <1%
• %TBR <54 mg/dL: ~0%
• %TAR >140 mg/dL: <25%

• %TIR 63 to 140 mg/dL: >70%
• %TBR <63 mg/dL: <4%
• %TBR <54 mg/dL: <1%
• %TBR >140 mg/dL: <25%

(CL-I2)

Two metrics, %TIR and %TBR, should be used as a starting point for the assessment of quality of glycemic control and as the basis for therapy adjustment, with emphasis on reducing %TBR when the percentages of CGM values falling below 54 mg/dL or 70 mg/dL are close to or exceed targets. (BL-I1)