Continuous Glucose Monitoring Sensor Glucose Data Analysis of Time in Range, Time Above Range, Time Below Range and Waveform Comparison Study of Time in Range Curve Against both Average Daily Glucose Curve and Glucose Fluctuation Curve for a 3.3 Year Period based on GH-Method: Math-Physical Medicine (No. 500)

Abstract

The author applies quantitative pattern and trend analysis tools using his collected continuous glucose monitoring (CGM) sensor data during a 3.3 year period from 5/8/2018 to 8/25/2021. Special attention has been placed on applying the American Diabetes Association (ADA) 2020 Guidelines for Time In Range (TIR) % with TIR average glucose values, Time Above Range (TAR) % with TAR average glucose value, and Time Below Range (TBR) % with TBR average glucose value. The purpose of this article is to study the correlations between the TIR curve and both average daily glucose curve (eAG) and glucose fluctuation curve (GF). GF is defined as the difference between the maximum glucose and the minimum glucose within one day or 24 hours duration. This GF term expresses the same meaning as the glycemic variability (GV) used by some diabetes research scientists. However, the author prefers GF over GV since GF describes the amplitude of glucose excursion in an exact and most direct way. Depending on the object of his research project, he sometimes selects the GF value within a meal’s PPG waveform of a 3-hours duration. Furthermore, the “primary range” of TIR is defined between 70 mg/dL and 180 mg/dL while a “secondary range” of TIR is defined between 70 mg/dL and 140 mg/dL. Of course, both the TIR’s and TAR’s percentages and their averaged values of secondary range (difference of 70 mg/dL) are smaller than the primary range results due to the secondary range’s narrower glucose range of 40 mg/dL (110-70 or 180-140). In summary, there are five noticeable findings from this study: (1) TIR: His TIR percentage (89%) and average TIR value (121 mg/dL) of the primary range, along with the TIR percentage (72%) and average TBR value (114 mg/dL) of the secondary range represent the majority of the data. This means that his type 2 diabetes (T2D) is quite well under control. (2) TBR: His TBR percentage (5%) and average TBR value (65 mg/dL) of the primary range, along with the same TBR percentage (5%) and the same average TBR value (65 mg/dL) of the secondary range contain rather small amounts. This means that his risk of having hypoglycemia (insulin shock) is relatively low.