Healthcare Professionals’ Knowledge of and Attitudes Towards the Use of Time in Range in Diabetes Management: Online Survey Across Seven Countries

• Published in: Diabetes therapy 2023-08, Vol.14 (8), p.1399-1413
• Main Authors: De Block, Christophe, Cheng, Alice Y. Y., Christensen, Trine Brandt, Patted, Usha Rani H., Ginovker, Anna
• Format: Article
• Language: English
• Subjects: Blood sugar; Blood sugar monitoring; Cardiology; Clinical practice guidelines; Control; Diabetes; Diabetes therapy; Empowerment; Endocrinology; Glucose monitoring; Internal Medicine; Medical personnel; Medicine; Medicine & Public Health; Methods; Nurse practitioners; Nurse specialists; Nurses; Original Research; Physician assistants; Quality management; Surveys
• ISSN: 1869-6953; 1869-6961
• DOI: 10.1007/s13300-023-01429-x

Introduction Time in range (TIR) is a metric of glycaemic target management derived from continuous glucose monitoring (CGM) data. This study aimed to understand knowledge of and attitudes towards use of TIR among healthcare professionals (HCPs), and gain insights into benefits and barriers to its use in clinical practice. Methods An online survey was disseminated across seven countries. Participants were sampled from online HCP panels and were aware of TIR (defined as amount of time in, below, and above target range). Participants were HCPs classified as specialists (SP), generalists (GP), or allied HCPs (AP; diabetes nurse specialists, diabetes educators, general nurses, nurse practitioners/physician assistants). Results Respondents included 741 SP, 671 GP and 307 AP. Most HCPs (approximately 90%) agreed TIR is likely/somewhat likely to become the standard of diabetes management. Perceived benefits of TIR included helping to optimise medication regimen (SP, 71%; GP, 73%; AP, 74%), giving HCPs the knowledge and insights to make informed clinical decisions (SP, 66%; GP, 61%; AP, 72%), and empowering people with diabetes with information to successfully manage their diabetes (SP, 69%; GP, 77%; AP, 78%). Barriers to wider adoption included limited CGM access (SP, 65%; GP, 74%; AP, 69%) and lack of HCP training/education (SP, 45%; GP, 59%; AP, 51%). Most participants considered integration of TIR into clinical guidelines, recognition of TIR by regulators as a primary clinical endpoint, and recognition of TIR by payers as a parameter for diabetes treatment evaluation as key factors for increased use. Conclusions Overall, HCPs agreed on the benefits of using TIR for diabetes management. Besides raising awareness among HCPs and people with diabetes, more training and healthcare system updates are needed to facilitate increased TIR use. In addition, integration into clinical guidelines and recognition by regulators and payers are needed. Plain Language Summary ‘Time in range’ is the proportion of time in a day that a person’s glucose level is within a particular range. The purpose of this study was to understand knowledge of and attitudes towards use of TIR among healthcare professionals. The study was carried out using an online survey and participants from seven countries were included. Participants were healthcare professionals classified as specialists (SP), generalists (GP), or allied healthcare professionals (AP; diabetes nurse specialists, diabetes educato