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SHR Neuro Cancer Cardio Lipid Metab Microb

Klonoff, DC; Wang, J; Rodbard, D; Kohn, MA; Li, C; Liepmann, D; Kerr, D; Ahn, D; Peters, AL; Umpierrez, GE; Seley, JJ; Xu, NY; Nguyen, KT; Simonson, G; Agus, MSD; Al-Sofiani, ME; Armaiz-Pena, G; Bailey, TS; Basu, A; Battelino, T; Bekele, SY; Benhamou, PY; Bequette, BW; Blevins, T; Breton, MD; Castle, JR; Chase, JG; Chen, KY; Choudhary, P; Clements, MA; Close, KL; Cook, CB; Danne, T; Doyle, FJ; Drincic, A; Dungan, KM; Edelman, SV; Ejskjaer, N; Espinoza, JC; Fleming, GA; Forlenza, GP; Freckmann, G; Galindo, RJ; Gomez, AM; Gutow, HA; Heinemann, L; Hirsch, IB; Hoang, TD; Hovorka, R; Jendle, JH; Ji, L; Joshi, SR; Joubert, M; Koliwad, SK; Lal, RA; Lansang, MC; Lee, WA; Leelarathna, L; Leiter, LA; Lind, M; Litchman, ML; Mader, JK; Mahoney, KM; Mankovsky, B; Masharani, U; Mathioudakis, NN; Mayorov, A; Messler, J; Miller, JD; Mohan, V; Nichols, JH; Nørgaard, K; O'Neal, DN; Pasquel, FJ; Philis-Tsimikas, A; Pieber, T; Phillip, M; Polonsky, WH; Pop-Busui, R; Rayman, G; Rhee, EJ; Russell, SJ; Shah, VN; Sherr, JL; Sode, K; Spanakis, EK; Wake, DJ; Waki, K; Wallia, A; Weinberg, ME; Wolpert, H; Wright, EE; Zilbermint, M; Kovatchev, B.
A Glycemia Risk Index (GRI) of Hypoglycemia and Hyperglycemia for Continuous Glucose Monitoring Validated by Clinician Ratings.
J Diabetes Sci Technol. 2023; 17(5):1226-1242 Doi: 10.1177/19322968221085273 [OPEN ACCESS]
Web of Science PubMed FullText FullText_MUG

 

Co-authors Med Uni Graz

Mader Julia

Pieber Thomas

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Abstract:

BACKGROUND: A composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data. METHODS: We assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low-glucose and low-glucose hypoglycemia; very high-glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation. RESULTS: The analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals. CONCLUSION: The GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic effects of prescribed and investigational treatments.

Find related publications in this database (using NLM MeSH Indexing)

Adult - administration & dosage

Humans - administration & dosage

Blood Glucose - administration & dosage

Blood Glucose Self-Monitoring - administration & dosage

Hypoglycemia - diagnosis

Hyperglycemia - diagnosis

Glucose - administration & dosage

Find related publications in this database (Keywords)

ambulatory glucose profile

composite metric

continuous glucose monitor

diabetes

glycemia risk index

hyperglycemia

hypoglycemia

time in range

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