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dc.contributor.authorKlonoff, David C
dc.contributor.authorWang, Jing
dc.contributor.authorRodbard, David
dc.contributor.authorKohn, Michael A
dc.contributor.authorLi, Chengdong
dc.contributor.authorLiepmann, Dorian
dc.contributor.authorKerr, David
dc.contributor.authorAhn, David
dc.contributor.authorPeters, Anne L
dc.contributor.authorUmpierrez, Guillermo E
dc.contributor.authorSeley, Jane Jeffrie
dc.contributor.authorXu, Nicole Y
dc.contributor.authorNguyen, Kevin T
dc.contributor.authorSimonson, Gregg
dc.contributor.authorAgus, Michael S D
dc.contributor.authorAl-Sofiani, Mohammed E
dc.contributor.authorArmaiz-Pena, Gustavo
dc.contributor.authorBailey, Timothy S
dc.contributor.authorBasu, Ananda
dc.contributor.authorBattelino, Tadej
dc.contributor.authorBekele, Sewagegn Yeshiwas
dc.contributor.authorBenhamou, Pierre-Yves
dc.contributor.authorBequette, B Wayne
dc.contributor.authorBlevins, Thomas
dc.contributor.authorBreton, Marc D
dc.contributor.authorCastle, Jessica R
dc.contributor.authorChase, James Geoffrey
dc.contributor.authorChen, Kong Y
dc.contributor.authorChoudhary, Pratik
dc.contributor.authorClements, Mark A
dc.contributor.authorClose, Kelly L
dc.contributor.authorCook, Curtiss B
dc.contributor.authorDanne, Thomas
dc.contributor.authorDoyle, Francis J
dc.contributor.authorDrincic, Angela
dc.contributor.authorDungan, Kathleen M
dc.contributor.authorEdelman, Steven V
dc.contributor.authorEjskjaer, Niels
dc.contributor.authorEspinoza, Juan C
dc.contributor.authorFleming, G Alexander
dc.contributor.authorForlenza, Gregory P
dc.contributor.authorFreckmann, Guido
dc.contributor.authorGalindo, Rodolfo J
dc.contributor.authorGomez, Ana Maria
dc.contributor.authorGutow, Hanna A
dc.contributor.authorHeinemann, Lutz
dc.contributor.authorHirsch, Irl B
dc.contributor.authorHoang, Thanh D
dc.contributor.authorHovorka, Roman
dc.contributor.authorJendle, Johan H
dc.contributor.authorJi, Linong
dc.contributor.authorJoshi, Shashank R
dc.contributor.authorJoubert, Michael
dc.contributor.authorKoliwad, Suneil K
dc.contributor.authorLal, Rayhan A
dc.contributor.authorLansang, M Cecilia
dc.contributor.authorLee, Wei-An Andy
dc.contributor.authorLeelarathna, Lalantha
dc.contributor.authorLeiter, Lawrence A
dc.contributor.authorLind, Marcus
dc.contributor.authorLitchman, Michelle L
dc.contributor.authorMader, Julia K
dc.contributor.authorMahoney, Katherine M
dc.contributor.authorMankovsky, Boris
dc.contributor.authorMasharani, Umesh
dc.contributor.authorMathioudakis, Nestoras N
dc.contributor.authorMayorov, Alexander
dc.contributor.authorMessler, Jordan
dc.contributor.authorMiller, Joshua D
dc.contributor.authorMohan, Viswanathan
dc.contributor.authorNichols, James H
dc.contributor.authorNørgaard, Kirsten
dc.contributor.authorO'Neal, David N
dc.contributor.authorPasquel, Francisco J
dc.contributor.authorPhilis-Tsimikas, Athena
dc.contributor.authorPieber, Thomas
dc.contributor.authorPhillip, Moshe
dc.contributor.authorPolonsky, William H
dc.contributor.authorPop-Busui, Rodica
dc.contributor.authorRayman, Gerry
dc.contributor.authorRhee, Eun-Jung
dc.contributor.authorRussell, Steven J
dc.contributor.authorShah, Viral N
dc.contributor.authorSherr, Jennifer L
dc.contributor.authorSode, Koji
dc.contributor.authorSpanakis, Elias K
dc.contributor.authorWake, Deborah J
dc.contributor.authorWaki, Kayo
dc.contributor.authorWallia, Amisha
dc.contributor.authorWeinberg, Melissa E
dc.contributor.authorWolpert, Howard
dc.contributor.authorWright, Eugene E
dc.contributor.authorZilbermint, Mihail
dc.contributor.authorKovatchev, Boris
dc.date.accessioned2022-04-18T15:02:32Z
dc.date.available2022-04-18T15:02:32Z
dc.date.issued2022-03-29
dc.identifier.urihttp://hdl.handle.net/10713/18597
dc.description.abstractBackground: 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.en_US
dc.description.urihttps://doi.org/10.1177/19322968221085273en_US
dc.language.isoenen_US
dc.publisherSAGE Publications Inc.en_US
dc.relation.ispartofJournal of Diabetes Science and Technologyen_US
dc.subjectambulatory glucose profileen_US
dc.subjectcomposite metricen_US
dc.subjectcontinuous glucose monitoren_US
dc.subjectdiabetesen_US
dc.subjectglycemia risk indexen_US
dc.subjecthyperglycemiaen_US
dc.subjecthypoglycemiaen_US
dc.subjecttime in rangeen_US
dc.titleA Glycemia Risk Index (GRI) of Hypoglycemia and Hyperglycemia for Continuous Glucose Monitoring Validated by Clinician Ratings.en_US
dc.typeArticleen_US
dc.identifier.doi10.1177/19322968221085273
dc.identifier.pmid35348391
dc.source.journaltitleJournal of diabetes science and technology
dc.source.beginpage19322968221085273
dc.source.endpage
dc.source.countryUnited States


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