Integrating the Glycemia Risk Index Into Clinical Practice and Research: A Consensus Report

A panel of experts in the use of continuous glucose monitoring (CGM) data in the treatment of diabetes met in Burlingame, California on October 27, 2025 to discuss the utility of the glycemia risk index (GRI) for clinical care research and population health management. The GRI composite metric is a single number (on a 0-100 percentile scale-lower is better) based on an expert-determined weighting of the seven individual components in the existing ambulatory glucose profile (AGP). The GRI describes the quality of glycemia based on glucose values collected in a 14-day CGM tracing, thus providing additional insights into CGM profiles beyond the AGP. During the meeting, the mathematical derivation of the GRI metric was presented along with its use for adult and pediatric individuals with diabetes and cancer who require medications that can adversely affect the glucose concentration. Examples where the GRI provided useful insights into the quality of CGM tracings were also discussed by the expert panel. In addition, a new smartphone application, the GRI Calculator, was presented. This app calculates the GRI of a CGM tracing and provides visualization of sequential CGM tracings for a specific individual. The GRI provides a reference measurement for the accuracy of artificial intelligence (AI) models assigning levels of glycemic quality to CGM tracings intended to match the assessments of clinicians. The GRI is now part of the data visualization panel for the Integration of Connected Diabetes Device Data into the Electronic Health Record (iCoDE-2) project, which standardizes both CGM and insulin dosing data. Further exploration of the potential value of the GRI for non-insulin users needs to be undertaken. The panel unanimously recommended that CGM manufacturers and developers of data visualization software for CGMs add the GRI to their data platforms for insulin users.

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Journal
Journal of Diabetes Science and Technology
Published
2026-03-07
DOI
https://doi.org/10.1177/19322968261432498
Primary Topic
Diabetes Management and Research
Type
article
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article

Integrating the Glycemia Risk Index Into Clinical Practice and Research: A Consensus Report

Marcus Lind, Deborah Osafehinti, Victoria C. Hsiao, Jenise C. Wong et al.
Journal of Diabetes Science and Technology
Diabetes Management and Research
article

Integrating the Glycemia Risk Index Into Clinical Practice and Research: A Consensus Report

Marcus Lind, Deborah Osafehinti, Victoria C. Hsiao, Jenise C. Wong, Michael Snyder, Ralph Oiknine, Mark A. Clements, Sun H. Kim, Steven V. Edelman, M. Kohn, Tracey McLaughlin, Priya Prahalad, Jane Jeffrie Seley, Eugene E. Wright, Elizabeth Healey, Steven Weitzman, A Dunová, Veronica Joyce Brady, D C Klonoff, David Scheinker, I. B. Hirsch, David M. Maahs, Osagie A. Ebekozien, GUIDO FRECKMANN, Boris Kovatchev, Moshe Phillip, Grazia Aleppo, Agatha F. Scheideman, Nestoras Mathioudakis, Lutz Heinemann, Laya Ekhlaspour, David Kerr, Eda Cengiz, Jing Wang, Sultan A. Meo, Julia K. Mader, Mohammed E. Al-Sofiani, Halis K. Akturk, Francis J. Doyle, Mandy M. Shao, Rayhan A. Lal, Viral N. Shah, Guillermo E. Umpierrez
article en

Abstract

A panel of experts in the use of continuous glucose monitoring (CGM) data in the treatment of diabetes met in Burlingame, California on October 27, 2025 to discuss the utility of the glycemia risk index (GRI) for clinical care research and population health management. The GRI composite metric is a single number (on a 0-100 percentile scale-lower is better) based on an expert-determined weighting of the seven individual components in the existing ambulatory glucose profile (AGP). The GRI describes the quality of glycemia based on glucose values collected in a 14-day CGM tracing, thus providing additional insights into CGM profiles beyond the AGP. During the meeting, the mathematical derivation of the GRI metric was presented along with its use for adult and pediatric individuals with diabetes and cancer who require medications that can adversely affect the glucose concentration. Examples where the GRI provided useful insights into the quality of CGM tracings were also discussed by the expert panel. In addition, a new smartphone application, the GRI Calculator, was presented. This app calculates the GRI of a CGM tracing and provides visualization of sequential CGM tracings for a specific individual. The GRI provides a reference measurement for the accuracy of artificial intelligence (AI) models assigning levels of glycemic quality to CGM tracings intended to match the assessments of clinicians. The GRI is now part of the data visualization panel for the Integration of Connected Diabetes Device Data into the Electronic Health Record (iCoDE-2) project, which standardizes both CGM and insulin dosing data. Further exploration of the potential value of the GRI for non-insulin users needs to be undertaken. The panel unanimously recommended that CGM manufacturers and developers of data visualization software for CGMs add the GRI to their data platforms for insulin users.

Journal of Diabetes Science and Technology
Florida State University (US), Northwestern University (US), Sutter Health (US), Central Piedmont Community College (US), Boston Children's Hospital (US), American Diabetes Association (US), The University of Texas MD Anderson Cancer Center (US), Johns Hopkins University (US), Emory University (US), Tel Aviv University (IL), University of California, San Francisco (US), Baylor College of Medicine (US), Universität Ulm (DE), University of Washington (US), Medical University of Graz (AT), Cornell University (US), University of Missouri–St. Louis (US), Brown University (US), American Association of Diabetes Educators (US), Johns Hopkins Medicine (US), South Piedmont Community College (US), Sahlgrenska University Hospital (SE), King Saud University (SA), University of California San Diego (US), NU Hospital Group (SE), Schneider Children's Medical Center (IL), Mills Peninsula Health Services (US), Lurie Children's Hospital (US), Deutsche Diabetes Stiftung (DE), Stanford Medicine (US), System Biosciences (United States) (US), Diabetes Technology Society (US), Indiana University School of Medicine, University of Virginia (US), University of Colorado Anschutz Medical Campus (US), Indiana University – Purdue University Indianapolis (US), University of Gothenburg (SE), The University of Texas Health Science Center at Houston (US), Stanford University (US)
Good health and well-being
Openalex Percentile: Top 31%
Diabetes Management and Research
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