Related Experiment Video
Updated: Aug 13, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
How good is your glucose control?
A Michael Albisser1, Rodolfo Alejandro, Luigi F Meneghini
1Bioengineering Department, University of California San Diego, La Jolla, California, USA. albisser@NIDM.org
Background:
Glycemic control is fundamental to the management of diabetes and maintenance of health. Popular measures of performance in glycemic control include A1c and self-monitoring of blood glucose (SMBG). As measures of performance, A1c has perspective, but it fails to recognize hypoglycemia, while SMBG lacking overall perspective finds use mainly by patients to simply evaluate their glycemic status and current response to therapy. An additional, preferably visual, measure of performance in diabetes management in general and glycemic control in particular is needed.
Methods:
To form a visual measure of performance, a graphical method of analysis from the statistician's toolbox (known as the lag plot) was adapted. It can utilize SMBG data sets from any source, including memory meters and registry databases in call centers. Data are retrieved, processed, formatted, and then plotted on a PC screen or printer. The resulting lag plots visually characterize the performance of glucose control achieved over periods (selectable by the user) from days to months. Supporting numerical statistics provide rigorous outcome measures that correlate with glycated hemoglobin.
Results:
Clinical use of the lag plot is illustrated in seven case studies spanning the range from no diabetes, through glucose intolerance, early-onset type 2 diabetes mellitus, type 1 diabetes, intensified therapy, pump therapy, and finally islet cell transplantation. Visual comparisons before and after action/referral show impacts of interventions, incidences of hypoglycemia, and changes in the polyglycemia of unstable diabetes. Statistical significance of observed changes are quantified.
Conclusions:
The simple lag plot can empower patients and their providers to identify problems in glycemic control, seek proactive action, adopt beneficial strategies, evaluate outcomes, and, most importantly, rule out interventions with no benefit.
Related Concept Videos
Hyperglycemia
Diabetes Mellitus: Type 2 and Gestational
Diabetes: Symptoms, Diagnosis, and Complications
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Glucose Homeostasis: Regulation of Blood Glucose
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
Hypoglycemia and Glucagon