Evaluating the Clinical Utility of the Glycemia Risk Index

The Glycemia Risk Index (GRI) is a composite score designed to simplify continuous glucose monitoring (CGM) interpretation by quantifying risks associated with hypoglycemia, hyperglycemia, and glucose variability in a single number. Although proposed as a decision-support tool, its clinical utility has not been well studied yet.

To evaluate how Diabetes Care and Education Specialists (DCESs) and other health care professionals (HCPs) perceive the GRI and its usefulness in clinical practice, and to assess its perceived advantages, limitations, and potential for integration into the care of individuals with diabetes.

In this observational study, 28 DCESs and other HCPs participated in a virtual educational session about the GRI and then completed an online survey. The survey collected demographic information, preferences for using GRI versus the Ambulatory Glucose Profile (AGP) to evaluate glycemic management, and feedback on the GRI's usefulness. Open-ended qualitative responses were rated independently by investigators on a 5-point Likert scale (1-5, with 1 being least positive/most negative and 5 being most positive/least negative) and analyzed thematically.

Most participants preferred using the GRI alongside the AGP rather than either tool alone. When tracking individual progress over time, 50% preferred using both tools, while 39% preferred the GRI alone, and 11% preferred the AGP alone. The majority (75%) were willing to integrate the GRI into their clinical workflows. Participants rated the GRI highly for its advantages (4.57 ± 0.84) and usefulness for primary care practitioners (4.5 ± 0.96) and diabetes specialists (4.18 ± 1.28), while concerns about disadvantages were moderate (3.04 ± 1.20). Participants discussed in free-text four themes, including how GRI (1) simplifies data, (2) helps clinical decision support, (3) promotes better understanding of CGM data, and (4) needs wider dissemination.

The GRI is perceived as a valuable complement to traditional CGM reports, particularly in facilitating quick clinical assessments and furthering diabetes care and education. While enthusiasm for broader integration is high, barriers such as lack of standardization, limited guideline adoption, and HCP training must be addressed to support its clinical uptake. Future work should assess the GRI's impact on clinical outcomes and explore implementation strategies.