Integrating the Glycemia Risk Index Into Clinical Practice and Research: A Consensus Report
Guillermo E Umpierrez1, Viral N Shah2, Veronica Brady3,4
1Emory University School of Medicine, Atlanta, GA, USA.
Journal of Diabetes Science and Technology
|March 7, 2026
Summary
The new Glycemia Risk Index (GRI) offers a single metric to assess glucose control quality from continuous glucose monitoring (CGM) data. Experts recommend its integration into CGM platforms for improved diabetes management and research.
Area of Science:
- Endocrinology
- Biomedical Informatics
- Data Science
Background:
- Continuous glucose monitoring (CGM) provides extensive data on glucose levels.
- Existing metrics like the Ambulatory Glucose Profile (AGP) offer insights but lack a single composite score.
- There is a need for a standardized metric to evaluate overall glycemic control quality from CGM data.
Purpose of the Study:
- To discuss the utility of the Glycemia Risk Index (GRI) for clinical care, research, and population health management.
- To present the mathematical derivation and application of the GRI metric.
- To introduce the GRI Calculator smartphone application and its role in assessing CGM data.
Main Methods:
- A panel of experts convened to discuss the GRI, a composite metric derived from seven components of the AGP.
- The mathematical basis of the GRI was presented.
- The GRI Calculator app was demonstrated for calculating GRI and visualizing CGM tracings.
Main Results:
- The GRI provides a single, percentile-based score (0-100, lower is better) reflecting glycemia quality over 14 days.
- The GRI demonstrated utility in specific cases, including patients with diabetes and cancer on glucose-affecting medications.
- The GRI serves as a benchmark for AI models assessing glycemic quality and is integrated into the iCoDE-2 project.
Conclusions:
- The expert panel unanimously recommended incorporating the GRI into CGM data platforms for insulin users.
- Further research is needed to explore the GRI's value for non-insulin users.
- The GRI enhances the interpretation of CGM data, aiding clinical care, research, and AI model development.
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