Trends in Glycemia Risk Index Over Time in Patients With Diabetes and Cancer Undergoing Remote Continuous Glucose
Deborah A Osafehinti1, Sonali Thosani2, Steven P Weitzman2
1Baylor College of Medicine, Houston, TX, USA.
Journal of Diabetes Science and Technology
|July 23, 2026
Summary
Sequential continuous glucose monitoring (CGM) review improved glycemic control in adults with cancer and diabetes. Remote CGM (RCGM) provided comparable results to in-person visits, supporting its use in oncology care.
Area of Science:
- Endocrinology
- Oncology
- Diabetes Management
Background:
- Continuous glucose monitoring (CGM) is crucial for managing diabetes in cancer patients, where HbA1c may be unreliable.
- The Glycemia Risk Index (GRI) quantifies hypoglycemia and hyperglycemia risk using CGM data.
- Evaluating CGM trends in a remote setting is essential for optimizing care in this population.
Purpose of the Study:
- To assess trends in the Glycemia Risk Index (GRI) and other CGM metrics in adults with diabetes and cancer.
- To evaluate the impact of sequential and remote continuous glucose monitoring (RCGM) on glycemic control.
- To compare the effectiveness of RCGM with traditional in-person monitoring.
Main Methods:
- Retrospective chart review of adults with diabetes and cancer undergoing CGM.
- Analysis of sequential CGM assessments, including remote (RCGM) and nonremote data.
- Generalized linear mixed models used to examine time and RCGM effects on GRI, GMI, average glucose, TIR, TAR, and TBR.
Main Results:
- Sequential CGM review showed significant improvements in GRI, GMI, average glucose, TAR, and TIR.
- Remote CGM (RCGM) did not significantly predict glycemic outcomes but was noninferior to nonremote review.
- RCGM demonstrated comparable effectiveness to in-person visits for key glycemic control metrics.
Conclusions:
- Sequential CGM review is associated with improved glycemic quality in adults with diabetes and cancer.
- Remote CGM is a viable and effective adjunct to in-person visits in the oncology setting.
- RCGM supports comparable glycemic outcomes, facilitating flexible patient management.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:22Complications of Diabetes Mellitus
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:19Type I Diabetes III: Clinical Manifestations
Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
01:12Type I Diabetes I: Introduction
Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1 diabetes is an...