title: Translating glucose variability metrics into the clinic via Continuous Glucose Monitoring: a Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©).
abstract: BACKGROUND
  Several metrics of glucose variability have been proposed to date, but an integrated approach that provides a complete and consistent assessment of glycemic variation is missing. As a consequence, and because of the tedious coding necessary during quantification, most investigators and clinicians have not yet adopted the use of multiple glucose variability metrics to evaluate glycemic variation.
  
  
  METHODS
  We compiled the most extensively used statistical techniques and glucose variability metrics, with adjustable hyper- and hypoglycemic limits and metric parameters, to create a user-friendly Continuous Glucose Monitoring Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©). In addition, we introduce and demonstrate a novel transition density profile that emphasizes the dynamics of transitions between defined glucose states.
  
  
  RESULTS
  Our combined dashboard of numerical statistics and graphical plots support the task of providing an integrated approach to describing glycemic variability. We integrated existing metrics, such as SD, area under the curve, and mean amplitude of glycemic excursion, with novel metrics such as the slopes across critical transitions and the transition density profile to assess the severity and frequency of glucose transitions per day as they move between critical glycemic zones.
  
  
  CONCLUSIONS
  By presenting the above-mentioned metrics and graphics in a concise aggregate format, CGM-GUIDE provides an easy to use tool to compare quantitative measures of glucose variability. This tool can be used by researchers and clinicians to develop new algorithms of insulin delivery for patients with diabetes and to better explore the link between glucose variability and chronic diabetes complications.
authors.affiliation: Center for Computational Medicine and Bioinformatics, University of Michigan, 100 Washtenaw Avenue, Ann Arbor, MI 48109-1055, USA.
authors.forename: Renata A
authors.initials: RA
authors.lastname: Rawlings
authors.forename: Hang
authors.initials: H
authors.lastname: Shi
authors.forename: Lo-Hua
authors.initials: LH
authors.lastname: Yuan
authors.forename: William
authors.initials: W
authors.lastname: Brehm
authors.forename: Rodica
authors.initials: R
authors.lastname: Pop-Busui
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Nelson
mesh_terms: D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000379:methods* / Q000592:standards; D003627:Data Interpretation, Statistical; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000378:metabolism*; D006801:Humans; D049451:Nomograms
chemical_list: D001786:Blood Glucose