News & Press
AGP is included in the ADA's Standards of Care recommendation for glucose assessment, "standardized, single-page reports with visual cues such as the Ambulatory Glucose Profiles (AGP) should be considered as a standard printout for all CGM devices."
- American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes—2023. Diabetes Care 2023;46(Supplement_1):S97–S110 https://doi.org/10.2337/dc23-S006
Updated Standards of Medical Care in Diabetes from ADA
On July 31, 2019, the American Diabetes Association released updated standards of medical care, with changes focusing on new metrics and reporting of continuous glucose monitoring (CGM) data, and new medication options. The glucose monitoring update was prompted by the publication of a broadly endorsed set of recommendations of the International Consensus on Time in Range (Battelino T, Danne T, Bergenstal RM, et al. Diabetes Care 2019 Jun 8). The ADA standards of medical care now provide guidance on standardized CGM metrics (see NEW Table at https://care.diabetesjournals.org/table_6.4_New). To make these metrics more actionable, standardized reports with visual cues, such as the Ambulatory Glucose Profile (see NEW Figure of AGP https://care.diabetesjournals.org/content/diacare/42/8/1593/F2.large.jpg) are recommended and may help the patient and the provider interpret the data and use it to guide treatment decisions.
Notably the ambulatory glucose profile report (AGP Report) was developed by the International Diabetes Center and is now being used across the globe to evaluate CGM data. More details here: https://care.diabetesjournals.org/content/42/Supplement_1/S61 or www.AGPreport.org.
1. Assessment, G. (2022). 6. Glycemic Targets: Standards of Medical Care in Diabetes—2022. Diabetes Care, 45, S83.
2. Bergenstal RM, Simonson GD, & Heinemann L. (2022) More green, less red: how color standardization may facilitate effective use of CGM data. Journal of diabetes science and technology, 16(1), 3-6.
3. Beck RW & Bergenstal RM. (2021). Beyond A1C—standardization of continuous glucose monitoring reporting: why it is needed and how it continues to evolve. Diabetes Spectrum, 34(2), 102-108.
4. Martens T, Beck RW, Bailey R, Ruedy KJ, Calhoun P, Peters AL, et al. & MOBILE Study Group. (2021). Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial. JAMA, 325(22), 2262- 2272.
5. Advani A. (2020) Positioning time in range in diabetes management. Diabetologia; 63(2), 242-252.
6. Johnson ML, Martens TW, Criego AB, Carlson AL, Simonson GD, & Bergenstal RM. (2019). Utilizing the ambulatory glucose profile to standardize and implement continuous glucose monitoring in clinical practice. Diabetes technology & therapeutics; 21(S2), S2-17.
7. Martin CT, Criego AB, Carlson AB, Bergenstal RM. (2019) Advanced technology in the management of diabetes: which comes first - continuous glucose monitor or insulin pump? Curr Diab Rep;19: 50.
8. Ekhlaspour L, Tabatabai I, Buckingham B. (2019) A Review of Continuous Glucose Monitoring Data Interpretation in the Age of Automated Insulin Delivery. J Diabetes Sci Technol; Jul;13(4):645-663.
9. Beck RW, Bergenstal RM, Laffel LM, Pickup JC. (2019) Advances in technology for management of type 1 diabetes. Lancet; Oct 5;394:1265-1273. 2019 Review
10. Shah VN, DuBose SN, Li Z, Beck RW, Peters AL, Weinstock RS, Kruger D, Tansey M, Sparling D, Woerner S, Vendrame F, Bergenstal R, Tamborlane WV, Watson SE, Sherr J. (2019) Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study. J Clin Endocrinol Metab; Oct 1;104(10):4356-4364.
11. Kröger J, Reichel A, Siegmund T, Ziegler R. (2019) Clinical Recommendations for the Use of the Ambulatory Glucose Profile in Diabetes Care. J Diabetes Sci Technol; Nov 13: 1-9.
12. Johnson ML, et al. (2019) "Utilizing the Ambulatory Glucose Profile to Standardize and Implement Continuous Glucose Monitoring in Clinical Practice." Diabetes technology & therapeutics 21: S2-17-25.
13. Beck RW, et al. (2019) "The Relationships Between Time in Range, Hyperglycemia Metrics, and HbA1c." Journal of diabetes science and technology; 1932296818822496.
14. Beck RW, et al. (2019)"Validation of time in range as an outcome measure for diabetes clinical trials." Diabetes care; 42.3: 400-405.
15. Richard M, et al. (2018) "Glucose management indicator (GMI): a new term for estimating A1C from continuous glucose monitoring." Diabetes care; 41.11: 2275-2280.
1. Holt RI, DeVries JH, Hess-Fischl A, Hirsch IB, Kirkman MS, Klupa T, Ludwig B, Nørgaard K, Pettus J, Renard E, and Skyler JS. (2021) The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European
Association for the Study of Diabetes (EASD). Diabetes Care, 44(11), pp.2589-2625.
2. Battelino, T., Danne, T., Bergenstal, R. M., Amiel, S. A., Beck, R., Biester, T., ... & Phillip, M. (2019). Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes care, 42(8), 1593-1603.
3. Danne T, Nimri R, Battelino T, Bergenstal RM, Close KL, DeVries JH, ... & Beck R. (2017). International consensus on use of continuous glucose monitoring. Diabetes care, 40(12), 1631-1640.
4. Riddle MC, Gerstein HC, and Cefalu WT. "Maturation of CGM and Glycemic Measurements Beyond HbA1c—A Turning Point in Research and Clinical Decisions." Diabetes Care 40.12 (2017): 1611-1613.
5. Petrie JR., Peters AL, Bergenstal, RM, Holl RW, Fleming GA., & Heinemann L. (2017). Improving the clinical value and utility of CGM systems: issues and recommendations. Diabetologia, 60(12), 2319-2328.
6. Buckingham BA, Close KL, Bergenstal RM, Danne T, Grunberger G, Kowalski AJ, Peters A, Heller SR (2017). Reaching an International Consensus on Standardizing Continuous Glucose Monitoring (CGM) Outcomes―Aligning Clinicians, Researchers, Patients, and
Regulators. American Diabetes Association 77th Scientific Meeting, June 2017, San Diego, CA.
Drs. Fonseca and Grunberger, Co-Chairs of AACE/ACE Consensus Conference Writing Committee submitted a letter to the editor of Endocrine Practice noting that AACE supports "making the AGP report standard across all platforms (diabetes devices and diabetes data management software)." The AGP report as standard, is also being added to the AACE CGM Consensus Conference Statement. Link to full letter. Vivian Fonseca and George Grunberger (2017) LETTER TO THE EDITOR. Endocrine Practice: May 2017, Vol. 23, No. 5, pp. 629-632. doi: http://dx.doi.org/10.4158/1934-2403-23.5.629