Physiology of GLP-1RA Therapy in T1D |
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Strong Recommendations |
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Outcomes of GLP-1RA Therapy in T1D |
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Strong Recommendations |
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What is Lacking in AID Systems Therapy in T1D: Better Sensors |
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Strong Recommendation |
Mild Recommendation |
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What is Lacking in AID Systems Therapy in T1D: Better Algorithms |
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Strong Recommendations |
Mild Recommendations |
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What is Lacking in AID Systems Therapy in T1D: Better Insulin |
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Strong Recommendation |
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How will GLP-1RA Therapy as Adjuvant Therapy with AID systems Improve Performance in T1D and Which Patients are Most Likely to Benefit? |
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Strong Recommendations |
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What are the Knowledge Gaps, Controversies, and Recommendations for Research in the Use of GLP-1RAs as Adjuvant Therapy with AID Systems in T1D? |
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Strong Recommendations |
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What Should Be the Role of GLP-1RAs with AID Systems in T1D? |
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Strong Recommendations |
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Halis Kaan Akturk, MD
Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Grazia Aleppo, MD
Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Lia Bally, MD, PhD
Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
Eda Cengiz, MD, MHS
University of California San Francisco, San Francisco, CA, USA
Ali Cinar, PhD
Department of Chemical and Biological Engineering, Illinois Institute of Technology, Chicago, IL, USA
Kathleen Dungan, MD, MPH
Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, OH, USA
Chiara Fabris, PhD
Center for Diabetes Technology, University of Virginia, Charlottesville, VA, USA
Peter G. Jacobs, PhD
Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA
David C. Klonoff, MD, FACP, FRCP (Edin), Fellow AIMBE*
Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
Rayhan A. Lal, MD
Division of Endocrinology, Department of Medicine, Stanford University, Stanford, CA, USA
Julia K. Mader, MD
Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
Umesh Masharani, MB, BS
University of California San Francisco, San Francisco, CA, USA
Anne L. Peters, MD**
Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Priya Prahalad, MD, PhD
Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, USA
Signe Schmidt, MD, PhD
Steno Diabetes Center Copenhagen, Gentofte, Denmark
Viral N. Shah, MD*
Division of Endocrinology & Metabolism, Indiana University School of Medicine, Indianapolis, IN, USA
Jennifer L. Sherr, MD, PhD
Yale University, New Haven, CT, USA
Guillermo E. Umpierrez, MD, CDCES, FACE, MACP**
School of Medicine, Emory University, Atlanta, GA, USA
Eric Zijlstra, PhD
Profil, Neuss, Germany
*Chairs
**Assistant Chairs
The expert panel members met virtually three times on January 17, 2024, and April 24, 2024, and August 14, 2024.
This project was supported by grants from Novo Nordisk and Lifecare.
March 29, 2022 – Burlingame, CA – Diabetes Technology Society today announced the publication of an article presenting a new actionable metric for describing the quality of glycemia in a continuous glucose monitor tracing in Journal of Diabetes Science and Technology. The article is entitled A Glycemia Risk Index (GRI) of Hypoglycemia and Hyperglycemia for Continuous Glucose Monitoring Validated by Clinician Ratings. The authors include 92 of the world’s leading diabetes and statistics experts from all six continents. The GRI is based on the opinions of the quality of glycemia of 330 experienced international clinicians who reviewed 225 CGM tracings. The GRI score correlates more closely with the expert opinions than other CGM metrics, such as Time in Range. The GRI can be used to 1) assess how well a patient is doing over time, 2) manage a population, and 3) predict outcomes in intervention studies.
“We are starting to see a dramatic expansion in the use of continuous glucose monitoring outside of the traditional indication as a technology for adults and children with type 1 diabetes and intensively treated type 2 diabetes. Increasingly, non-specialists will have access to CGM data and therefore there is a need for novel approaches to understanding CGM data that can be used by the non-specialist. The Glycemic Risk Indicator fulfills that need and is a major step-forward in the use of CGM to support individuals and their families living with diabetes in all of its forms,” said David Kerr, MD, Director of Research and Innovation at the Sansum Diabetes Research Institute in Santa Barbara, California.
“Glycemic Risk Index, is a single score composed of various CGM metrics that clinicians take into account to assess the quality of glycemic control for patients with diabetes. Clinicians are used to composite scores to predict the risk for certain diseases (e.g. cardiovascular risk calculator) or to make therapeutic decisions (e.g. treatment of osteoporosis based on FRAX score) and therefore, GRI score is a most welcome step to assess quality of glycemic control in patients with diabetes. The use of GRI in clinical trials or real-life studies would be easy to implement and may provide direction of change in quality of control with different newer therapies for managing diabetes,” said Viral Shah, MD, Associate Professor of Medicine at the Barbara Davis Center for Diabetes and the University of Colorado Anschutz Medical Center in Aurora, Colorado.
“The Glycemic Risk Index (GRI) is a unique tool to assist the HCP in charting a patient’s glycemic journey while providing insights on adjustments to therapy not obvious from the A1c or Time In Range. It not only serves as an early warning indicator for glycemic control, it informs the clinician and patient where to start to adjust therapy. The GRI is a great addition to our toolkit,” said Eugene E. Wright, Jr. MD, Medical Director, Performance Improvement at the Charlotte Area Health Education Center in Charlotte, North Carolina.
A Glycemia Risk Index (GRI) of Hypoglycemia and Hyperglycemia for Continuous Glucose Monitoring Validated by Clinician Ratings” is available at https://journals.sagepub.com/doi/full/10.1177/19322968221085273.
The GRI Calculator to determine the GRI of an individual patient or a population of patients is available at www.diabetestechnology.org/gri.