Ambulatory glucose profile (AGP): utility in UK clinical practice

Abstract

Glycaemic variability may contribute to the pathophysiology of diabetes complications independently of the average level of blood glucose and increases the barriers to achieving such mean goals as well as the risk of hypoglycaemia. Continuous glucose monitoring (CGM) has the potential to identify and address glycaemic variability. Achieving effective use of the extensive data generated by CGM within a routine diabetes consultation is challenging, particularly where glycaemic variability is high. Expert groups have called for more standardisation of the analysis and reporting of glycaemic data. The Ambulatory Glucose Profile (AGP) is an internationally recognised, consensus-approved visual representation which simply summarises glycaemic data and its descriptive statistics in a clinically meaningful format, thus providing a solution to this unmet need. The AGP collates and presents several days of glucose records in a single projection, presenting a visual trace for the median glucose level, with its 25–75th and 10–90th percentiles, according to a ‘modal’ day. In this way, the AGP provides a straightforward and visual means of identifying times of increased risk of hypoglycaemia or hyperglycaemia that, in turn, provides a robust platform for the diabetes healthcare professional and the person with diabetes to explore, discuss and resolve the underlying reasons for suboptimal diabetes control.