UNDERSTANDING THE AMBULATORY GLUCOSE PROFILE (AGP) REPORT
The AGP report shows data measured by continuous glucose monitoring (CGM) in a standardized visual format, providing a comprehensive overview of the glucose profile for a person with diabetes.1-4 This can help give people with diabetes and their healthcare professionals a better understanding of glucose levels and acts as a tool to support shared decision‑making.1-4
Dr Richard Bergenstal, International Diabetes Center, Minneapolis, explains how to use the AGP to get a quick overview of a person’s glycemic variability and pinpoint areas for improvement.
Healthcare professional has received a fee from Novo Nordisk Inc. for his participation.
The one-page AGP report is based on glucose levels measured over the course of each day and night.1,4 The report displayed combines the daily data to show glucose levels over several days or weeks displayed in the context of a typical 24-hour day. Fourteen days of CGM data are generally sufficient to generate a reliable AGP report.1 Where there is a large degree of variability, a longer period of measurement may be useful.
The standardized report has been welcomed by the diabetes community2 and is recommended by the American Diabetes Association (ADA) in the 2023 Standards of Medical Care in Diabetes.4
Example one-page AGP report
The AGP report displays core CGM metrics and targets, as well as glucose fluctuations and daily glucose profiles.2,4 Time in Range (TIR), Time Above Range (TAR; the percentage of time spent above 180 mg/dL), and Time Below Range (TBR; the percentage of time spent below 70 mg/dL) are presented as a stacked, color-coded bar chart.
- TIR is represented in green. According to clinical guidance, most people with diabetes should spend at least 70% of the day (around 17 hours) in the target glycemic range of 70 to 180 mg/dL2
- TBR is represented in red (low) and dark red (very low). Most people with diabetes should spend less than 4% of their day (1 hour) below range2
- <1% of time (15 minutes) should be spent in the "very low" TBR of <54 mg/dL.2,4 This also applies to pregnant women with type 1 diabetes
- TAR is represented in yellow (high) and orange (very high). Most people with diabetes should spend less than 25% of their day (6 hours) above range2
- <5% of time (~1 hour, 12 minutes) should be spent in the “very high” TAR of >250 mg/dL2,4
- Kröger J, Reichel A, Siegmund T, et al. Clinical Recommendations for the Use of the Ambulatory Glucose Profile in Diabetes Care. J Diabetes Sci Technol. 2020;14(3):586-594.
- Battelino T, Danne T, Bergenstal RM, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care. 2019;42(8):1593-1603.
- Carlson AL, Mullen DM, Bergenstal RM. Clinical Use of Continuous Glucose Monitoring in Adults with Type 2 Diabetes. Diabetes Technol Ther. 2017;19(S2):S4-S11.
- American Diabetes Association. Standards of Care in Diabetes—2023. Diabetes Care. 2023;46(suppl 1):S1-S291.
