Table 3.

Practical guidance on the basic elements of AGP report interpretation

Elements of assessment	Parameters in report	Additional guidance
Issue
Quality of data captured by the CGM system	Section 1: number of days using the system, percentage of time that the CGM system is active	The recommended analysis period is 14 days For patients with high glycaemic variability, a longer period of observation is recommended Recommended percentage of CGM system activity time  is > 70% Evaluate the frequency of scans (for FreeStyle Libre system)
Percentages of time in each target range	Section 1: TIR, TAR, TBR	The priority of the procedure is to increase the TIR while reducing TBR % of time in each range is also presented to the patient on a smartphone (e.g. FreeStyle Libre Link app)/reader
Average glucose control	Section 1: glucose management indicator (GMI) [8]	Even when the target GMI value is the same as for HbA1c, the GMI value can be different to the laboratory-tested HbA1c value (it does not take into account several non-glycaemic factors that affect the HbA1c value, such as changes in the survival time of erythrocytes, haemoglobin, chemical modifications, anaemias, renal disease) Shorter periods are indicated for comparative assessment of progressive improvement or deterioration of glycaemic control in each patient
Glycaemic variability	Section 1: CV Section 2: 25th–75th percentile band (IQR) 5th–95th percentile band	A wide IQR band indicates the need for the correction of therapy-dependent factors (e.g. inadequate insulin dose, incorrect insulin correction factor or insulin/carbohydrate ratio, incorrectly predicted effects of exercise) A wide 5th–95th percentile band indicates the need to verify/reinforce education regarding insulin therapy, diet, physical activity or other behavioural factors, as well as the motivation of the patient to comply with treatment recommendations The most common causes of high glycaemic variability are a mismatch of insulin dosing or timing with meals, physical activity, inability to accurately carbohydrate count, or chasing glucose in response to hypoglycaemia The %CV describes the intensity of fluctuations between successive high and low glucose levels during the day, which may be outside the target range but also within the target range; patients meeting the TIR target may not meet the target for glycaemic variability (e.g. TIR = 75% and CV = 40%)
Identify clinical problem and offer solution to patient
Hypoglycaemia	Section 2: ambulatory glucose profile (AGP) Section 3: daily glucose profiles	Identify:  Consistent patterns of hypoglycaemia during the day  Patterns and trends in patient behaviour and activity  Recurrent causes of hypoglycaemia Individualise assessment and targets, especially for pregnant women, the elderly and/or others with a high risk of hypoglycaemia Pay attention to low-glucose events with periods of hypoglycaemia lasting > 15 min Assess the glucose values at which the symptoms of hypoglycaemia occur A more detailed assessment of the frequency, severity and duration of hypoglycaemia can be performed using additional detailed online reports (e.g. LibreView)
High glycaemic variability	Section 2: ambulatory glucose profile (AGP) Section 3: daily glucose profiles	Identify:  Patterns of glycaemic variability within and between days  Patterns and trends in patient behaviour and activity  Consistent causes of high glucose variability
Hyperglycaemia	Section 2: ambulatory glucose profile (AGP) Section 3: daily glycaemic profiles	Identify:  Recurrences of hyperglycaemic episodes during the day  Patterns and trends in patient behaviour and activity  Consistent causes of hyperglycaemia