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Review
. 2025 Sep;48(9):1995-2000.
doi: 10.1007/s40618-025-02609-1. Epub 2025 May 17.

Glycemia risk index (GRI): a metric designed to facilitate the interpretation of continuous glucose monitoring data: a narrative review

Philippe Oriot  1   2 , Gaëtan Prévost  3 , Jean-Christophe Philips  4 , Noemie Klipper Dit Kurz  5 , Michel P Hermans  6
Affiliations
Review

Glycemia risk index (GRI): a metric designed to facilitate the interpretation of continuous glucose monitoring data: a narrative review

Philippe Oriot et al. J Endocrinol Invest. 2025 Sep.

Abstract

The Glycemia Risk Index (GRI) is a novel composite metric that integrates both hypoglycemia and hyperglycemia episodes to provide a comprehensive view of glycemic control in individuals with type 1 or type 2 diabetes. Unlike traditional metrics such as HbA1c or time-in-range (TIR), the GRI highlights extreme glycemic excursions and aligns more closely with clinical perceptions of glycemic risk. It correlates well with other CGM-derived indicators and has demonstrated relevance in various settings, including the management of individuals using hybrid closed-loop systems. In individuals with HbA1c ≤ 7%, the GRI can reveal hidden risks not captured by HbA1c alone, highlighting its added value in routine clinical assessment. Despite these strengths, the GRI has limitations. It was developed using CGM data from healthy adults on intensive insulin therapy, limiting generalization to other populations. Unlike HbA1c or TIR, it is not yet validated against hard clinical outcomes. As CGM technology evolves, the GRI holds promise as a valuable tool, provided its current limitations are addressed through further research and clinical integration.

Keywords: Advanced hybrid closed-loop systems; Ambulatory glucose profile; Continuous glucose monitoring; GRI; Glycemia risk index; Hyperglycemia; Hypoglycemia.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Klonoff DC, Wang J, Rodbard D et al (2023) A glycemia risk index (GRI) of hypoglycemia and hyperglycemia for continuous glucose monitoring validated by clinician ratings. J Diabetes Sci Technol 17:1226–1242. https://doi.org/10.1177/19322968221085273 - DOI - PubMed
    1. Shah VN, Sakamoto C, Pyle L (2023) Optimal sampling duration for continuous glucose monitoring for the Estimation of glycemia risk index. Diabetes Technol Ther 25:140–142. https://doi.org/10.1089/dia.2022.0401 - DOI - PubMed
    1. Kim JY, Yoo JH, Kim JH (2023) Comparison of glycemia risk index with time in range for assessing glycemic quality. Diabetes Technol Ther 25:883–892. https://doi.org/10.1089/dia.2023.0264 - DOI - PubMed
    1. Rizzi A, Tartaglione L, Paoli LL, Leo ML, Popolla V, Viti L, Barberio A, Di Leo M, Pontecorvi A, Pitocco D (2024) Evaluation of time in tight range and the glycaemia risk index in adults with type 1 diabetes using an advanced hybrid closed loop system: a 1-year real-world assessment. Diabetes Obes Metab 26:4078–4086. https://doi.org/10.1111/dom.15766 - DOI - PubMed
    1. Herranz-Antolín S, Coton-Batres C, López-Virgos MC et al (2024) Glycemia risk index in a cohort of patients with type 1 diabetes mellitus stratified by the coefficient of variation: A Real-Life study. Diabetes Technol Ther 26(12):960–967 - PubMed

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