Introduction and Objective: T1D population health requires synthesizing multiple data points. GRI summarizes severity-weighted hypo/hyperglycemia into zone categories. We assessed whether GRI can be used to characterize a pediatric cohort in relation to CGM targets.Methods: We analyzed up to 24 months of CGM data in 225 children with T1D and calculated GRI in consecutive 14-day windows. The earliest eligible window was defined as T1 and the latest as T2. Baseline GRI zone distribution and time in range metrics were summarized. Differences in mean GRI across subgroups were assessed using nonparametric tests. Associations between GRI and diabetes outcomes were assessed with Spearman correlation.Results: Median age was 8 years; 51.1% were female and 57.3% used CGM plus insulin pump. Baseline GRI zones and time in range metrics are shown in Figure 1. Higher GRI was strongly associated with lower TIR at both T1 and T2 (ρ=−0.98,−0.98; p<0.001) and with higher GMI (ρ=0.96, 0.92; p<0.001). Increases in GRI over time were strongly associated with decreases in TIR (ρ=−0.94; p<0.001) and increases in GMI (ρ=0.86; p<0.001). No association was observed with utilization or HgbA1c.Conclusion: GRI zone classification may provide a practical, single-metric approach to cohort-level stratification in pediatric T1D, with very strong alignment to standard CGM targets cross-sectionally and longitudinally. GRI zones could be operationalized as a simple, tiered review framework, enabling scalable population surveillance.
N. Krishnamurthi: None. C. Rand: None. N. Fogel: Other – Spouse’s employer; Current; Medline. D. Klonoff: Advisory Panel; Current; Afon Technology, Atropos Health, Embecta, Glooko, Inc., Glucotrack, Lifecare, Inc. Advisory Panel; Ended; Novo Nordisk. Advisory Panel; Current; Sanofi, Synchneuro, Thirdwayv Inc. J. Espinoza: Consultant; Current; Dexcom, Inc., Sanofi. Board Member; Current; Glooko, Inc.
Helmsley Charitable Trust
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