Clinically Similar Clusters of Daily Continuous Glucose Monitoring Profiles: Tracking the Progression of Glycemic Control Over Time

Background: The adoption of continuous glucose monitoring (CGM) results in vast amounts of data, but their interpretation is still more art than exact science. The International Consensus on Time in Range (TIR) proposed the widely accepted TIR system of metrics, which we now take forward by introducing a finite and fixed set of clinically similar clusters (CSCs), such that the TIR metrics of daily CGM profiles within a cluster are homogeneous.Methods: CSC definition and validation used 204,710 daily CGM profiles in health, and types 1 and 2 diabetes (T1D and T2D) on different treatments. The CSCs were defined using 23,916 daily CGM profiles (Training set), and the final fixed set of CSCs was obtained using another 37,758 profiles (Validation set). The Testing set (143,036 profiles) was used to establish the robustness and generalizability of CSCs.Results: The final set of CSCs contains 32 clusters. Any daily CGM profile was classifiable to a single CSC, which approximated common glycemic metrics of the daily CGM profile, as evidenced by regression analyses with 0 intercept (R-squares & GE;0.83, e.g., correlation & GE;0.91), for all TIR and several other metrics. The CSCs distinguished CGM profiles in health, T2D, and T1D on different treatments, and allowed tracking of daily changes in a person's glycemic control over time.Conclusion: Daily CGM profiles can be classified into one of 32 prefixed CSCs, which enables a host of applications, for example, tabulated data interpretation and algorithmic approaches to treatment, database indexing, pattern recognition, and tracking disease progression.