Ambulatory Glucose Profiles

reveal glucose trends and patterns at a glance and help identify when patients are out of target range.1

HCP talking to a patient
HCP talking to a patient
HCP talking to a patient

Introduction

There are four key components of an AGP:

  • Median
  • 25th–75th Percentile
  • 5th–95th Percentile
  • Target Glucose Range

Each of these elements tells a clear story about your patients’ glucose control and variability over a selected time period.

Black/blue solid line: Median line

The ‘average’ (middle) point of all glucose levels that shows ‘what usually happens’ during a day.2 Look at whether it is in the target glucose range and how much it swings up and down throughout the day.

Inner blue-shaded band: 25th to 75th percentile

This band indicates where glucose levels are ‘half the time’. Look at width of the band throughout the day. The wider this band is, the more variable the glucose levels are day-to-day.2

Outer grey-shaded band: 5th to 95th percentile

This band indicates more ‘occasional’ high or low glucose levels. Look at areas where the band is widest, this indicates more day-to-day variation at these times.2

Two parallel lines: Target glucose range

This is the corridor where glucose levels should be as much as possible. According to international consensus, the target glucose range is usually 3.9 mmol/L–10 mmol/L for adults with type 1 and type 2 diabetes who are not pregnant, not older, or at risk.3

The benefits of reviewing AGP

The benefits of reviewing an AGP during a diabetes clinical review

✓ AGP is a visually impactful way to quickly identify times of greater risk of hypoglycaemia or unwanted glucose variability.2

✓ The visual format of the AGP allows the eye to quickly focus on areas that may need review and these can be assessed in terms of how significant they are by their timing, duration and how low glucose has fallen.2

✓ You can use the elements of the AGP in a systematic and straightforward way to help identify trends in glucose control. This includes not only the areas that may require remedial action, but also the parts of each day that reveal when glucose is in range and you are able to reinforce and encourage behaviour choices.2

3-Step Guide to Interpreting the AGP

  • Low: Hypoglycaemia

    • Check if any part of the inner blue band dips below the target glucose range.

    • A narrow inner blue band in the hypo zone shows a consistent low-glucose trend, indicating a need to consider adjusting basal or mealtime insulin dose and timing.

    • A wider band suggests variability in lows, pointing to lifestyle or behavioural factors that may need investigation.
  • High: Hyperglycaemia

    • Identify persistent high glucose trends, especially when the median (solid) line is elevated and the inner blue band is narrow.

    • When there is “air under the clouds” (white space between the target range lower limit and the outer grey band), it indicates potential to improve glucose control without raising hypoglycaemia risk.2
  • Variability

    • Within-day variability: A “rollercoaster” shape of the median line means frequent high-low swings; this may require adjusting pre-meal insulin doses or timing after ruling out other causes.

    • Day-to-day variability: Narrow inner blue and outer grey bands mean stable daily patterns; wide, billowing bands indicate fluctuating glucose from day to day, suggesting management of factors like unplanned meals, snacks, intermittent exercise, or differences between weekdays and weekends.4

AGP & LibreView

Easily visualise AGP for your patients with LibreView₼ 

With the AGP report on LibreView you can:

  • See Time in Target guidelines and an overview of patient glucose data
  • Quickly assess your patient’s AGP
  • Identify trends and patterns at a glance
  • Identify specific times of deviation with the Daily Glucose Profiles
  • When talking to your patient, use AGP to highlight the positive advancements on their diabetes management.

References & Disclaimers

Images are for illustrative purposes only. Not real patient or data.

₼ The LibreView website is only compatible with certain operating systems and browsers. Please check www.LibreView.com for additional information.

1. Wright, E.E. Jr. and Hirsch, I.B., (2015). The ambulatory glucose profile: a new view of glucose patterns. Journal of Family Practice, 64(12 Suppl), pp.S4–S10.

2. Gibb, F. W., Jennings, P., Leelarathna, L., & Wilmot, E. et al. AGP in Daily Clinical Practice: A guide for use with the Freestyle Libre Flash Glucose Monitoring System. British Journal of Diabetes. Retrieved June 30, 2022, from https://doi.org/10.15277/bjd.2020.240

3. 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.

4. Evans, M., Cranston, I. and Bailey, C. (2017). British Journal of Diabetes, 17(1), 

ADC-2637241 v2.0 04/26