How Is an AGP Report Built and Used in Practice? A Step-by-Step Guide to CGM Interpretation

1. How Is the AGP Graph Created?

  • AGP (Ambulatory Glucose Profile) condenses 14 days of CGM data into a 24-hour glucose curve.
  • Values at each time point are sorted, and five percentiles (5th, 25th, 50th, 75th, 95th) are calculated.
  • These percentiles form five smoothed curves that summarize glucose distribution across the day.
  • The graph filters out extremes and reveals typical daily glucose trends.

2. Visual Elements in the AGP Graph

  • Target Range (70–180 mg/dL): Two horizontal lines for assessing control.
  • Median Curve (50th percentile): Shows typical daily pattern. A flatter curve = more stable glucose.
  • Interquartile Range (25th–75th percentiles): Dark shaded band showing typical variability. Narrow = consistent control.
  • Interdecile Range (5th–95th percentiles): Light shaded area reflecting broader lifestyle-related fluctuations.
  • Together, these visuals offer a layered view of glucose behavior across time.

3. Daily Glucose Profiles: Identifying Repeating Patterns

  • These curves show glucose changes on individual days.
  • Help detect post-meal spikes, overnight lows, and unusual deviations that might not appear in the summary graph.
  • Especially useful for spotting behavioral or timing-based issues that need intervention.

4. How to Use AGP in Clinical Practice

A step-by-step clinical approach:
  1. Check data quality → Is the device worn >70% of the time over 14 days?
  2. Review glucose metrics → Evaluate mean glucose, GMI, time in range (TIR), time above/below range (TAR/TBR), and variability.
  3. Interpret the AGP Graph → Assess the shape of the median curve, the width of shaded areas, and time spent within target range.
  4. Analyze daily profiles → Identify recurring high/low episodes and their timing.
  5. Integrate patient context → Align findings with medication timing, meals, symptoms, and lifestyle to guide personalized treatment changes.