Twenty-Four-Month Evaluation of the Glycemia Risk Index in Adults With Type 1 Diabetes Using Advanced Hybrid Closed-Loop systems

Purpose The Glycemia Risk Index (GRI) is a recently introduced continuous glucose monitoring (CGM)–derived metric that has been evaluated to date in a limited number of studies involving type 1 diabetic adult users of Advanced Hybrid Closed-Loop (AHCL) systems. Methods To further characterize its clinical utility and to investigate its correlations with CGM-derived metrics, particularly Time in Tight Range (TITR), this single-center, observational, retrospective, real-world study assessed GRI in adults with type 1 diabetes using AHCL systems (MiniMed™ 780G, n = 45; Tandem t:slim X2 IQ technology, n = 20) in routine clinical practice, over a 24-month follow-up period. Results GRI showed progressive improvement throughout the observation period, consistent with sustained glycemic control. Baseline GRI was positively correlated with glycated hemoglobin and inversely correlated with Time in Tight Range (TITR) at 12 and 24 months. Conclusion These findings suggest that GRI may serve as a useful, readily interpretable metric for predicting long-term glycemic outcomes and support its complementary role alongside TITR in clinical assessment.