Calculating the mean amplitude of glycemic excursion from continuous glucose monitoring data: an automated algorithm. 2011

Peter A Baghurst
Public Health Research Unit, Women's and Children's Hospital, Children Youth and Women's Health Service, North Adelaide, South Australia, Australia. Peter.Baghurst@health.sa.gov.au

BACKGROUND Glycemic variability is currently under scrutiny as a possible predictor of the complications of diabetes. The manual process for estimating a now classical measure of glycemic variability, the mean amplitude of glycemic excursion (MAGE), is both tedious and prone to error, and there is a special need for an automated method to calculate the MAGE from continuous glucose monitoring (CGM) data. METHODS An automated algorithm for identifying the peaks and nadirs corresponding to the glycemic excursions required for the MAGE calculation has been developed. The algorithm takes a column of timed glucose measurements and generates a plot joining the peaks and nadirs required for estimating the MAGE. It returns estimates of the MAGE for both upward and downward excursions, together with several other indices of glycemic variability. RESULTS Details of the application of the algorithm to CGM data collected over a 48-h period are provided, together with graphical illustrations of the intermediate stages in identifying the peaks and nadirs required for the MAGE. Application of the algorithm to 104 CGM datasets (92 from children with diabetes and 12 from controls) generated plots that, on visual inspection, were all found to have identified the peaks, nadirs, and excursions correctly. CONCLUSIONS The proposed algorithm eliminates the tedium and/or errors of manually identifying and measuring countable excursions in CGM data in order to estimate the MAGE. It can also be used to calculate the MAGE from "sparse" blood glucose measurements, such as those collected in home blood glucose monitoring.

UI MeSH Term Description Entries
D008297 Male Males
D001786 Blood Glucose Glucose in blood. Blood Sugar,Glucose, Blood,Sugar, Blood
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003627 Data Interpretation, Statistical Application of statistical procedures to analyze specific observed or assumed facts from a particular study. Data Analysis, Statistical,Data Interpretations, Statistical,Interpretation, Statistical Data,Statistical Data Analysis,Statistical Data Interpretation,Analyses, Statistical Data,Analysis, Statistical Data,Data Analyses, Statistical,Interpretations, Statistical Data,Statistical Data Analyses,Statistical Data Interpretations
D003920 Diabetes Mellitus A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000465 Algorithms A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. Algorithm
D015190 Blood Glucose Self-Monitoring Self evaluation of whole blood glucose levels outside the clinical laboratory. A digital or battery-operated reflectance meter may be used. It has wide application in controlling unstable insulin-dependent diabetes. Blood Sugar Self-Monitoring,Home Blood Glucose Monitoring,Monitoring, Home Blood Glucose,Self-Monitoring, Blood Glucose,Glucose, Blood, Self Monitoring,Glucose, Blood, Self-Monitoring,Blood Glucose Self Monitoring,Blood Glucose Self-Monitorings,Blood Sugar Self Monitoring,Blood Sugar Self-Monitorings,Glucose Self-Monitoring, Blood,Glucose Self-Monitorings, Blood,Self Monitoring, Blood Glucose,Self-Monitoring, Blood Sugar,Self-Monitorings, Blood Glucose,Self-Monitorings, Blood Sugar,Sugar Self-Monitoring, Blood,Sugar Self-Monitorings, Blood

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