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  • Writer's pictureSweetSpot Team

Embracing Personalized Precision Diabetes Care With GRI 

In a groundbreaking 2022 article published in the Journal of Diabetes Science and Technology (JDST), Dr. David Klonoff introduced the Glycemia Risk Index (GRI) as a promising new metric for assessing glycemic control in diabetes care. However, despite its potential to offer insights beyond the traditional glycated hemoglobin (A1c) and Time in Range (TIR) metrics, GRI has struggled to gain widespread traction among diabetes care providers.

Dr. Ralph Oiknine, Chief Medical Officer of SweetSpot, recently published a Letter to the Editor of the JDST hypothesizing that GRI is being overlooked due to a "lack of practical, daily provider access to glucose data."

This blog post explores the main points that Dr. Oiknine addresses in the article, specifically how SweetSpot serves as a solution to the lack of widespread adoption of GRI. You can find the published article online here. (Note: you will have to purchase access to view the entire letter.)

Overcoming Barriers With a Centralized Platform

In the article, Dr. Oiknine emphasizes that he believes that one of the main hurdles to broader adoption of GRI and other advanced metrics is the absence of a unified solution that can seamlessly gather, integrate, assess, and triage data from various continuous glucose monitors (CGMs) and insulin delivery devices. A centralized platform that consolidates this information into a single, user-friendly dashboard is essential for practical application, he argues.

At his practice, Diabetes and Endocrinology Specialists (DES) in St. Louis, Missouri, Dr. Oiknine's team has implemented such a solution - SweetSpot. SweetSpot supports all major devices and calculates GRI alongside the usual ambulatory glucose profile (AGP) metrics, offering a comprehensive view of a patient's glycemic health.

Enhancing Patient Engagement and Care

Traditionally, Dr. Oiknine writes, his discussions with patients have focused on TIR. However, TIR alone can be misleading, as two patients with the same TIR can have vastly different glycemic issues. By starting the conversation with GRI, he explained that his team can quickly identify whether a patient's remaining time outside the target range is due to severe hyperglycemia or hypoglycemia. The GRI graphic is an intuitive visual tool that helps the team prioritize patients needing immediate attention and engage them in a more meaningful way, he wrote.

Dr. Oiknine proposes incorporating GRI into the standard AGP report to enhance patient-provider interactions. This addition, he argues, would make the complex AGP metrics more accessible and understandable for both patients and providers, shifting the conversation from A1c and TIR to a more detailed and informative discussion.

While diabetes technology has eased the burden on patients, it has often increased workload and overhead for providers, contributing to burnout. The use of a centralized platform like SweetSpot has alleviated these issues for Dr. Oiknine's practice, enabling them to deliver more personalized, precision diabetes care. By integrating GRI as a composite metric, more diabetes care team can enhance their ability to provide expert care and improve patient outcomes. Read the full published article here.

Want to learn more about SweetSpot and how we are revolutionizing diabetes management? Check out our website or shoot us a message at  


SweetSpot is a remote diabetes management platform that provides physicians with a single view of their patients’ data. SweetSpot's intelligent algorithm identifies the most optimal CPT codes for both remote and in-person diabetes management, and a dedicated team of Certified Diabetes Care & Education Specialists are available to provide ongoing support.  

As a company founded and powered by physicians and diabetes care providers, we place a strong emphasis on ensuring that there are no obstacles to getting started with SweetSpot. That’s why SweetSpot is easy to set up and designed to seamlessly integrate into your existing workflows and comes with no setup costs or subscription fees. 



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