Continuous Glucose Monitoring Interpretation Report

Patient Name: [Patient full name]

DOB: [Date of birth]

MRN: [Medical record number]

Report Date: [Date of interpretation]

Interpreting Clinician: [Name, credentials]

Ordering Clinician: [Name, credentials] (Omit if self-ordered or not applicable.)

Indication and Clinical Context

[Brief indication for CGM interpretation and relevant clinical context] (2–4 sentences. Include diabetes type and current therapy only as relevant to pattern interpretation. Note key safety context such as hypoglycemia unawareness or high-risk occupation if applicable. If therapy details are unavailable, state that interpretation is based on CGM patterns alone.)

CGM Data Summary

• Device: [CGM system name] — [personal / professional]; [real-time / intermittently scanned]; [blinded / unblinded] (Use "Not specified in source report" for any missing element.)
• Data Window: [Start date] through [End date] ([Total duration in days])
• Data Capture: [Percent time active or sensor wear percentage]
• Data Sufficiency: [Statement confirming ≥72 hours available and whether dataset supports reliable pattern assessment. If suboptimal, note limitations.]
• Target Range: [70–180 mg/dL / individualized: specify range and brief rationale]
• Event Markers: [meals / insulin / exercise / limited markers / none available] (Select all that apply.)

Summary Metrics

(Include only metrics available in source report. Omit lines without data.)

• Mean glucose: [value] mg/dL; GMI: [value]%
• Coefficient of variation (CV): [value]%
• Time in Range (70–180 mg/dL): [value]%
• Time Above Range: 181–250 mg/dL: [value]%; >250 mg/dL: [value]%
• Time Below Range: 54–69 mg/dL: [value]%; <54 mg/dL: [value]%

Interpretation

[Overall impression of glycemic control and dominant issues identified]

Hypoglycemia: [TBR quantification, timing (nocturnal vs daytime), severity including any <54 mg/dL exposure, episode characteristics, and hypoglycemia awareness status if relevant. If no clinically significant hypoglycemia, state explicitly.]

Hyperglycemia: [TAR breakdown, whether elevations are persistent or episodic, time-of-day patterns, apparent contributors if supported by data.]

Pattern Analysis: [Overnight trends, postprandial responses, day-to-day consistency, glycemic variability. Use "pattern consistent with" rather than definitive causal claims unless corroborated. Note whether patterns support reliable adjustments.]

Recommendations and Communication

• Therapy adjustments: [Insulin dose changes, pump/AID modifications, or medication timing changes. Note who is implementing: clinician / patient self-adjustment / deferred to specialist.] (Omit if none.)
• Lifestyle recommendations: [Meal timing, carbohydrate consistency, exercise strategies relevant to patterns.] (Omit if none.)
• Monitoring/device: [Alert threshold adjustments, sensor wear guidance, fingerstick confirmation indications.] (Omit if none.)
• Safety counseling: [Hypoglycemia treatment plan, glucagon availability, driving/work precautions.] (Omit if not applicable.)

Communication: [in-person / phone / video / portal message] on [date]. Findings reviewed with [patient / caregiver]; [understanding and agreement confirmed / questions addressed / concerns noted]. [Patient-reported context affecting interpretation, if any.] (If patient not reached, document attempt with date/time and note recommendations pending discussion.)

Follow-Up

• Next CGM review: [Interval or timeframe] (Or state "Follow-up per ordering clinician.")
• Escalation instructions: [Guidance for severe lows, persistent hyperglycemia, or other urgent situations.] (Omit if not applicable.)
• Referrals: [Specialist referrals or care coordination triggered by findings.] (Omit if none.)

Attestation

I reviewed and interpreted the CGM data and generated this report. The dataset [met / did not meet] the minimum data threshold for interpretation (≥72 hours). [If threshold not met, state limitations.]

AGP/Standardized CGM Report Attached: [Yes / No] [Attachment location if stored separately]

Signature: [Interpreting clinician name, credentials] — [Date and time]