nightscout-cgm-skill

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原始内容

---
name: nightscout-cgm
description: Analyze CGM blood glucose data from Nightscout. Use this skill when asked about current glucose levels, blood sugar trends, A1C estimates, time-in-range statistics, glucose variability, or diabetes management insights.
---

# Nightscout CGM Analysis Skill

This skill provides tools for fetching and analyzing Continuous Glucose Monitor (CGM) data from Nightscout.

## ⚠️ Before Making Changes

**Always run tests before and after modifying `cgm.py`:**

```bash
cd <skill-path>
python -m pytest tests/ -q           # Quick check (281+ tests)
python -m pytest tests/ --cov=scripts  # With coverage
```

## Available Commands

Run the `cgm.py` script from this skill's `scripts/` directory:

```bash
python <skill-path>/scripts/cgm.py <command> [options]
```

Where `<skill-path>` is the location where this skill is installed (e.g., `~/.copilot/skills/nightscout-cgm`, `.github/skills/nightscout-cgm`, or `.claude/skills/nightscout-cgm`).

### Commands

| Command | Description |
|---------|-------------|
| `current` | Get the latest glucose reading |
| `analyze [--days N]` | Analyze CGM data (default: 90 days) |
| `report [--days N] [--output PATH] [--open]` | Generate interactive, PDF-printable HTML report with charts |
| `goals [view|set|clear]` | View, configure, or clear local report goals |
| `compare --period1 P1 --period2 P2` | Compare two time periods side-by-side |
| `alerts [--days N]` | Get trend alerts for recurring patterns |
| `refresh [--days N]` | Fetch latest data from Nightscout |
| `auto-refresh [view|set|on|off]` | Configure refresh-on-query sync, no daemon required |
| `patterns [--days N]` | Find interesting patterns (best/worst times, problem areas) |
| `query [options]` | Query with filters (day of week, time range) |
| `day <date> [options]` | View all readings for a specific date |
| `worst [options]` | Find your worst days for glucose control |
| `chart [options]` | Terminal visualizations (heatmap, sparkline, day chart) |
| `pump` | Get current pump status (IOB, COB, predicted glucose) * |
| `treatments [--hours N]` | Get recent treatments (boluses, temp basals, carbs) * |
| `events [--tag TEXT] [--days N]` | Correlate glucose response around existing Nightscout treatments/events * |
| `ages [--count N]` | Get CAGE/SAGE/IAGE from Site/Sensor/Insulin Change events * |
| `profile` | Get pump profile settings (basal rates, ISF, carb ratios) * |

\* **Optional pump/treatment commands require matching Nightscout uploads.** `pump` and `profile` require Loop, OpenAPS, AndroidAPS, or similar devicestatus/profile data. `treatments`, `events`, and `ages` require treatment/event entries. CGM-only users won't see errors—commands return a structured message explaining that the data is not available.

### Report Command

Generate a comprehensive, self-contained HTML report with interactive charts:
- `--days N` - Number of days to include (default: 90)
- `--output PATH` - Custom output path (default: nightscout_report.html)
- `--open` - Open report in browser after generating

**Auto-Sync:** Reports automatically sync from Nightscout if local data is more than 30 minutes old.

**Report Features:**
- Interactive date controls (7d/14d/30d/90d/6mo/1yr/All + custom date pickers)
- All charts recalculate dynamically in browser
- Sticky section navigation for long reports
- Deterministic executive summary with concise status bullets
- Print / Save PDF action with print-friendly styles
- Time-in-Range pie chart
- Modal Day (24-hour profile with percentile bands and target range lines)
- Daily trends, Day of week comparison
- Glucose histogram, Heatmap with hover tooltips
- Weekly summary with week-over-week TIR delta, best day, and context notes
- Key stats: TIR%, GMI (estimated A1C), CV (variability)
- Goal tracking: configurable TIR, CV, GMI, and average glucose targets
- **Insulin Delivery** (if using Loop/OpenAPS): TDD breakdown (bolus/basal), stacked bar chart, carb tracking

### Goals Command

Configure local report goals stored in `config.json`:
- `goals` or `goals view` - Show active goals
- `goals set --tir PCT --cv PCT --gmi PCT --average MGDL` - Set one or more goals
- `goals clear` - Remove custom goals and return to defaults
- Goal directions: TIR is minimum target; CV, GMI, and average glucose are maximum targets

### Auto-Refresh Command

Configure stale-data sync before read-only queries. This does not run a persistent daemon:
- `auto-refresh` or `auto-refresh view` - Show current refresh-on-query settings
- `auto-refresh set --minutes N` - Sync before queries when the newest local reading is older than N minutes
- `auto-refresh on` / `auto-refresh off` - Enable or disable refresh-on-query
- Use `refresh --days N` for explicit manual sync

### Day Command

View detailed readings for a specific date:
- `day <date>` - Date can be 'today', 'yesterday', '2026-01-16', or 'Jan 16'
- `--hour-start H` - Start hour for time window (0-23)
- `--hour-end H` - End hour for time window (0-23)

### Worst Command

Find your worst days ranked by peak glucose:
- `--days N` - Number of days to search (default: 21)
- `--hour-start H` - Start hour for time window (0-23)
- `--hour-end H` - End hour for time window (0-23)
- `--limit N` - Number of worst days to show (default: 5)

### Query Options

The `query` command supports flexible filtering:
- `--days N` - Number of days to analyze (default: 90)
- `--day NAME` - Filter by day of week (e.g., Tuesday, or 0-6 where 0=Monday)
- `--hour-start H` - Start hour for time window (0-23)
- `--hour-end H` - End hour for time window (0-23)

### Chart Options

The `chart` command creates terminal visualizations:
- `--sparkline` - Compact trend line using Unicode blocks (▁▂▃▄▅▆▇█)
- `--hours N` - Hours of data for sparkline (default: 24)
- `--date DATE` - Specific date for sparkline (e.g., today, yesterday, 2026-01-16)
- `--hour-start H` - Start hour for sparkline time window (0-23)
- `--hour-end H` - End hour for sparkline time window (0-23)
- `--heatmap` - Weekly grid showing time-in-range by day and hour
- `--day NAME` - Hourly breakdown for a specific day of week
- `--color` - Use ANSI colors (for direct terminal, not inside Copilot)

### Pump and Treatment Commands (Optional)

These commands use optional Nightscout endpoints. The skill auto-detects capabilities and returns a helpful CGM-only message when the required data is not available.

**`pump`** - Get current pump/loop status:
- IOB (Insulin on Board) and COB (Carbs on Board)
- Predicted glucose trajectory
- Recommended bolus
- Last enacted action (temp basal or bolus)
- Pump status (manufacturer, model, suspended/bolusing)
- Phone battery level

**`treatments [--hours N]`** - Get recent treatments:
- Boluses (automatic and manual)
- Temp basals
- Carb entries
- Summary totals (total insulin, total carbs)

**`events [--tag TEXT] [--days N] [--window-minutes N]`** - Correlate existing Nightscout events:
- Matches text in event type, notes, enteredBy, foodType, or reason
- Compares the 30-minute baseline before the event to the post-event window
- Does not store local annotations or edit Nightscout data
- Useful for questions like "what happens after pizza?" when those events already exist in Nightscout

**`ages [--count N]`** - Get CAGE/SAGE/IAGE:
- CAGE: time since last `Site Change`
- SAGE: time since last `Sensor Change`
- IAGE: time since last `Insulin Change`
- Average interval in days and observed change count per type

**`profile`** - Get pump profile settings:
- Basal rates by time of day
- Total daily basal
- ISF (Insulin Sensitivity Factor) by time
- Carb ratios by time
- Target glucose ranges
- Loop settings (max bolus, pre-meal targets, override presets)

### Examples

```bash
# Get current glucose
python scripts/cgm.py current

# Generate interactive HTML report (opens in browser)
python scripts/cgm.py report --days 90 --open

# Configure report goals
python scripts/cgm.py goals view
python scripts/cgm.py goals set --tir 75 --cv 34 --gmi 6.8 --average 145

# Configure refresh-on-query sync
python scripts/cgm.py auto-refresh view
python scripts/cgm.py auto-refresh set --minutes 15

# Analyze last 30 days
python scripts/cgm.py analyze --days 30

# Find patterns automatically (best/worst times, problem areas)
python scripts/cgm.py patterns

# What happened yesterday during lunch (11am-2pm)?
python scripts/cgm.py day yesterday --hour-start 11 --hour-end 14

# Find my worst lunch days in the last 3 weeks
python scripts/cgm.py worst --days 21 --hour-start 11 --hour-end 14

# What happens on Tuesdays after lunch?
python scripts/cgm.py query --day Tuesday --hour-start 12 --hour-end 15

# How are my overnight numbers on weekends?
python scripts/cgm.py query --day Saturday --hour-start 22 --hour-end 6
python scripts/cgm.py query --day Sunday --hour-start 22 --hour-end 6

# Morning analysis across all days
python scripts/cgm.py query --hour-start 6 --hour-end 10

# Show sparkline of last 24 hours (compact visual trend)
python scripts/cgm.py chart --sparkline --hours 24

# Show sparkline for a specific date and time range (with colors)
python scripts/cgm.py chart --date yesterday --hour-start 11 --hour-end 15 --color

# Show heatmap of time-in-range by day/hour
python scripts/cgm.py chart --heatmap

# Show hourly breakdown for a specific day
python scripts/cgm.py chart --day Saturday

# Generate interactive HTML report (opens in browser)
python scripts/cgm.py report --days 90 --open

# Compare two time periods
python scripts/cgm.py compare --period1 "last 7 days" --period2 "previous 7 days"
python scripts/cgm.py compare --period1 "this week" --period2 "last week"

# Get trend alerts (recurring patterns)
python scripts/cgm.py alerts --days 30

# Refresh data from Nightscout
python scripts/cgm.py refresh

# Correlate existing Nightscout event/treatment notes
python scripts/cgm.py events --tag pizza --days 90

# Get site/sensor/insulin change ages
python scripts/cgm.py ages --count 100
```

## Example Questions You Can Ask

With the pattern analysis capabilities, you can ask natural questions like:

- "What's my current glucose?"
- "Generate a report of my last 90 days"
- "Compare this week to last week"
- "How am I doing vs last month?"
- "What trend alerts do you see?"
- "Analyze my blood sugar for the last 30 days"
- "What patterns do you see in my data?"
- "What's happening on Tuesdays after lunch?"
- "When are my worst times for blood sugar control?"
- "How are my overnight numbers?"
- "When do I tend to go low?"
- "What day of the week is my best for time-in-range?"
- "Show me my morning patterns"
- "Show me a sparkline of my last 24 hours"
- "Show me a heatmap of my glucose"
- "What does Saturday look like?"
- "What was my worst lunch this week?" (you'll be asked what hours you eat lunch)
- "Show me what happened yesterday during dinner"
- "What were my worst days for breakfast the last two weeks?"

### Pump-Related Questions (if using Loop/OpenAPS)

- "What's my current IOB?"
- "How much insulin on board do I have?"
- "Show me my pump status"
- "What's my predicted glucose?"
- "What treatments have I had in the last 6 hours?"
- "How much insulin did I take today?"
- "What are my basal rates?"
- "What's my carb ratio?"
- "What are my ISF settings?"
- "Show me my Loop profile"

## Output Interpretation

### Time in Range (TIR)
- **Very Low** (<54 mg/dL): Dangerous hypoglycemia
- **Low** (54-69 mg/dL): Hypoglycemia
- **In Range** (70-180 mg/dL): Target range
- **High** (181-250 mg/dL): Hyperglycemia
- **Very High** (>250 mg/dL): Significant hyperglycemia

### Key Metrics
- **GMI**: Glucose Management Indicator (estimated A1C from CGM data)
- **CV**: Coefficient of Variation (<36% indicates stable glucose)
- **Hourly Averages**: Shows patterns throughout the day

## Configuration (Required)

Set the `NIGHTSCOUT_URL` environment variable to your Nightscout API endpoint:

```bash
# Linux/macOS
export NIGHTSCOUT_URL="https://your-nightscout-site.com/api/v1/entries.json"

# Windows PowerShell
$env:NIGHTSCOUT_URL = "https://your-nightscout-site.com/api/v1/entries.json"

# Windows (persistent)
[Environment]::SetEnvironmentVariable("NIGHTSCOUT_URL", "https://your-nightscout-site.com/api/v1/entries.json", "User")
```

The script will not run without this environment variable configured.

name: nightscout-cgm description: Analyze CGM blood glucose data from Nightscout. Use this skill when asked about current glucose levels, blood sugar trends, A1C estimates, time-in-range statistics, glucose variability, or diabetes management insights.

Nightscout CGM Analysis Skill

This skill provides tools for fetching and analyzing Continuous Glucose Monitor (CGM) data from Nightscout.

⚠️ Before Making Changes

Always run tests before and after modifying cgm.py:

cd <skill-path>
python -m pytest tests/ -q           # Quick check (281+ tests)
python -m pytest tests/ --cov=scripts  # With coverage

Available Commands

Run the cgm.py script from this skill's scripts/ directory:

python <skill-path>/scripts/cgm.py <command> [options]

Where <skill-path> is the location where this skill is installed (e.g., ~/.copilot/skills/nightscout-cgm, .github/skills/nightscout-cgm, or .claude/skills/nightscout-cgm).

Commands

Command	Description
`current`	Get the latest glucose reading
`analyze [--days N]`	Analyze CGM data (default: 90 days)
`report [--days N] [--output PATH] [--open]`	Generate interactive, PDF-printable HTML report with charts
`goals [view	set
`compare --period1 P1 --period2 P2`	Compare two time periods side-by-side
`alerts [--days N]`	Get trend alerts for recurring patterns
`refresh [--days N]`	Fetch latest data from Nightscout
`auto-refresh [view	set
`patterns [--days N]`	Find interesting patterns (best/worst times, problem areas)
`query [options]`	Query with filters (day of week, time range)
`day <date> [options]`	View all readings for a specific date
`worst [options]`	Find your worst days for glucose control
`chart [options]`	Terminal visualizations (heatmap, sparkline, day chart)
`pump`	Get current pump status (IOB, COB, predicted glucose) *
`treatments [--hours N]`	Get recent treatments (boluses, temp basals, carbs) *
`events [--tag TEXT] [--days N]`	Correlate glucose response around existing Nightscout treatments/events *
`ages [--count N]`	Get CAGE/SAGE/IAGE from Site/Sensor/Insulin Change events *
`profile`	Get pump profile settings (basal rates, ISF, carb ratios) *

* Optional pump/treatment commands require matching Nightscout uploads. pump and profile require Loop, OpenAPS, AndroidAPS, or similar devicestatus/profile data. treatments, events, and ages require treatment/event entries. CGM-only users won't see errors—commands return a structured message explaining that the data is not available.

Report Command

Generate a comprehensive, self-contained HTML report with interactive charts:

--days N - Number of days to include (default: 90)
--output PATH - Custom output path (default: nightscout_report.html)
--open - Open report in browser after generating

Auto-Sync: Reports automatically sync from Nightscout if local data is more than 30 minutes old.

Report Features:

Interactive date controls (7d/14d/30d/90d/6mo/1yr/All + custom date pickers)
All charts recalculate dynamically in browser
Sticky section navigation for long reports
Deterministic executive summary with concise status bullets
Print / Save PDF action with print-friendly styles
Time-in-Range pie chart
Modal Day (24-hour profile with percentile bands and target range lines)
Daily trends, Day of week comparison
Glucose histogram, Heatmap with hover tooltips
Weekly summary with week-over-week TIR delta, best day, and context notes
Key stats: TIR%, GMI (estimated A1C), CV (variability)
Goal tracking: configurable TIR, CV, GMI, and average glucose targets
Insulin Delivery (if using Loop/OpenAPS): TDD breakdown (bolus/basal), stacked bar chart, carb tracking

Goals Command

Configure local report goals stored in config.json:

goals or goals view - Show active goals
goals set --tir PCT --cv PCT --gmi PCT --average MGDL - Set one or more goals
goals clear - Remove custom goals and return to defaults
Goal directions: TIR is minimum target; CV, GMI, and average glucose are maximum targets

Auto-Refresh Command

Configure stale-data sync before read-only queries. This does not run a persistent daemon:

auto-refresh or auto-refresh view - Show current refresh-on-query settings
auto-refresh set --minutes N - Sync before queries when the newest local reading is older than N minutes
auto-refresh on / auto-refresh off - Enable or disable refresh-on-query
Use refresh --days N for explicit manual sync

Day Command

View detailed readings for a specific date:

day <date> - Date can be 'today', 'yesterday', '2026-01-16', or 'Jan 16'
--hour-start H - Start hour for time window (0-23)
--hour-end H - End hour for time window (0-23)

Worst Command

Find your worst days ranked by peak glucose:

--days N - Number of days to search (default: 21)
--hour-start H - Start hour for time window (0-23)
--hour-end H - End hour for time window (0-23)
--limit N - Number of worst days to show (default: 5)

Query Options

The query command supports flexible filtering:

--days N - Number of days to analyze (default: 90)
--day NAME - Filter by day of week (e.g., Tuesday, or 0-6 where 0=Monday)
--hour-start H - Start hour for time window (0-23)
--hour-end H - End hour for time window (0-23)

Chart Options

The chart command creates terminal visualizations:

--sparkline - Compact trend line using Unicode blocks (▁▂▃▄▅▆▇█)
--hours N - Hours of data for sparkline (default: 24)
--date DATE - Specific date for sparkline (e.g., today, yesterday, 2026-01-16)
--hour-start H - Start hour for sparkline time window (0-23)
--hour-end H - End hour for sparkline time window (0-23)
--heatmap - Weekly grid showing time-in-range by day and hour
--day NAME - Hourly breakdown for a specific day of week
--color - Use ANSI colors (for direct terminal, not inside Copilot)

Pump and Treatment Commands (Optional)

These commands use optional Nightscout endpoints. The skill auto-detects capabilities and returns a helpful CGM-only message when the required data is not available.

pump - Get current pump/loop status:

IOB (Insulin on Board) and COB (Carbs on Board)
Predicted glucose trajectory
Recommended bolus
Last enacted action (temp basal or bolus)
Pump status (manufacturer, model, suspended/bolusing)
Phone battery level

treatments [--hours N] - Get recent treatments:

Boluses (automatic and manual)
Temp basals
Carb entries
Summary totals (total insulin, total carbs)

events [--tag TEXT] [--days N] [--window-minutes N] - Correlate existing Nightscout events:

Matches text in event type, notes, enteredBy, foodType, or reason
Compares the 30-minute baseline before the event to the post-event window
Does not store local annotations or edit Nightscout data
Useful for questions like "what happens after pizza?" when those events already exist in Nightscout

ages [--count N] - Get CAGE/SAGE/IAGE:

CAGE: time since last Site Change
SAGE: time since last Sensor Change
IAGE: time since last Insulin Change
Average interval in days and observed change count per type

profile - Get pump profile settings:

Basal rates by time of day
Total daily basal
ISF (Insulin Sensitivity Factor) by time
Carb ratios by time
Target glucose ranges
Loop settings (max bolus, pre-meal targets, override presets)

Examples

# Get current glucose
python scripts/cgm.py current

# Generate interactive HTML report (opens in browser)
python scripts/cgm.py report --days 90 --open

# Configure report goals
python scripts/cgm.py goals view
python scripts/cgm.py goals set --tir 75 --cv 34 --gmi 6.8 --average 145

# Configure refresh-on-query sync
python scripts/cgm.py auto-refresh view
python scripts/cgm.py auto-refresh set --minutes 15

# Analyze last 30 days
python scripts/cgm.py analyze --days 30

# Find patterns automatically (best/worst times, problem areas)
python scripts/cgm.py patterns

# What happened yesterday during lunch (11am-2pm)?
python scripts/cgm.py day yesterday --hour-start 11 --hour-end 14

# Find my worst lunch days in the last 3 weeks
python scripts/cgm.py worst --days 21 --hour-start 11 --hour-end 14

# What happens on Tuesdays after lunch?
python scripts/cgm.py query --day Tuesday --hour-start 12 --hour-end 15

# How are my overnight numbers on weekends?
python scripts/cgm.py query --day Saturday --hour-start 22 --hour-end 6
python scripts/cgm.py query --day Sunday --hour-start 22 --hour-end 6

# Morning analysis across all days
python scripts/cgm.py query --hour-start 6 --hour-end 10

# Show sparkline of last 24 hours (compact visual trend)
python scripts/cgm.py chart --sparkline --hours 24

# Show sparkline for a specific date and time range (with colors)
python scripts/cgm.py chart --date yesterday --hour-start 11 --hour-end 15 --color

# Show heatmap of time-in-range by day/hour
python scripts/cgm.py chart --heatmap

# Show hourly breakdown for a specific day
python scripts/cgm.py chart --day Saturday

# Generate interactive HTML report (opens in browser)
python scripts/cgm.py report --days 90 --open

# Compare two time periods
python scripts/cgm.py compare --period1 "last 7 days" --period2 "previous 7 days"
python scripts/cgm.py compare --period1 "this week" --period2 "last week"

# Get trend alerts (recurring patterns)
python scripts/cgm.py alerts --days 30

# Refresh data from Nightscout
python scripts/cgm.py refresh

# Correlate existing Nightscout event/treatment notes
python scripts/cgm.py events --tag pizza --days 90

# Get site/sensor/insulin change ages
python scripts/cgm.py ages --count 100

Example Questions You Can Ask

With the pattern analysis capabilities, you can ask natural questions like:

"What's my current glucose?"
"Generate a report of my last 90 days"
"Compare this week to last week"
"How am I doing vs last month?"
"What trend alerts do you see?"
"Analyze my blood sugar for the last 30 days"
"What patterns do you see in my data?"
"What's happening on Tuesdays after lunch?"
"When are my worst times for blood sugar control?"
"How are my overnight numbers?"
"When do I tend to go low?"
"What day of the week is my best for time-in-range?"
"Show me my morning patterns"
"Show me a sparkline of my last 24 hours"
"Show me a heatmap of my glucose"
"What does Saturday look like?"
"What was my worst lunch this week?" (you'll be asked what hours you eat lunch)
"Show me what happened yesterday during dinner"
"What were my worst days for breakfast the last two weeks?"

Pump-Related Questions (if using Loop/OpenAPS)

"What's my current IOB?"
"How much insulin on board do I have?"
"Show me my pump status"
"What's my predicted glucose?"
"What treatments have I had in the last 6 hours?"
"How much insulin did I take today?"
"What are my basal rates?"
"What's my carb ratio?"
"What are my ISF settings?"
"Show me my Loop profile"

Output Interpretation

Time in Range (TIR)

Very Low (<54 mg/dL): Dangerous hypoglycemia
Low (54-69 mg/dL): Hypoglycemia
In Range (70-180 mg/dL): Target range
High (181-250 mg/dL): Hyperglycemia
Very High (>250 mg/dL): Significant hyperglycemia

Key Metrics

GMI: Glucose Management Indicator (estimated A1C from CGM data)
CV: Coefficient of Variation (<36% indicates stable glucose)
Hourly Averages: Shows patterns throughout the day

Configuration (Required)

Set the NIGHTSCOUT_URL environment variable to your Nightscout API endpoint:

# Linux/macOS
export NIGHTSCOUT_URL="https://your-nightscout-site.com/api/v1/entries.json"

# Windows PowerShell
$env:NIGHTSCOUT_URL = "https://your-nightscout-site.com/api/v1/entries.json"

# Windows (persistent)
[Environment]::SetEnvironmentVariable("NIGHTSCOUT_URL", "https://your-nightscout-site.com/api/v1/entries.json", "User")

The script will not run without this environment variable configured.