A Visually Continuous Multi-Vendor Glucose Curve Is Not a Medical Record: A Stack-Wise Evaluation Framework for Sensing, Interoperability, Forecasting and AI Briefing in Digital Glucose Care

<jats:p>Background. Digital glucose technologies include continuous glucose monitoring (CGM), emerging sensing modalities, multi-vendor platforms, forecasting models and artificial-intelligence (AI) briefings. These components are already chained into one patient journey, yet they are still often judged by a single convenient metric, such as MARD, a fused curve, RMSE/R² or fluent text. Visual continuity across brands can look like a medical record while stack safety for care remains unevaluated. Risk can therefore propagate along the product stack.Framework and contributions. We propose a four-layer, stack-wise evaluation framework for digital glucose care comprising sensing (L1), platform interoperability and provenance (L2), forecasting (L3), and human–AI briefing (L4). The framework makes three contributions. First, it organises the glucose product stack as successive clinical gates and identifies the false reassurance associated with each layer, complementing horizontal multidomain AI tools. Second, it specifies the cross-brand longitudinal account as an informatics object and treats L2 provenance as the hinge on which L3 and L4 may inherit trust, with acceptance criteria independent of sensor MARD. Third, it translates the gates into a brand-switching cascade test (Figure 3), a Have-you checklist for procurement and ethics (Table 3), an evidence-bound briefing template (Figure 2), and constrained deployment modes.Findings. Synthesising public evaluation and interoperability literature, we show that silent L2 splicing can carry forward as unchanged L3 score thresholds and categorical L4 prose even when L1 labelled claims are individually acceptable; provenance-visible segments, forecast abstention and evidence-bound briefings interrupt that cascade. Tables 1–3 and Figures 1–3 operationalise the gates.Conclusion. Stack-wise gating, with L2 provenance as the hinge, makes readiness for care an evaluable claim before procurement. A visually continuous multi-vendor glucose curve remains an interface achievement until layer-wise warrants are in place.</jats:p>