Alarm settings of continuous glucose monitoring systems and associations to glucose outcomes in type 1 diabetes

Yu Kuei Lin, Danielle Groat, Owen Chan, Man Hung, Anu Sharma, Michael W. Varner, Ramkiran Gouripeddi, Julio C. Facelli, Simon J. Fisher

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Context: Little evidence exists regarding the positive and negative impacts of continuous glucose monitor system (CGM) alarm settings for diabetes control in patients with type 1 diabetes (T1D). Objective: Evaluate the associations between CGM alarm settings and glucose outcomes. Design and Setting: A cross-sectional observational study in a single academic institution. Patients and Main Outcome Measures: CGM alarm settings and 2-week CGM glucose information were collected from 95 T1D patients with > 3 months of CGM use and ≥ 86% active usage time. The associations between CGM alarm settings and glucose outcomes were analyzed. Results: Higher glucose thresholds for hypoglycemia alarms (ie, ≥ 73 mg/dL vs < 73 mg/dL) were related to 51% and 65% less time with glucose < 70 and < 54 mg/dL, respectively (P = 0.005; P = 0.016), higher average glucose levels (P = 0.002) and less time-in-range (P = 0.005), but not more hypoglycemia alarms. The optimal alarm threshold for < 1% of time in hypoglycemia was 75 mg/dL. Lower glucose thresholds for hyperglycemia alarms (ie, ≤ 205 mg/dL vs > 205 mg/dL) were related to lower average glucose levels and 42% and 61% less time with glucose > 250 and > 320 mg/dL (P = 0.020, P = 0.016, P = 0.007, respectively), without more hypoglycemia. Lower alarm thresholds were also associated with more alarms (P < 0.0001). The optimal alarm threshold for < 5% of time in hyperglycemia and hemoglobin A1c ≤ 7% was 170 mg/dL. Conclusions: Different CGM glucose thresholds for hypo/hyperglycemia alarms are associated with various hypo/hyperglycemic outcomes. Configurations to the hypo/hyperglycemia alarm thresholds could be considered as an intervention to achieve therapeutic goals.

Original languageEnglish
Article numberbvz005
JournalJournal of the Endocrine Society
Volume4
Issue number1
DOIs
StatePublished - Jan 1 2020

Bibliographical note

Funding Information:
Financial Support: The current study was supported by NIDDK/WUSM DRC 2P30DK020579, University of Utah Diabetes and Metabolism Research Center, NIDDK 5T32DK091317, and NCATS 1ULTR002538.

Publisher Copyright:
© Endocrine Society 2019.

Keywords

  • Continuous glucose monitoring systems
  • Hyperglycemia
  • Hypoglycemia
  • Type 1 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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