I’ve had this exact same issue, my high alert is also set to 180, and sometimes my body just likes to hang there. I’ve temporarily changed my high alert to 170, and that works for me. It’s frustrating, but that’s your Dexcom at work.
Remember the alerts are not for a target range but rather to alert you when something needs to be done. If you often hit 180 after meals then perhaps 180 is not the best high alert for you.
We do hit 180 after meals. That is relatively normal. For us. If the insulin kicks in and everything works, it comes back down and does not keep going up. So we do not alert as that is simply a typical condition.
We have the high alert set to 220. Going past 180 and hitting 220 would not be normal for us. It could happen from an unusual meal but more likely would mean something is wrong and action is required on our end.
You may set the “high-alert snooze” to control the amount of time it’s quiet before you are re-alerted. I set mine for 45 minutes especially for those alerts that occur during sleep that may cross that level and float there a while before heading down.
I use the G4 and I think this is still available on the G5 & G6.
Main Menu > Alerts > Advanced > High Snooze > [Use up or down arrow key to set snooze up to 5 hours in 15 minute increments.]
I used to deal with this situation by turning the high alert off after it wakes me up more than once, but when I looked back at the overnight trace after getting up and see a line that’s above my high alert for many hours, I realize that’s not the result I want. So If my BG does not fall below my high threshold in 45 minutes, I definitely want to take some action.
I just learned this trick recently even though I’ve been using Dex systems for nine years!
That does work well for when the Dex BG crosses and stays above the high threshold. We have ours set to 2 hours as it takes generally takes that long to correct a high at that level before it comes down.
However an issue is if the BG is bouncing back and forth across the high threshold itself then the high snooze gets reset each time the BG falls below and so would trigger a new alert when it recrossed the high threshold in the upwards direction.
when it drives you nuts, turn the alert OFF. I had a steroid shot on Friday, which elevates my bg’s to the point where I need about TRIPLE my normal basal and boluses. I was awake much of last night, thanks to being above 150, bolusing numerous times to prevent it from going even higher. Thankfully by the time I got up I was down to the 70’s and that feels fine to me.
Yeah. I might see that at like 65 at times. Which is typically what our low alert is set to. But sometimes that seems to be the “resting spot” and it oscillates very gently up and down continually crossing that 65 threshold. If watching then I might want to just let it go and keep an eye on it. Especially if I know there were slow carbs eaten that most likely are going to be kicking in over the next two hours and bumping it up naturally anyway. So, I bump the alert lower in case I am wrong and it actually drifts lower (like 60 or 55) then it alerts because realistically I am not really watching that 100%. I am doing other things. So dynamically moving the alerts around depending on the situation works well for us.
Tim35, the thing is, if I change the alarm permanently to 220, I’m going to bolus at that time (rather than at 180) and it could get to 250 (or higher) before coming down.
180 is a good number to treat for hyperglycemia if the trend is going up really quickly, so I do not necessarily want to reduce it.
What I do want to eliminate is the repeated, unmutable alerts caused by my bgs repeatedly crossing the “high” threshold within a short period of time.
Turning the alert off, as sis1 and Dave44 suggest, might work but isn’t ideal unless you can turn it off for, let’s say 2 hours before it automatically reactivates. This is effectively the extended snooze alarm that I’m looking for anyway. (It is too easy for me to forget to turn it back on.)
“Shelfing” at a low mark of 65 is not the same issue for me because a low bg must be treated immediately. And once you do, shelfing at 65 becomes a non-issue.
I’m kind of surprised they’re isn’t more hubbub about this annoying UI flaw, as I’m sure it affects a significant number of Dexcom users.
Tim35, do you not use the Dexcom with your endocrinologist to indicate how long a % of time you’re within goal range? That goal for me is 80-180 and is reflected by the (more or less) permanent hi/lo alerts set on the device.
For me, 65 is most certainly a low that must be treated right away. My understanding is that below 80 is low and below 70 must be treated, while 55 or below is urgent. I didn’t think there was too much individual variation on this.
The International Hypoglycaemia Study Group published its recommendations regarding specific hypoglycemia thresholds in Diabetes Care in January 2017. They provide some background in the paper’s introduction as to why specific hypoglycemia thresholds have not produced agreement in clinical and research settings.
Glycemic thresholds for responses to hypoglycemia vary, not only among individuals with diabetes but also in the same individual with diabetes as a function of their HbA1c levels and hypoglycemic experience; it is therefore not appropriate to cite a specific glucose concentration that defines hypoglycemia in diabetes. As a consequence, the American Diabetes Association has defined hypoglycemia in diabetes nonnumerically as “all episodes of an abnormally low plasma glucose concentration that expose the individual to potential harm” (6,7).
This leaves the people with diabetes no specific number to use guiding selection of alarm levels in our diabetes technology. This group did, however, publish some specific glucose levels for researchers and those who conduct clinical trials to use.
My big takeaway with this paper is that hypoglycemia can be thought of as split into two categories: an upper “alert” level from 54-70 mg/dL (3.0-3.9 mmol/L) and a lower level below 54 mg/dL (3.0) that the study characterizes as “serious, clinically important hypoglycemia.”
I realize that the glucose levels that produce hypo symptoms vary from person to person and also within the individual from time to time.
My experience using CGM has shown me that I dependably produce hypo symptoms (increased heart rate and perspiration) at 65 mg/dL (3.6). I expect my doctor to concur with this way of measuring and characterizing my glucose experience in the clinical setting.
I don’t consider 80 or even 70 mg/dL (4.4, 3.9) as a hypo. I don’t want to count these values as hypo since I view them as “normal.” If I treat the 65-80 mg/dL (3.6-4.4) as hypo then I will needlessly be treating normal BGs as hypos and make my overall control effort harder than it needs to be.
We each need to make these decisions for ourselves. I respect different judgments made by others since I believe that we do differ somewhat from each other. I like to use the info collected by this study as the guidance for my actions regarding hypoglycemia. I find it useful when talking with a doctor who likes to characterize much higher levels of glucose as “serious and clinically significant.”
Most things have already been covered to try and help so this is just my 2 cents worth.
First alarm fatigue is the biggest reason people give up on CGM’s. And I must admit, it was almost a deal breaker for me until I was told about the snooze alarms. Once I set my high repeat for 120 minutes (because that is how long it can take sometimes to come down), I wasn’t getting beeped at every 15 minutes. I think that might be the factory setting. I did the same with the low snooze. I have mine set at 45 minutes because it takes some time for any treatment to work.
I must say, I haven’t really noticed alarms going on as it hovers around that 180 mark. I think the term Terry used the blood sugars shelve and hold. I don’t recall it bouncing much above and below my threshold number. Once your numbers get up there, they do tend to get “sticky” and hold.
But really the only option is to treat the high and turn it off until it comes down, not forgetting to turn it back on later. Sorry the alarms are driving you crazy. I hope it doesn’t turn you off to the technology. I feel it’s the best tool out there right now!
The only alarm my daughter has set it her low and urgent low and falling fast. We check it often and know exactly where she is on the blood sugar scale at all times. She’d hate the cgm if she had alarms going off all the time. She knows if she’s high and corrects.
Jim, surely that’s true in a broad sense, but I hope we can all agree that 50 mg/dl, for example, is low for everyone. There’s a point where an individual’s thresholds bump up against an undeniable physiological reality, which is what the researchers in Terry4’s cited study suggest.