What are your High and Low Alerts?

How do you live between the lines? My high alert is 220 and low is 80 I have been using dexy for right at a month now I started out with high alert 240 now i seem to be coming more into line better i want to drop my high alert to 200 am I doing this too soon?? Thanks Renz

It really depends on how strict you want to be with yourself taking a little shot of insulin when you see the numbers going thru the roof… :slight_smile:

I have been using the Seven+ for just about two months, and noticed that the defaults of 200-80 were a little too lax for what I could do, so I moved them to 160-70 and am very happy about it. I need to be around 50 to really start to feel “low” and thus I am experimenting a bit with a lower low setting, while 160 gives me enough room to play before I need to correct with some additional insulin. I don’t use a pump.

My last HbA1C before I started with the Seven+ was 7.0% so I was doing relatively OK, did some blood tests after barely 1 1/2 months on the Seven+ and was already down to 6.4%, so I expect wonders in a couple months, when I’ll do another round of blood tests.

Maybe that 220 is a little too high… try to get more “feeling” for the device and see if you can stay lower than that figure, but without stressing out. I’d rather have a slightly higher HbA1C and not be stressed out, than the opposite!

Ciao, Luca

Yeah, I have my high alert set pretty low. I often change it several times during the day (btw 120 and 160), depending on what I’m doing. If I just ate lunch and am expecting to rise somewhat, I might put it at a higher number. However, if I’m sitting at my desk doing nothing and not expecting to see a rise, I’ll set it very low.

Because my alerts are so low, I spend a considerable amount of time “out of range”. However, since I have the Seven Plus, I can set it to remind me every 30 minutes while I am still high. I prefer to know as soon as I start to get high and be reminded frequently while I’m still a bit above where I want to be.

Hi. We used to use Minimed and had the high alarm set at 180 with a 2 hour snooze. It was always way off and if MM sensor read 180, it was usually 220 or higher by then. We then turned off the second alarm for two hours and she was usuallly back lower than 180 by then… or another alarm. When we set her up on Dex 7 Plus, I want the alarm at 160 but will have to make it higher if at school. If Dex reads lower than 160, fine. If it reads higher, I’ll make it 150 or 140. I would do what you feel comfortable with. You can always lower it again, later on. P.S. Would like to catch the high early, because in our case if she is high, it will take hous to come down. Would like to see if we can get a head start on the high.

I had not thought of changing it up and down but thats a great idea and I do think 220 is to high but when i started I was running way 250 to 375 so things are coming in line which is how I know I made the right choice with the Dexy & Opod combination Thanks RenZ

140 “high”, 80 “low” for me.

Rick, I consider you one of the experts in cgms use. On the CWD forums there is an amazing parent who keeps his daughter’s BS in a nondiabetic range (with the exception of postprandial spikes, which he appears to have her go no higher than 160, for the most part). In order to do this, he sets her low target at 80 and her high target at 100. He has a fantastic (if onerous) system in place. He has trained his daughter well and she does not appear to mind his system. He, basically, avoids inaccuracy in Minimed’s Guardian cgms (as you know, these devices are off during quickly changing BS, or when out of a certain blood sugar range), by keeping and correcting in a very tight range, thus avoiding incorrect BGs from the sensor. He finds it easier, in the long run, to stop the roller-coaster before it even gets started. Your thoughts? My sister wants to start her range at 80-120. This would be fine, but is there any way to avoid constant beeps post-prandial? P.S. Dexcom Rep cancelled and we have a tentative startup date next Friday. She is going to summer camp at the end of June and will not want to have alarms going off repeatedly at camp (or at school). But we can keep a tight range at home. I would like to try the 80-100 range overnight as that is the range I would like her in while sleeping (we are up until at least 3am, checking BS and will continue to do so).

P.S. Disregard the above post. I asked the question before we had actually inserted the Dexcom. The high alarm at 120 is too low for us at the moment. For us, Dex more accurate than the Minimed so don’t have to set the high alarm a lot lower (MM used to read 50, 100 points off on the highs and 30 points above the lows for her). Unless BS is rapidly changing, Dex is usually within 20 points of her fingersticks maximum.

Right now my low is set for 70 and my high for 200.

I have it at 70-180. I barely go over 150 after a meal these days…though sometimes in the morning I might hit a 180 after breakfast…though that is more related to the coffee (my only vice these days) than anything else as in an hour time I will be back to 90-120 area, so I do not even correct for that.

At night I turn my high off and check in the morning if there have been any abnormalities, I only have my low on for the night as that is what really scares me.

Further I saw that Carolyn wrote that she spends a considerable time out of range. Though Dexcom has the functionality to set the ranges differently when you have downloaded everything so though you might have set yourself for 80-200 you could view your graph for before breakfast at the range of 70-108 and change it for mid morning etc.

Right now, 55 and 240…hopefully I’ll be bringing that 240 down soon :slight_smile:

I have my alerts set at 80 and 200. I have only been using the dex for two weeks. I have had 3 or 4 nights when my low alert has went off in the middle of the night. I get up and test. Typically, Dex has been about 20 points lower than my monitor however I would rather it wake me then not. Possibly down the road I may lower the bottom to 70 or so.

Hey, Tony: Have you entered a calibration reading to teach it that low readings (with and without alarms) are pretty consistently showing lower than reality?

Don’t just follow the “once per 12 hours” nags from the receiver to do calibrations. If you’re having bG readings in the 80-100 range, which Dexcom showing consistently higher, go ahead and put them in-- that will really help to adjust the calibration. If you only enter bG numbers with higher values (110, 120, 150…) the “curve” for lower readings is based on guesswork. It’s much better to give Dexcom GENUINE data points to work with, if you want the lower readings to be close. (And for most of us, accuracy on lows is much more important than accuracy on highs.)

Even if you’re down at 70 mg/dL, and about to eat a couple of Glucose tabs to “play it safe”, go ahead and put it in-- then eat the tabs. Dex will match your calibration up with the next reading (less than 5 minutes away), and those sugar tabs won’t contribute to major “distortion” of the measurements for about 10-12 minutes.

But, I feel that meter bG readings much below 70 mg/dL probably shouldn’t be used-- the accuracy inside Dexcom’s Sensor falls off to much at these low readings, and excessive variability in those “raw data” at low bG seems to hurt the accuracy of calibration, rather than help it.

You’re entering values via the menu, right? Even if you are using the old “Ultra-2” meter, DO NOT EVER use the download cable. The accuracy advantage which the 7-plus has over the old seven, mostly, is inside changes to the calibration software-- and from what I’ve seen, the “put more weight on the RECENT readings” improvement is disabled when you use the cable. A non-fatal software mistake, I suspect. The best way to avoid it is to throw the download cable away, never use it.

May I ask Rickst29 , who is a great expert in my opinion. He helped me a lot about 1 year ago, when I startet with Dexcom.
You set the alerts at 140 / 80 . What is your HbA1C ? . I reached HbA1C 5,6 - 5,7 by setting at 160/60 , being most of the time below 140 . Can I still improve it ?? (having a very severe diabetes : type I since more than 20 years , hypoglycaemia-unawareness etc., no pump ).

Hi, Ederhi.

Alarm settings like mine will get your attention quicker when you’re “hanging around” moderately high readings of 140-160. But, unless you do fairly extreme diet changes to make your response to meals ultra-smooth, it’s just a bunch of nags-- you WILL go higher, for at least a little while, post-prandial.

If you’re willing to get all “OCD” about timing everything within your meals, making them very slow and complex, then you can almost certainly gain a few tenths of A1C. But the benefits aren’t large, even in that case (probably just a few more tenths downwards). And setting off the alarm so often can the drive people around you absolutely crazy…

You’re doing great already. My A1Cs are about the same, not better than yours. I have to keep my low alarm much higher, because my lows come on really fast and hard, with devastating effects on brain function. (I start grabbing sugar tabs at any reading below 80, and that’s a normal bG for people without my long, terrible history.) If you CAN go all the way down to 60 mg/dL without becoming “falling down stupid”, I love your settings. Keep 'em!

Hi Rickst29,
thank you for your honest reply. I guess we are fellow sufferer, as I really know what you are talking about lows (my wife found me lots of times unconscious - before Dexcom - , it is a wonder that I am still alive) . Inspite of being in great danger with bloodsugar under 70 , I never start a meal > 80 mg%. I have to take just up to 20 g KH per meal - about 8 to 10 snacks a day. And I have to check Dexcom with 3 or 4 blood sugar readings per day, especially before sleeping. And you have to have a bed-fellow, who can rescue you if getting unconscious. Being alone in a hotel I set the low-alarm at 80 aswell. You convinced me: I changed my alerts to 140/60 (day) and 160/60 (night). With setting 140/80 I would get lots of alerts every night - I guess you will have a night without alerts just once a week. If you are a snorer, you have to take a examination for sleeping-apnoe / hypopnoe. I am no snorer , even though I have a little (!) apnoe (demanding no therapy so far), that wake me up about 50 to 100 times (!) a night without noticing it. Every diabetic like us has to do this check, as the frequent (!) apnoe worsen your profile. So I really hate any additional disturbances at night by alerts.

We have had a little experience (less than a month) with Dex now. What I thought we could do (based on one parent on CWDs stellar results), we cannot do. Neither Dexcom nor Minimed is accurate enough all the time to dose from, and her readings may be a little more inaccurate than many. Now we set DN’s high alarm to 180 with a one-hour snooze and the low alarm, we set to 80 usually. At night, before going to sleep, we take note of how Dex is comparing to fingersticks. If Dex has been reading 20 or 30 points higher than the fingerstick, we leave the low alarm at 80 for the night. If Dex is reading lower, we adjust the low alarm higher, such as 100.

My high alert is 120 and low is 80. At night I turn the low alarm off because I don’t like to be woken up. If the 55 alarm goes off at night I drink half a glass of orange juice. My reason for having the low alarm at 80 and not lower is that I need time to react to a falling BG. If the fall is fast I might be at 70 already when the 80 alarm goes off because of the delay. Even if I eat food with a high GI right away the BG will fall further and I might bottom out at 60. That is close enough to the brink for me. I started out with the low alarm at 70 and found it to be unmanageable. The 120 alarm only tells me that I ate too much. I know then that the next time I have to eat less of the same food. The way I measure my ‘success’ is different. I look at mean BG, SD and % of time spent above 140. For the past week my numbers are mean BG=101, SD=23, 6% spent above 140.

Helmut, you will definitely have lots of alerts at night ( with 120 / 80 ). The alarms will be at 120 and at 80 ! If you do not have alerts, you must be a medical wonder ! Turning off the alarm at night is the most stupid you can do. But actually you are doing the same as I do : your low-alarm is 55, my is 60 , no big differance. I like to be woken up when I get higher than 160 (trend will be going to 180 and more at dawn) - so I can shoot a little bit of insulin to prevent it. At daytime you must not eat much when being at 70 , but you have to eat 10 - 20 g KH and 5 (-10) g Glucose with water (!!) first, if you do not like to go down to 50 .

Ederhi, thanks for your response. By turning my low alarm off I end up with alarms at 120/55. In an attempt to separate fact from fiction I consulted the dex download data about my alarm frequency. There is no nice summary about alarms so I had to look at the data day by day. What a revelation! I thought nights are all the same but they are not. At least not for me. I don’t see any reliable pattern. 6 out of 7 nights I am below 80 at some point in time. I get about 2 low alarms at 55 and 2 high alarms at 120 per week (nights only). Interestingly enough I never bottomed out between 55 and 60. Thus I will change my low alarm from 55 to 60. I like the idea of catching the low a little earlier.