[en] Continuous Glucose Monitoring (CGM) has improved the diabetes follow up. The use of CGM can be expected to reduce the long-term complications of diabetes. To achieve this, education of physicians and diabetic individuals is essential. The latest CGMs have alarms to improve glycemic control by avoiding hypoglycemia and hyperglycemia, hence the importance of proper setting of these alarms. Although useful to signal these events, we have noted that these alarms do not necessarily meet with unanimity in consultations… Are alarms considered a comfort or a possible disturbance ?
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Oriot, Philippe ; Service de Diabétologie et Endocrinologie, Centre Hospitalier de Mouscron, Mouscron, Belgium
Klipper dit kurz, Noemie; Service de Diabétologie et Endocrinologie, Centre Hospitalier de Mouscron, Mouscron, Belgium
Ponchon, Michel; Service D'endocrino-Diabétologie, Hôpital Saint-Jean, Belgium
Weber, Eric; Service D'endocrino-Diabétologie, Cliniques du Sud Luxembourg-Vivalia, Arlon, Belgium
Colin, Ides.M.; Unité de Recherche en Endocrino-Diabetologie, Département de Médecine Interne, Centre Hospitalier Régional (CHR) Mons-Hainaut/Groupe Jolimont, Mons, Belgium
McKnight, J.A., Wild, S.H., Lamb, M.J.E., Cooper, M.N., Jones, T.W., Davis, E.A., et al. Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison. Diabetic Med 32:8 (2015), 1036–1050, 10.1111/dme.12676.
Battelino, T., Danne, T., Bergenstal, R.M., Amiel, S.A., Beck, R., Biester, T., Bosi, E., Buckingham, B.A., Cefalu, W.T., Close, K.L., Cobelli, C., Dassau, E., DeVries, J.H., Donaghue, K.C., Dovc, K., Doyle, F.J. 3rd, Garg, S., Grunberger, G., Heller, S., Heinemann, L., Hirsch, I.B., Hovorka, R., Jia, W., Kordonouri, O., Kovachev, B., Kowalski, A., Laffel, L., Levine, B., Mayorov, A., Mathieu, C., Murphy, H.R., Nimri, R., Nørgaard, K., Parkin, C.G., Renard, E., Rodbard, D., Saboo, B., Schatz, D., Stoner, K., Urakami, T., Weinzimer, S.A., Phillip, M, Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care, 42(8), 2019, 15.
Bolinder, J., Antuna, R., Geelhoed-Duijvestijn, P., Kröger, J., Weitgasser, R., Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet Lond Engl 388:10057 (2016), 2254–2263 5 Nov.
Deshmukh, H., Wilmot, E.G., Gregory, R., Barnes, D., Narendran, P., Saunders, S., et al. Effect of Flash Glucose Monitoring on Glycemic Control, Hypoglycemia, Diabetes-Related Distress, and Resource Utilization in the Association of British Clinical Diabetologists (ABCD) Nationwide Audit. Diabetes Care. 21536) (5) Abraham SB, Arunachalam S, Zhong A, Agrawal P, Cohen O, McMahon CM. Improved Real-World Glycemic Control With Continuous Glucose Monitoring System Predictive Alerts J Diabetes Sci Technol, 43(9), 2020, 10.1177/1932296819859334 2021 Jan;15(1):91-97Epub 2019 Jul 4. PMID: 31272204; PMCID: PMC7783013.
Abraham, S.B., Arunachalam, S., Zhong, A., Agrawal, P., Cohen, O., McMahon, C.M., Improved Real-World Glycemic Control With Continuous Glucose Monitoring System Predictive Alerts. J Diabetes Sci Technol 15:1 (2021), 91–97, 10.1177/1932296819859334 JanEpub 2019 Jul 4. PMID: 31272204; PMCID: PMC7783013.
Mitrakou, A., Ryan, C., Veneman, T., Mokan, M., Jenssen, T., Kiss, I., Durrant, J., Cryer, P., Gerich, J., Hierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms, and cerebral dysfunction. Am J Physiol 260:1 (1991), E67–E74 1 Pt.
Lin, Y.K., Groat, D., Chan, O., Hung, M., Sharma, A., Varner, M.W., et al. Alarm settings of continuous glucose monitoring systems and associations to glucose outcomes in type 1 diabetes. J Endocr Soc, 4(1), 2020 bvz0053.
Feig, D.S., Donovan, L.E., Corcoy, R., Murphy, K.E., Amiel, S.A., Hunt, K.F., Asztalos, E., Barrett, J.F.R., Sanchez, J.J., de Leiva, A., Hod, M., Jovanovic, L., Keely, E., McManus, R., Hutton, E.K., Meek, C.L., Stewart, Z.A., Wysocki, T., O'Brien, R., Ruedy, K., Kollman, C., Tomlinson, G., Murphy, H.R., CONCEPTT Collaborative Group. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet, 390(10110), 2017, 10.1016/S0140-6736(17)32400-5 Nov 252347-2359Epub 2017 Sep 15. Erratum in: Lancet. 2017 Nov 25;390(10110):2346. PMID: 28923465; PMCID: PMC5713979.
Szadkowska, A., Czyżewska, K., Pietrzak, I., Mianowska, B., Jarosz-Chobot, P., Myśliwiec, M., Hypoglycaemia unawareness in patients with type 1 diabetes. Pediatr Endocrinol Diabetes Metab 2018:3 (2018), 126–134, 10.5114/pedm.2018.80994 EnglishPMID: 30786677.
Geddes, J., Wright, R.J., Zammitt, N.N., Deary, I.J., Frier, B.M., et al. Practical implementation, education and interpretation guidelines for continuous glucose monitoring: a French position statement. Diabetes Metab, 44(1), 2018 Feb61 72.).
Lin, Y.K., Chan, O., Fisher, S.J., RE: RE: impaired awareness of hypoglycemia continues to be a risk factor for severe hypoglycemia despite the use of continuous glucose monitoring system in type 1 dibabetes. Endocr Pract 25:10 (2019), 1080–1081.
Scheen, A.J., The student's diagnostic vignette. Diagnosis and assessment of hypoglycemia in patients with diabetes mellitus. Rev Med Liege 69:2 (2014), 110–115 FebFrench. PMID: 24683833.
Oriot P., Hermans M.P., Neve C., Vermeulen S., Gruber A., Holvoet M., Luypaert S.: https://abstract.sfdiabete.org/congress/Medias/2020/backoffice/93463/abstract/abstract.pdf.
The barrier of hypoglycemia in diabetes. Diabetes. 2008;57(12):3169–3176]Cryer, P.E, Feig, D.S., Donovan, L.E., Corcoy, R., Murphy, K.E., Amiel, S.A., Hunt, K.F., Asztalos, E., Barrett, J.F.R., Sanchez, J.J., de Leiva, A., Hod, M., Jovanovic, L., Keely, E., McManus, R., Hutton, E.K., Meek, C.L., Stewart, Z.A., Wysocki, T., O'Brien, R., Ruedy, K., Kollman, C., Tomlinson, G., Murphy, H.R., CONCEPTT Collaborative Group. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet 390:10110 (2017), 2347–2359, 10.1016/S0140-6736(17)32400-5 Nov 25Epub 2017 Sep 15. Erratum in: Lancet. 2017 Nov 25;390(10110):2346. PMID: 28923465; PMCID: PMC5713979.
Castellanos, L., Tuffaha, M., Koren, D., Levitsky, L.L., Management of diabetic ketoacidosis in children and adolescents with type 1 diabetes mellitus. Paediatr Drugs 22:4 (2020), 357–367, 10.1007/s40272-020-00397-0 AugPMID: 32449138.
Visser, M.M., Charleer, S., Fieuws, S., De Block, C., Hilbrands, R., Van Huffel, L., Maes, T., Vanhaverbeke, G., Dirinck, E., Myngheer, N., Vercammen, C., Nobels, F., Keymeulen, B., Mathieu, C., Gillard, P., Comparing real-time and intermittently scanned continuous glucose monitoring in adults with type 1 diabetes (ALERTT1): a 6-month, prospective, multicentre, randomised controlled trial. Lancet 397:10291 (2021), 2275–2283, 10.1016/S0140-6736(21)00789-3 Epub 2021 Jun 2PMID34089660.
Avari, P., Moscardo, V., Jugnee, N., Oliver, N., Reddy, M., Glycemic variability and hypoglycemic excursions with continuous glucose monitoring compared to intermittently scanned continuous glucose monitoring in adults with highest risk type 1 diabetes. J Diabetes Sci Technol 14:3 (2020), 567–574, 10.1177/1932296819867688 MayEpub 2019 Aug 2. PMID: 31375042; PMCID: PMC7576953.
Puhr, S., Derdzinski, M., Welsh, J.B., Parker, A.S., Walker, T., Price, D.A., Real-world hypoglycemia avoidance with a continuous glucose monitoring system's predictive low glucose alert. Diabetes Technol Ther 21:4 (2019), 155–158, 10.1089/dia.2018.0359 AprEpub 2019 Mar 22. PMID: 30896290; PMCID: PMC6477579.
Shivers, J.P., Mackowiak, L., Anhalt, H., Zisser, H., Turn it off!": diabetes device alarm fatigue considerations for the present and the future. J Diabetes Sci Technol, 7(3), 2013, 10.1177/193229681300700324 May 1789-94PMID: 23759412; PMCID: PMC3869147.
Roberts, R., Walsh, J., Heinemann, L., Help! Someone is beeping. J Diabetes Sci Technol, 8(4), 2014, 10.1177/1932296814532882 Jul627-9Epub 2014 May 12. PMID: 24876435; PMCID: PMC4764223.
Lin, Y.K., Chan, O., Fisher, S.J., RE: RE: impaired awareness of hypoglycemia continues to be a risk factor for severe hypoglycemia despite the use of continuous glucose monitoring system in type 1 dibabetes. Endocr Pract 25:10 (2019), 1080–1081.
Diouri, O., Cigler, M., Vettoretti, M., Mader, J.K., Choudhary, P., Renard, E., Consortium, HYPO-RESOLVE, Hypoglycaemia detection and prediction techniques: a systematic review on the latest developments. Diabetes Metab Res Rev, 37(7), 2021, e3449, 10.1002/dmrr.3449 OctEpub 2021 Mar 24. PMID: 33763974; PMCID: PMC8519027.