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What's your Low Alarm Set at on CGMS?

Discussion in 'Parents of Children with Type 1' started by heamwdevine, May 2, 2011.

  1. heamwdevine

    heamwdevine Approved members

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    I had Anna's alarm set to go off at 80. Well, guess what she really was 32:eek: It makes me think I should set it at 100?

    Just curious what your high and low alarms are set at? After meals she will sometimes go over 200 and I don't want it alarming all the time on her at school.

    Anna doesn't wear it all the time, but I'd like to get a little better with it. We need some help, especially at night. The circles under my eyes are huge and I can barely keep them open. The diabetes camp is sounding better and better, just for the sleep I might get. I'm ready to check into a hotel for one night just to catch up a little. I am digressing. This is really about the CGMS and the alarms LOL
     
  2. bibrahim

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    we have it set at 80 but confirm on the meter and once had a 37 so it happens. It could be falling fast or could be under calibrated. There is also a margin of error on the meter so that figures in too.
     
  3. MOM to KELLSE

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    we have our low alarm set for 100 and our high alarm set for 200.
     
  4. heamwdevine

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    Thanks!:cwds:
     
  5. Flutterby

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    We have low set at 89, and fall rate set at 2, so we get a warning faster. Most of the time it picks it up before a low low happens but sometimes she's just falling to fast so we'll find her a little lower.

    High alarm is set at 200 with the rise rate set at 3 (so they don't get as many rise rate alarms after meals at school).
     
  6. Darryl

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    Until this year we used to set our alarms to 80/100 24 hours a day. Now with basal needs varying so much, we build in more safety margin when basal is high. If her basal is over 1.5u/hr we change the alarms to 100/120, and if over 2.5u/hr we set the alarms at 120/140. With a high basal rate there is always a lot of IOB, so it's too risky to set the low alarm at 80 when basal is high (for the reason you mentioned, e.g., a 32 when BG is just starting to fall on the CGM). We do make a point, though, to return the low alarm to 80 as soon as a period of high basal rate ends. Unless there was a meal bolus error, the risk of a serious hypo is minimum when basal rate is very low.
     
  7. selketine

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    Darryl - I love ya but there aren't many who can do that! :)

    When William first started I set the low alarm high enough that it caught most lows before he got to below 50. I think cgms devices vary so much (we have a Nav still) that it is hard to tell someone else what to do. I think there is always the chance that your child will get fairly low before it beeps if the drop is that fast - and not much you can do except with the cgms you will catch it before there is big trouble usually (IMHO). We now keep his low at 90 which works for us and his low and projected low alarms stay on all the time.

    I would turn off the high alarm completely at school if possible.

    Gary Scheiner (http://www.integrateddiabetes.com/cg_optuse.shtml) has some great advice on starting out with a cgms so that it doesn't drive you insane with alarms - but will help you catch the important things as you learn what works best.
     
  8. Darryl

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    The hard part wasn't the 80/100 alarms. The hard part was admitting it and getting criticized for correcting Leah's BG too often. :):)
     
  9. hawkeyegirl

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    Our low is set at 90 during the day and 80 at night. We rarely have a "fast low" at night, which is why the low alarm can be set lower then.
     
  10. selketine

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    I'll admit I found those discussions about why and how you do it (along with the criticisms) informative - frankly fascinating - and it gave me a different perspective of working with a cgms. I think I am better at setting the high alarm and taking steps to prevent a high (without over-doing it) after reading those threads. I am very happy that you continue to participate in the forums.:)

    The MM cgms has different settings than my Nav so I can't advise on how best to set those. I also think the Nav has more flaws in the higher ranges and with the "indefinite mute" issue on the Nav - it is a real pain to work with the high alarms at night on the Nav if your child is high. Hopefully the MM and Dex aren't that way.

    I think it best for those starting (or restarting) cgms use to set the low alarms higher than some of us do on a regular basis - and perhaps even turn the high alarms off - but check (or have your child if older look themselves) the receiver - even if it means setting the alarm clock once overnight to look. I think one reason people give up on a cgms is all the alarming/beeping drives them crazy. I'd rather see people start out with the minimum of alarms and go from there.:cwds:
     
  11. selketine

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    And sometimes laying on the transmitter (for us) can make it seem he is a bit lower than he really is - for us.
     
  12. hawkeyegirl

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    Oh yes. We have that issue too.
     
  13. denise3099

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    I think ours are set at like 90-200. But we have the predicting alarms set too for 15 minutes. So a steady 95 would trigger anything but a 110 that dropped fast would trigger a low predicited. I find the predicting alarms most useful, even more than the rate, since the rate may go off for dropping from 175 to 150 too fast even if you are no where near low. I forget what system you use but see what options you have. Predictive alarms really help avoid those fast lows.

    Another thing is to really review your data--if you're having lots of alarms, it may not be your alarms that need to be reset but your insulin basal/bolus. 200 is too high for us but it does happen with a spike or whatever, but when I review the data and I see lots of 200 or a 200 for a long time or recognize a pattern then I know that some adjustments need to be made to rates or timing (prebolusing or superbolusing or square bolusing).
     
  14. slpmom2

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    We have different settings for daytime and overnight. During the day, she's set at 80/300, because high alarms were making her crazy at school when she peaked from breakfast. We know that she really can't correct a breakfast spike before 4 hours or she'll crash, so she's not going to do much with high alarms under 300. At night, she's set at 80/200, so that we can catch highs faster. In all cases, we have the predictive alerts set for 20 min; that tends to catch the lows before they're horrible. And then we have a baby monitor in her room so that we can sleep at night and know that we'll be woken up if she alarms. Sleep is a good thing.:cwds:
     
  15. jules12

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    Thanks for posting your fall/rise rates - I think I need to look at his more closely. Right now we are set at 90 and 180 but I think I am going to tweak his fall/rise rates when I get home!!!
     
  16. mom2ejca

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    Our low alarm is generally set at 80, but we reset the alarms based on activity, high/low trends, illness, etc.

    For activity we might move the low alarm up to 100 or higher depending on the intensity and duration of the exercise. Also, on days that I can't keep bg's out of the gutter, I'll bump up the low threshold so that we can try to stay ahead with carbs/basal reductions.

    On a night that bg is hanging out steady in the 80's (meter confirmed), I'll drop the alarm down to 70-75, so we don't get nuisance alarms.
     
  17. mom2two

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    Our low alarm is set at 100 and we don't use the high alarm at school but at home I have it set at 300.
     

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