Alarm Fatigue

Hey all- I’m new to the forums but not to T1D. I have a t:Slim X2 and Dexcom G6 and wondering if anyone has tips on alarm fatigue. Ever since the Dexcom and iOS update last year that implemented the whole “critical alerts” things I feel like i’m going crazy. I have everything turned off that I want to have turned off but the alerts stopping any media, and the insane volume change on the low alerts and fall rate are getting the better of me. I’ve thought about ditching the Dexcom app and just using the t:connect app to see if that will help some but wondered how everyone else is dealing with it all? I understand that it’s like a FDA compliance thing and all that but, man, it would be so nice to be able to customize all these alerts however we see fit.

Alarm fatigue with T1D is horrible! It almost made me give up on my pump before I figured out the magic of vibrate.
I find my tandem pump to be the main source of my fatigue. To turn off/vibrate my pump alarms I go options> down arrow>device settings>sound volume and set all of the options to vibrate, except for pump alarms (occlusion alert, empty cartridge, etc) Those are on low volume. I found that helps a lot.
There’s also another set of settings in the tandem pump- alerts and reminders. To find those settings go from options>my pump>alerts & reminders. Then you’ve got 2 options- in pump reminders I’ve got all of those reminders turned off (low/high BG, after bolus BG) except for missed meal reminders and that volume is turned to vibrate in the sound volume settings. My alerts I leave on- I think you’re required to - low insulin and auto off alerts.

Unfortunately CIQ nearly doubles the amount of alerts you get.

In my dexcom app I only have my low alarms and fall rate alerts set and the other alerts you can’t turn off (for example, urgent low soon) and then I also have my alert schedule so that my phone only makes noise to alert me to lows in the afternoons/evenings/weekends and not during school hours. Since I’m attached to my pump/phone 24/7 and I monitor my BG pretty closely during the day I don’t need all that many alarms. The alert schedule in the G6 app let’s me set my alert settings differently for nights.

Basically my strategy is to turn off any alarms I don’t need/find helpful and turn the remainder to vibrate or low volume.

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Nice to have you return to the Forum, Jenna @Jricer5634 after being silent for a few years.

Lise @6yGodsGr has provided some very good direction for minimizing alarm and alert distraction and you will find more detail when you read the User Manuals, again. Note that during nighttime, all alerts [not alarms] can be silenced.

Rather early on, Basal IQ period before CIQ was released I noticed duplicate alerts - one set from Tandem and one set from Dexcon, I looked through both devices in parallel and did my best to eliminate any overlap - I still get one duplicate I cant figure out. Alarms are important, so I keep them in place for safety.

The other way to eliminate takes a lot of effort - that is, get your basal rates and I:Cr in line and get accurate carb counts. Most of my alerts now are the double up arrows when really guess wrong on carbs. Good luck with this; takes a lot of time.

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Jenna - I am right there with you. There was actually a study. I saw a few months ago that talked about this exact issue specific to type ones. It said that sleep was greatly disturbed by this but other aspects of life as well. They had no answer just said it does exist and needs to be addressed. As you mentioned, the FDA mandates these things, so the companies can’t do anything about it. But the redundancy is rather annoying. If you find any way to get around things, or make it more tolerable, please let me know, and I will do the same.

Hi Jenna -

Thanks for raising this topic in the forum. There are good suggestions here to minimize alerts and turn everything you can to vibrate. I have always immediately turned off/to vibrate every alert and alarm that I can. For me, they’ve always been excessive and not as customizable as I’d like. If it weren’t such a great BG management tool overall, I would have quit using the CIQ system a while ago.

What’s driven me crazy are the audible alarms that interrupt work meetings (I was having some issues with rapid drops, so the system would ramp up from vibrate) and especially the ‘may go low’ vibrate alerts that interrupt my sleep even though usually CIQ effectively prevents me from actually going low. To Dennis’ point, though, the alerts are there for safety. In my case, I’ve been working intensively with my endo team to address the rapid lows, which were concerning. The unnecessary middle-of-the-night alerts continue to drive me nuts, but we’ve made adjustments to address that as well that have helped.

I’m glad to see that there have been studies on the impact of sleep disruption from unnecessary alerts. It often feels like the requirements don’t look seriously enough at real life impacts that can prompt people to stop using otherwise helpful technology.

Hang in there, Jenna. You’re not alone in this!

  • Kristin

Hi Jenna,

I have my T:slim X2 set to vibrate as well. I also adjusted my high and low alert settings so that my low will only my CGM Alerts will sound (IE: my pump alerts are all turned off - - I’ don’t remember if this can be done with Control - IQ or not, as I haven’t used it for quite a while). I have these alerts set so that my low alert will only repeat at 1 hour intervals and my high alerts will only repeat at 4 hour intervals. This way, they are not continually sounding while I am addressing the low or high blood sugar. Check to see if this is a possibility for you. It really helped me!

Pam K.
T1D 58.5 years and counting!