Alarm Fatigue: Turning Disruption Into Data-Driven Action
By IDS intern Amber Jackson, RN, DCESClose your eyes and dream with me. Wrapped in warm sheets, finally at peace after a long day, your eyes are so heavy they drift into bliss. Sleep comes like the warmth of a sunrise, and you’re walking through a quiet utopia in the clouds.
Then the ground begins to shake. A siren of alarms blasts you awake.
Your blood sugar is running off course. Again.
All you want is to sleep. But here we are—awake, frustrated, mentally bargaining with every possible solution to avoid getting out of bed. You would rather do anything than get up.
A “responsible” person with diabetes might change a site, eat something, or do all the right diabetes things. For me, this is when I reluctantly swing my legs out of bed, walk outside in the middle of the night, stomp across the street, and hurl my malfunctioning Omnipod over the fence onto the train tracks with a dramatic UGH. There. Much better.
BEEP. The CGM goes off.
No, I didn’t throw my phone over the fence. But I know I’m not alone in this level of alarm frustration.
People living with diabetes manage constant interruptions—day and night. We experience the annoyance most people feel from a morning alarm, layered with real fear and urgency, 24 hours a day, 365 days a year. It is reasonable to feel overwhelmed. You are one person, doing the best you can.
The question then becomes:
How can we reduce the burden while still using these tools effectively?
What the Research Tells Us About Alarm Response
Continuous glucose monitoring (CGM) systems and connected insulin delivery tools are designed to improve glycemic outcomes—but only if alerts prompt timely action.
A recent retrospective analysis published by Healio Endocrinology examined CGM and smart insulin pen (InPen) data from 1,852 adults with diabetes over a four-month period. The findings underscore the clinical importance of responding consistently and promptly to CGM alerts.
Key Findings:
- Adults who administered bolus insulin 75–100% of the time following a missed-dose alert achieved a mean time in range (TIR) of 67.2%, compared with 50.1% TIR among those who responded 25% of the time or less [1].
- Adults who administered bolus insulin within 10 minutes of a confirmed high-glucose alert achieved a 71.9% TIR, compared with 48.8% TIR when bolusing was delayed by 31–60 minutes [1].
These results demonstrate a clear association between timely insulin response to CGM alerts and improved glycemic control. Faster response times and higher adherence to alerts were consistently linked with increased time in range.
From Alarm Fatigue to Intentional Action
While alarm fatigue is a well-recognized challenge, these findings suggest that alerts can serve as effective clinical tools when paired with realistic expectations and supportive strategies. Recommendations from the Unit of Pediatric Endocrinology, Diabetes and Metabolism suggest practical, sustainable approaches:
- Avoid dismissing alarms without assessment. Even a brief review of the data and a small corrective action can prevent prolonged hyperglycemia or lessen the hypoglycemia. It is easier to deal with it now than suffer the consequences later. [2]
- Reframe alarms as clinical tools. An alarm is not a judgment or failure—it is a prompt to reassess and adjust.
- Individualize alert thresholds. I would love my BG to be 80-110, but that’s just not realistic to live the life I want to live. Targets should reflect realistic, sustainable goals that align with your lifestyle and reduce burnout [2].
- Address glucose issues before sleep and respond to overnight alarms promptly. Proactive correction before bedtime and timely responses during the night can reduce recurrent alerts, improve sleep quality, and help condition alarms as cues for action rather than stressors.
- Respond without judgment. Missed doses happen. The most impactful action is addressing the issue promptly and moving forward. No judgement – clear the alarm, dose, and move forward.
- Support trust in technology. Improved accuracy, user-friendly alert customization, and algorithm development promote sustained and effective alarm use [2].
Supporting Better Outcomes
Technology alone does not improve outcomes—how we use it does. With appropriate education, individualized targets, and intentional responses, CGM alerts can shift from being disruptive to being protective.
For individuals seeking support with alarm settings, response strategies, or establishing realistic glycemic goals, IDS is committed to providing guidance and partnership throughout your diabetes journey. Please let us know how we can help!
References:
[1] Monostra, M. (2025, December 4). Quick response to smart insulin pen alerts improves time in range in type 1 diabetes. Healio: Endocrinology Today. https://www.healio.com/news/endocrinology/20251204/quick-response-to-smart-insulin-pen-alerts-improves-time-in-range-in-type-1-diabetes
[2] Giza, S., Kotanidou, E. P., Tsinopoulou, V. R., Poukoulidou, T., Ntouma, S., & Galli-Tsinopoulou, A. (2025). Can Glucose Alarm Fatigue Threaten the Absolute Clinical Benefit of Continuous Glucose Monitoring in Optimal Glucose Management in Children and Adolescents with Type 1 Diabetes? A Narrative Review. Children, 12(12), 1668. https://doi.org/10.3390/children12121668
