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Optimizing Diabetes Management: 3 Layers of CGM Alerts

By Naomi Kingery

Social Community Manager

Posted:  2/26/2013 4:00 PM


With diabetes, it’s extremely important to know where your blood glucose is, where it’s going, and how fast it’s getting there. Today, Kristin Baker, a CGM Product Specialist here at Medtronic, joins us to talk about three types of continuous glucose monitoring (CGM) alerts to help with that information – Threshold, Predictive, and Rate of Change alerts.

Have you ever had the odd feeling that someone was watching over you throughout the day? The feeling that at just the right moment, someone or something was stepping in at just the right time to help you avoid what could have been a disastrous situation?

For those using the MiniMed Paradigm REAL-Time Revel System or the Guardian REAL-Time CGM System, Continuous Glucose Monitoring (CGM) can in some cases act as a “Guardian Angel” – monitoring your glucose patterns and trends and stepping in to alert you to potential dangerous glucose events ahead so you can take action sooner. 

Our distinctive system offers you not one, not two, but three different types of protection from dangerous glucose levels by allowing you to set threshold, predictive, and rate of change alerts. 

Threshold Alerts: Notify you when your sensor glucose readings have reached or moved below or above the glucose limits you have programmed into your device. 

How It Helps -- Think about when you head out for your morning walk/run to get your day started. Let’s say half way in you start feeling crummy and stop to test. You notice you have a very low blood sugar and stop immediately to take action. When using Threshold alerts, you could have avoided stopping  your walk/run short by setting your low threshold alert and receiving an alert earlier on to warn you that you have reached your low sensor glucose limit and should consider confirming the reading with a fingerstick and taking action (i.e. having a snack or taking some glucose tabs).

Other facts about Low and High Threshold Alerts:
• You may set either the low or high limit or both with guidance from your healthcare team.
• You can set up to eight customizable Low and High limits for different periods of the day.

Predictive Alerts: Notify you to oncoming low or high glucose levels up to 30 minutes before they occur.

How It Helps -- Let’s say you always check your blood glucose before you get in your car to drive in to work or school, and things looks good. But during the drive, as you sense it, you experience a low blood glucose and have to pull over to treat it. How could you have known earlier? Well, when set in your device, predictive alerts could have alerted you 30 minutes before that low glucose level occurred, allowing you to confirm the reading with a fingerstick and consider taking action before you step in the car.

Other facts about Low and High Predictive Alerts:
• You may set a Predictive Low, Predictive High, both or neither with guidance from your healthcare team. 
• Can be set anywhere between 5 to 30 minutes.

Rate of Change Alerts: Notify you about how fast sensor glucose values rise or fall outside your glucose rate of change limits.

How It Helps -- Its lunchtime and you are having a great conversation with friends about your plans for the weekend. Suddenly, the break is over and you rush back to work or class, but you realize you forgot to give yourself a bolus for your meal and now you are concerned about high glucose levels later that afternoon. What do you do? Give your meal bolus and use the rate of change alerts on your CGM device to help you closely monitor the trends of your glucose levels. It will alert you of rapid changes in your glucose levels so you can have more information for further action.

Other facts about Rate-of-Change Alerts:
• You may set a Fall Rate, Rise Rate, both or neither with guidance from your healthcare team. 
• The Rate of Change Alerts can be set from 1.1 to 5.0 mg/dL/minute.
• Alert displays as single or double arrows on your screen

Now, we can’t promise that the Medtronic CGM devices are going to step in and act as your guardian throughout all aspects of your life, but it can offer some additional support when it comes to managing your diabetes. If you have one of these devices and aren’t using these alerts and are interested in experiencing the added protection, ask your doctor about them at your next appointment. 

- Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems. 
- Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms. 

Medtronic Diabetes Insulin Infusion Pumps
- Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day. 
- Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately. 

Medtronic Diabetes Continuous Glucose Monitoring (CGM) Systems
- The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a home glucose meter. A confirmatory fingerstick is required prior to treatment. 
- Insertion of a glucose sensor may cause bleeding or irritation at the insertion site. Consult a physician immediately if you experience significant pain or if you suspect that the site is infected. 

Please visit for complete safety information.


Martha Grimaldo

Posted on Tue Feb 26 20:05:24 GMT 2013

I would like to have more information, and if you have the info. in Spanish will be great.

David Hurlburt

Posted on Tue Feb 26 20:25:55 GMT 2013

Hi, I'm waiting for the "new" CGM that is already approved in Europe and it's been promised to be released here in the US early 2012 (yes, 2012!!). Any information related to the timing of that would be great.

Jamie Griffiths

Posted on Tue Feb 26 20:38:29 GMT 2013

Hi, My son currently has a mini-med insulin pump. He has had it for a few years, how do I go about getting him the larger insulin pump? The other question is, what do you typically need to do to get a CGM?

Thank You!

Annette Gentile

Posted on Tue Feb 26 20:53:51 GMT 2013


I would like to get more information on how to get one of these on Medicare. Thank you.

cherry gardner hartley

Posted on Tue Feb 26 21:12:35 GMT 2013

I would like to know if a prescription is needed for this, how much it costs, does insurance pay for any of it? I have the medtronic revel pump now and it is approx. 2 years old. I would like to have the monitoring system.

Gordon P. Jones

Posted on Tue Feb 26 21:17:33 GMT 2013

My endocrinologist says I need to be on a CGM because of my lack of awareness. I can test and be shocked to see a 28 or a 328. She knows an awful lot, my endocrinologist. However, she has no clue how I'm going to pay for even part of a CGM system on Social Security.


Posted on Tue Feb 26 21:37:59 GMT 2013

Thanks for your questions Martha, Jamie, Annette and Cherry! I’ve passed along your information and someone will be reaching out shortly to help. David, I’m not allowed to talk about future products due to FDA rules. However, please know we have an incredibly bright and dedicated team working hard on what’s next!

Joy Evans

Posted on Tue Feb 26 23:04:13 GMT 2013

How do you go about finding out if your insurance pays for it?


Posted on Tue Feb 26 23:23:55 GMT 2013

So is this like an insulin pump?

Bonita Marston

Posted on Tue Feb 26 23:50:10 GMT 2013

How do you get the cgm, I have your mini med insulin pump but I can,t feel it anymore when it gets low. My other question is would Medicare pay for cgm?

David Anthony Ferrie

Posted on Wed Feb 27 00:22:31 GMT 2013

I've had T-1 Diabetes for 44 yrs and I 'be been on the Medtronics Pump for about 7yrs now,after taking up to 8 shots a day it made Life so much easier you have no idea.It Was Like Receiving A Christmas Present That Changed My Life Forever To The Good! I was taking up to eight shots a day,it was miserable at times.Why can't Medtronics make (1)system that pairs both Pump & CGM?I have a CGM and have used it but it got so ex$pensive to use that I couldn't afford it.


Posted on Wed Feb 27 19:25:12 GMT 2013

I have been diagnosed with diabetes for over twenty years and pumping for eight years. Twice I have used a CGM and benefited from the results each time. The discounted CGM from Medtronics is a great step forwards, making the CGM itself affordable, but I cannot understand why the consumables are; 1, are so expensive, 2. why they have such a limited 'Use by' date and, 3. why can't they be recognised and added to the (Australian) Pharmaceutical Benefits Scheme.


Posted on Wed Feb 27 19:39:01 GMT 2013

Hi Joy, we have a team of people here who would love to help you with submitting to your insurance. Over the years, we’ve worked to ensure access to continuous glucose monitoring. Today, we estimate that nearly 90 percent of people with type 1 diabetes with commercial insurance have access to Personal CGM when medical criteria is met. We work with more than 600 insurers nationwide and can often help with the process and paperwork. We also offer financial assistance for those who qualify. I already have your email address so I’ll have a member from my team follow up with you about your options.

Lenea, the Paradigm Revel system, which is the product Kristin is talking about in this post, is an insulin pump with built-in continuous glucose monitoring (CGM). You can learn more about insulin pump therapy and CGM here: If you’d like to talk to someone, you can email me at


Posted on Wed Feb 27 19:43:41 GMT 2013

Bonita, at this time Medicare does not cover CGM for most patients. Medtronic is actively working with the Centers for Medicare & Medicaid Services (CMS) to ultimately establish coverage consistent with other healthcare insurance companies in the US. Our goal is to ensure consistent access for CGM and insulin pump therapy for all who can benefit. The first step is to work with CMS to assign CGM to a benefit category. We are excited to work this through with industry partners and will keep you updated. We do offer financial assistance to those who qualify, which you can learn more about here Please let me know if you have any other questions or if you would like to be connected with a team member to learn about your options.


Posted on Thu Feb 28 18:42:55 GMT 2013

David, I’m so happy to hear that the insulin pump has helped you to better manage your diabetes. Our MiniMed Paradigm Revel System does integrate both insulin pump and CGM into one device. For safety and product info, please see and I can also have someone reach out to you with some more information.

Hi Phil, Thanks so much for reaching out! I’m glad to hear you’ve had such positive experiences with CGM. We’re the U.S. team and It sounds like you’re in Australia. So, for answers to your questions about the cost and reimbursement in Australia, your best bet would be to talk to your local team. If you contact them at or +61 2 9857 9000 someone would be happy to help you.


Posted on Fri Mar 01 20:18:06 GMT 2013

My Diabetes Educator made an interesting statement during a recent consultation that I am testing. 'Insulin loses it's potency after being exposed to heat after three days'. Three days of insulin equates to approximately 150 units so I am now only filling the reservoirs half way. The results have been very good if you believe glucometer averages. Mine is showing an average of 5.5 over 14 days and has been that way since that meeting. Has anybody else heard of and tried this? and if so, did it make any difference to you? I have purchased a CGM (thanks to the vastly reduced price of $375.00) but I an concerned about the ongoing price ($75.00 per sensor) and how often I should use it. Does anyone have experience of the frequency the CGM should be used?


Posted on Thu Mar 07 22:27:37 GMT 2013

Phil, we recommend changing your insulin, reservoir and infusion set every 2-3 days and are glad to hear you and your diabetes educator have found the best way to do this with the amount of insulin that you use. I’m sorry to hear about your concern about the cost of sensors, but we are committed to working with our customers to determine the best options for access to our therapies ongoing, whether it be payment plans or insurance coverage support. Studies have shown that the more often sensors are worn, the better the clinical outcomes, with the best results occurring when people wear sensors all the time. We suggest speaking with your healthcare provider to determine the best frequency of use for your individual needs and goals.

lupe alikhani

Posted on Sun Mar 10 18:34:25 GMT 2013

need to fined where to get this

indira gogoxia

Posted on Wed Mar 13 16:19:04 GMT 2013

hi,I live in georgia(tbilisi)end i wont tu know how to use this device and how much will cost .thenk you


Posted on Wed Mar 13 17:23:30 GMT 2013

Hi Indira, we're the US team, but please check here for local contacts who would be happy to help you with your questions:

Cory Cyronak

Posted on Thu Mar 21 16:28:52 GMT 2013

I have learned so much from you guys. Thanks for all your posts. Pumps are where its at if you are diabetic. I love medtronic.
Current CGM-104.

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