Glucose alarms approach with flash glucose monitoring system: a narrative review of clinical benefits

Abstract Attaining an adequate glycemic control has been associated with a better prognosis and with a reduction in the risk of developing long-term microvascular and macrovascular diabetic complications. Continuous glucose monitoring (CGM) has been shown to improve glycemic control and reduce blood glucose variability. Furthermore, CGM is associated with greater treatment adherence and higher satisfaction. Hypoglycemia is the most frequent acute complication in individuals with insulin treated diabetes and may limit the achievement of glycemic control. Furthermore, repeated episodes of hypoglycemia, particularly when a severe hypoglycemia event occurs are associated with adverse outcomes. The introduction of glucose alarms improves not only safety of subjects, but also contributes to improve glycemic control. However, depending on the glycemic thresholds, the frequency of alarms could be perceived as excessive, leading to a state of ‘alarm fatigue’, limiting the effective response to the alarms by the individual. The optimization of alarm thresholds tailored to individual needs and preferences can enhance the clinical utility of CGM while minimizing alarm fatigue. When alarms occur, their underlying causes should be investigated to enable appropriate corrections and adjustments. CGM systems equipped with alarms, such as FreeStyle Libre 2, have demonstrated efficacy in reducing hyperglycemia and severe hypoglycemic events, leading to improvements in time in range and quality of life of people with diabetes.