Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Apr 30;9(5):1126-37.
doi: 10.1177/1932296815583507.

Hypo- and Hyperglycemic Alarms: Devices and Algorithms

Daniel Howsmon  1 , B Wayne Bequette  2
Affiliations
Review

Hypo- and Hyperglycemic Alarms: Devices and Algorithms

Daniel Howsmon et al. J Diabetes Sci Technol. .

Abstract

Soon after the discovery that insulin regulates blood glucose by Banting and Best in 1922, the symptoms and risks associated with hypoglycemia became widely recognized. This article reviews devices to warn individuals of impending hypo- and hyperglycemia; biosignals used by these devices include electroencephalography, electrocardiography, skin galvanic resistance, diabetes alert dogs, and continuous glucose monitors (CGMs). While systems based on other technology are increasing in performance and decreasing in size, CGM technology remains the best method for both reactive and predictive alarming of hypo- or hyperglycemia.

Keywords: alarm systems; continuous glucose monitoring; hypoglycemia; low glucose suspend.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(A) CGM alarm sounds, (B) waking dog, who moves to adult room, (C) barking, and awaking adult, who either (D1) pulls lever placing pillow over head or (D2) pulls lever activating SMBG device (E). Low reading (F) causes lever to pull cord, moving bowling ball (G) to wake up child and (H) causing pitcher to pour glass of orange juice, so that the child can now alleviate the hypoglycemia.
Figure 2.
Figure 2.
Illustration of the nadir in skin conductance associated with hypoglycemia.
Figure 3.
Figure 3.
Illustration of an electroencephalogram signal during (a) euglycemia and (b) the increased alpha frequencies associated with hypoglycemia.
Figure 4.
Figure 4.
Illustration of (a) an electrocardiogram signal during euglycemia and (b) the lengthened QT interval associated with hypoglycemia.
See this image and copyright information in PMC

References

    1. Clarke SF, Foster JR. A history of blood glucose meters and their role in self-monitoring of diabetes mellitus. Br J Biomed Sci. 2012;69(2):83-93. - PubMed
    1. Banting FG, Best CH, Collip JB, Campbell WR, Fletcher AA. Pancreatic extracts in the treatment of diabetes mellitus. Can Med Assoc J. 1922;12(3):141-146. - PMC - PubMed
    1. Olmsted JMD, Logan HD. The effect of insulin on the central nervous system and its relation to the pituitary body. Am J Physiol. 1923;66:437-444.
    1. Cannon WB, McIver MA, Bliss SW. Studies on the conditions of activity in endocrine glands. Am J Physiol. 1924;69(1):44-66.
    1. Foshay L. Observations upon the action of insulin on the blood, with special reference to the cause of the condition known as hypoglycemia. Am J Physiol. 1925;73(2):470-479.

Publication types