Mitigating CGM Alarm Fatigue in Pediatric Type 1 Diabetes

Continuous glucose monitoring (CGM) alarm fatigue is emerging as a leading barrier to sustained device use for children with type 1 diabetes and their caregivers.

The literature documents a substantial alarm burden—repeated, often nonactionable alerts, frequent nighttime awakenings, and caregiver distress—that erodes trust and daily functioning. With rapid adoption of CGM and hybrid closed-loop systems, alarm-related burden now threatens the clinical gains of continuous monitoring and risks device discontinuation and reduced adherence.

Studies report increased caregiver burden, frequent sleep disruption, and device abandonment in a meaningful subset of users. Data include evidence of discontinuation, reduced responsiveness in some cohorts, and parental anxiety—signals that translate into monitoring gaps and an increased risk of suboptimal glycemic control.

Clinician-facing mitigation strategies in the review are practical and actionable: personalizing alarm thresholds by individual risk and time of day, implementing tiered alarm triage to separate urgent from non-urgent alerts, providing focused caregiver education and expectation-setting, and scheduling structured follow-up to recalibrate settings.