How Many of Your Lows Go Unnoticed?


How Many of Your Lows Go Unnoticed?

By Bonnie Goldberg, MA, RD, CDE

We all know that hypoglycemia can be extremely dangerous, and catching and treating these lows is challenging (to say nothing of taking too much time out of your day). But did you know that 57% of lows go unnoticed? Many people are having lows without even knowing it, especially at night.* So, what do you do about it?

Well, continuous glucose monitoring (CGM) is a great first step. It measures glucose levels from the fluid under your skin, giving you 288 readings per day instead of just the occasional fingerstick readings. But if you really want protection from lows (especially the ones you might not even know you’re having) knowing your sensor number isn’t enough. You need a system that takes action!

The MiniMed® 530G system with SmartGuard™ technology is the only insulin pump and CGM on the market proven to reduce your risk of lows.^ It includes SmartGuard technology exclusive to Medtronic, a revolutionary breakthrough in diabetes control that automatically stops insulin delivery when your sensor value reaches or falls below a pre-set threshold.

Now, How Does it Work?

When your sensor glucose reaches or falls below the value that you and your healthcare team have set for you, the pump will go into Threshold Suspend (the SmartGuard technology). That means that the pump will sound an alarm, stop all insulin delivery, and display “THRESH SUSPEND” on the screen. When your pump goes into THRESH SUSPEND, you can do one of two things:

1. Clear the Threshold Suspend alarm and select continue to suspend all insulin delivery for two hours from the time that the alarm first occurred.
2. Clear the Threshold Suspend alarm and select restart basal insulin delivery.

The two options above assume that you are able to respond to the Threshold Suspend alarm. But what happens when you are unable to (or choose not to) respond to the Threshold Suspend alarm? Great question. A few things will happen:

1. The Threshold Suspend alarm will continue to siren until you clear the alarm. (The siren cycle includes intervals of the following: a siren alarm, silence, vibration, silence.)
2. Insulin delivery will remain suspended for two hours.
3. Your pump screen will display an emergency message if the alarm isn’t cleared within two minutes of occurring.

If you do not respond to the Threshold Suspend alarm after insulin delivery has been stopped for two hours, basal delivery will restart (regardless of your sensor glucose value).

Want to learn more about the MiniMed 530G system and SmartGuard technology? Visit to see if you qualify for a free trial!

Bonnie Goldberg, MA, RD, CDE, is a Registered Dietitian with a Masters Degree in Health Education from Columbia University. She specializes in diabetes care, and has spent her career educating and empowering people with diabetes. She is proud to currently work for Medtronic Diabetes.


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. MiniMed 530G with Enlite system is intended for the delivery of insulin and continuous glucose monitoring for the management of diabetes mellitus by persons 16 years of age or older who require insulin.

Pump therapy is not recommended for people who are unwilling or unable 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.

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 making adjustments to diabetes therapy. MiniMed 530G with Enlite system is not intended to be used directly for preventing or treating hypoglycemia but to suspend insulin delivery when the user is unable to respond to the Threshold Suspend alarm and take measures to prevent or treat hypoglycemia themselves.

Please visit for more details.

WARNING: The Threshold Suspend feature will cause the pump to temporarily suspend insulin delivery for two hours when the sensor glucose reaches a set threshold. Under some conditions of use the pump can suspend again resulting in very limited insulin delivery. Prolonged suspension can increase the risk of serious hyperglycemia, ketosis, and ketoacidosis. Before using the Threshold Suspend feature, it is important to read the Threshold Suspend information in the MiniMed 530G System User Guide and discuss proper use of the Threshold Suspend feature with your healthcare provider.

*       Bergenstal RM, et al. N Engl J Med 2013;369:224-232

^       Raju B, Arbelaez AM, Breckenridge SM, Cryer PE. Nocturnal hypoglycemia in type 1 diabetes: an assessment of preventive bedtime treatments. J Clin Endocrinol Metab. 2006;91(6):2087-2092.