Preventing Hypoglycemia in High-Risk Patients with Regular CGM Data Reviews

Hypoglycemia can be one of the most dangerous complications for people with diabetes. While early signs may include shakiness, sweating, or tingling, more severe episodes can lead to seizures, loss of consciousness, or even death if untreated.

Specifically, glucose levels below 70 mg/dL are considered clinically significant and can impair brain function and increase cardiovascular risk.1 For many, the fear of hypoglycemia is just as disruptive as the condition itself — contributing to anxiety, disrupted sleep, and hesitancy to follow treatment plans that aim for tighter glucose management.²

This fear of hypoglycemia can also disrupt a good night’s sleep for caregivers and people with diabetes. Research demonstrates that people with greater fear of hypoglycemia have poorer sleep quality than someone who has low fear of hypoglycemia.3,4

But with the right tools and regular diabetes data reviews, hypoglycemia doesn't have to be a constant threat. In this post, we’ll explore how ongoing CGM monitoring and data analysis can help you identify patterns, guide treatment, and prevent hypoglycemia — especially in high-risk patients.

Who’s at Higher Risk for Hypoglycemia?

While anyone with diabetes may experience a low blood sugar event from time to time — due to missed meals, delayed eating, or increased activity — certain patients face a much higher risk.

The primary cause of hypoglycemia in people with diabetes is glucose-lowering therapy. Patients taking insulin or sulfonylureas are especially vulnerable⁵ Highly active individuals, such as athletes, are also more prone to lows due to increased energy expenditure.⁶

Over time, some patients may develop impaired awareness of hypoglycemia (IAH) — meaning they no longer experience the typical warning signs. This can make lows even more dangerous, as they may go unnoticed until severe.⁷

One cohort study found that nearly one out of ten people with type 2 diabetes treated with insulin had IAH  — and over 30% had an episode of severe hypoglycemia in the last year.8 Without real-time data, it can be unclear how often lows occur, especially in the absence of symptoms. Without access to real-time data, these events can be difficult to detect or prevent.

The Role of Remote Monitoring and CGM Data Reviews

Prescribing a CGM is a powerful first step — but the greatest benefits come when data is reviewed regularly. Here’s how remote monitoring and frequent data analysis can make a meaningful impact:

1.Spot Hidden patterns and Reduce Time Below Range

CGM reports show you more than just averages — they highlight time below range (TBR), revealing how often a patient dips into hypoglycemia (whether they feel it or not).

The ADA 2025 Standards of Care recommend keeping TBR for Level 1 hypoglycemia (54–69 mg/dL) below 4% in most adults — and under 1% in older adults. For Level 2 (<54 mg/dL), TBR should stay below 1% for everyone.9

Regular data reviews can help you catch trends early, identify impaired awareness, and make timely insulin or medication adjustments to keep patients safer. When TBR reveals the patient is experiencing frequent lows, for example, you can evaluate the patterns and immediately make pump adjustments and other necessary interventions.

2. Determine the Right Cadence of Care

Frequent lows may signal the need for closer follow-up. With CGM insights, you can triage your patient population — prioritizing those who need tighter oversight and scheduling touch points accordingly. SweetSpot makes this possible with a comprehensive data dashboard that allows providers to view CGM/insulin pump data across all major devices across their entire patient population.

When follow-ups occur every 1–2 weeks, outcomes improve. One study found that this cadence of remote data review was linked with better glucose management.10

3. Improve Adherence Through Accountability and Support

When patients know their data is being reviewed consistently — and that someone is looking out for them — they’re more likely to stick to medication regimens and follow behavior recommendations.

That connection fosters trust and reinforces the message that they’re not managing diabetes alone. And as you spot patterns and offer timely support, you’re also helping patients build confidence in managing their condition.11

Empowering Proactive, Data-Driven Diabetes Care

CGM technology provides real-time alerts for dropping blood glucose levels — allowing patients to take action before symptoms escalate. But the real magic happens when those insights are shared with a care team that knows how to act on them.

At SweetSpot, we partner with endocrinology practices to make ongoing CGM monitoring simple, efficient, and effective. Our CDCES-led team proactively reviews data, connects with patients between visits, and helps reduce time spent in dangerous glucose zones — especially for those most at risk.

Want to reduce the burden of hypoglycemia for your patients — and your practice? Let’s work together to make it happen. SweetSpot delivers the consistent CGM/pump monitoring and clinical support needed to prevent lows and keep patients thriving. Check out our website or shoot us a message at info@sweetspot.health.  

References

1. Akhaury K, Wanjari A, Sinha AH, Kumar M. Hypoglycemia and Cardiovascular Disease: Exploring the Connections. Cureus. 2023;15(10):e47784. Published 2023 Oct 27. doi:10.7759/cureus.47784

2. Przezak A, Bielka W, Molęda P. Fear of hypoglycemia-An underestimated problem. Brain Behav. 2022;12(7):e2633. doi:10.1002/brb3.2633

3. Suteau V, Saulnier PJ, Wargny M, et al. Association between sleep disturbances, fear of hypoglycemia and psychological well-being in adults with type 1 diabetes mellitus, data from cross-sectional VARDIA study. Diabetes Res Clin Pract. 2020;160:107988. doi:10.1016/j.diabres.2019.107988

4. Xu J, Xiao S, Xie X, Kang Y, Peng D, Lu Y. Latent Profile Analysis of Fear of Hypoglycemia in Middle-Aged and Elderly Hospitalized Patients with Type 2 Diabetes and Its Relationship with Sleep Quality. Diabetes Metab Syndr Obes. 2023;16:3641-3654. Published 2023 Nov 13. doi:10.2147/DMSO.S431704

5. McCall AL, Lieb DC, Gianchandani R, et al. Management of Individuals With Diabetes at High Risk for Hypoglycemia: An Endocrine Society Clinical Practice Guideline [published correction appears in J Clin Endocrinol Metab. 2023 Feb 15;108(3):e44. doi: 10.1210/clinem/dgac737.]. J Clin Endocrinol Metab. 2023;108(3):529-562. doi:10.1210/clinem/dgac596

6. Cockcroft EJ, Narendran P, Andrews RC. Exercise-induced hypoglycaemia in type 1 diabetes. Exp Physiol. 2020;105(4):590-599. doi:10.1113/EP088219

7. Yu X, Fan M, Zhao X, et al. Prevalence of impaired awareness of hypoglycaemia in people with diabetes mellitus: A systematic review and meta-analysis from 21 countries and regions. Diabet Med. 2023;40(9):e15129. doi:10.1111/dme.15129

8. van Meijel LA, de Vegt F, Abbink EJ, et al. High prevalence of impaired awareness of hypoglycemia and severe hypoglycemia among people with insulin-treated type 2 diabetes: The Dutch Diabetes Pearl Cohort. BMJ Open Diabetes Res Care. 2020;8(1):e000935. doi:10.1136/bmjdrc-2019-000935

9. American Diabetes Association Professional Practice Committee. Glycemic goals and hypoglycemia: Standards of Care in Diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S128-S145. doi:10.2337/dc25-S006

10. Sawyer K, Saxon D, Zane R, et al. A successful remote patient monitoring program for diabetes. Front Endocrinol (Lausanne). 2025;16:1524567. Published 2025 Feb 10. doi:10.3389/fendo.2025.1524567

11. Park S, Kum HC, Zheng Q, Lawley MA. Real-World Adherence and Effectiveness of Remote Patient Monitoring Among Medicaid Patients With Diabetes: Retrospective Cohort Study. J Med Internet Res. 2023;25:e45033. Published 2023 Aug 22. doi:10.2196/45033

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SweetSpot partners with endocrinology practices to provide virtual CGM monitoring and enhanced patient care.

SweetSpot combines a centralized software platform for managing diabetes device data, such as data from CGMs and insulin pumps, with wrap-around clinical support services. SweetSpot’s virtual team of Certified Diabetes Care and Education Specialists (CDCES) perform monthly CGM data reviews and coordinate with providers and patients to facilitate treatment plan changes. By actively managing and remotely reviewing CGM data between patient visits, we ensure patients receive timely treatment adjustments to improve glycemic control and patient outcomes.

Additionally, SweetSpot’s automated capture of reimbursable care events optimizes CPT code utilization, unlocking new revenue streams for practices and making our partnerships both clinically effective and financially profitable.