What’s New in the Dexcom Clarity App
As a Dexcom user, I have developed a close relationship with data from my CGM. My Dexcom G6 measures my glucose level nearly 300 times per day, which adds up to a lot of info to go through when it comes to looking at patterns and trends. To help make diabetes management less overwhelming, Dexcom recently rolled out some new features for the CLARITY app.
Essentially, the latest updates to Dexcom CLARITY are organized to allow me and other users to dive deeper into our data, and also simplified so that we can check to see where things are at a glance. Endocrinologists and certified diabetes educators (CDEs) can access shared patient data through CLARITY, resulting in more human analysis and interaction between visits.
I reached out to the Beyond Type 1 community to break down some of these (along with some trusted older features) and now you can check out their impressions and insights! Read on for more:
This feature provides a quick reference for your most on-target day each week. It’s handy for reviewing by yourself or when sharing data with your diabetes care team.
Kenny Rodenheiser, BSN, RN, CDE, just celebrated his 16th diaversary, and he checks CLARITY about once a week to get an idea of where his BG levels are. He also works with the app to help his patients manage their diabetes. Healthcare providers could benefit from more information on what contributed to the Best Day, like integration with a step-tracking app, but PWDs can get some positive benefits as it is:
“It’s a nice pat on the back for the hard work you put in, OR a wake-up call that your best day is still not so hot.”
Average Glucose (CGM) & Glucose Management Indicator (GMI)
Charli McCarter, whose mom, Tracey, is a member of the Board of Directors for Beyond Type 1, has had Type 1 for over 10 years. Charli says she goes into her CLARITY before appointments with her endocrinologist to make sure things are on track. When using the app, Charli says she is particularly focused on the data that she can check “if I want to see progress on my A1c goal.”
When checking CLARITY, I tend to look at the Average Glucose tab to get an idea of where my BGs have been landing. It’s nice to be able to choose a date range between 2 and 90 days – it reminds me that while there can be room to improve, things that affect my blood sugar (food, exercise, sleep, stress, everything) change over time and might be particularly challenging for one period of time over the next.
The Glucose Management Indicator (GMI) is another resource that can serve as a quick indicator of how your management is going. It’s a tool that estimates what your A1c would be if you got it measured in a lab, based on sensor data from a minimum of 12 days.
Rodenheiser agrees that this feature can put things in perspective: “I use this weekly feature to make settings changes on Sundays, if appropriate. It’s a nice reminder to think about the big picture of diabetes when I am just focusing on the daily tasks of diabetes.”
However, he thinks it could also be improved with some “non-judgmental verbiage that will spark a thought,” like an encouraging message.
Time in Range & Goal: Time in Range
He says that looking at the data presented this way can lead to more tweaks, which hopefully lead to more satisfying outcomes. Compared to the GMI, Kenny tells patients, “You could have a bunch of BG’s in the 400s (mg/dL) and a bunch in the 40s (mg/dL) and have a great Glucose Management Indicator, whereas Time In Range shows true control.”
Like Kenny, who uses Time in Range to gauge how his management has been, I like to see the representation of the percentage of time BGs have been low, high, and in the target range in a simple graph.
Without scrolling through page after page of numbers, I can glance at the CLARITY summary page and get a general idea of how my management has been within a selected timeframe. The simplicity makes the info easy to digest: green = on target percentage, yellow = hyperglycemia, red = hypoglycemia. Precise percentages are right there for easy reference.
The Patterns feature tracks how often BGs remain in the high or low range at certain intervals during the days, for multiple days. It also offers suggestions for improvement.
If CLARITY detects a pattern of Nighttime Highs, it will alert after a minimum of three days and offers some considerations like evening meal times or basal rates that could be adjusted. The alert is broken down to five minutes past the hour (i.e. 2:05am – 6:50am) – not that I know from personal experience, of course!
The default target ranges for BG levels can be customized in the app, and changing these won’t change any settings on your CGM. It only affects how the data is analyzed. The default low threshold is 3.9 mmol/L70 mg/dL, and the default high threshold is 10.0 mmol/L180 mg/dL. Users can set separate target ranges for daytime and nighttime, and the times are also customizable.
Analyzing the data about how often BG levels go below the low threshold, how low the BGs get, and how often this happens gives us a combined rating. Mine’s currently “minimal,” and as a babysitter of kids with Type 1, I’d imagine that this information would be helpful for a family with a young child with Type 1 who are sharing caregiver responsibilities with a babysitter or healthcare provider. A higher-risk rating might result in having extra juice boxes on hand and more tweaking of fast fall alerts.
The tool can be useful, but it’s not a one-size-fits-all feature. Katarina Braune, MD, is a pediatric endocrinologist from Germany who has lived with Type 1 since 2001. She agrees with standards discussed at ATTD 2019 that defined a Time in Range goal of above 3.9 mmol/L70 mg/dL and a low range percentage of below 2% for all age groups.
“The younger the child, the harder it is to control, with children being active, being unpredictable in their meal intake. It is a good feature, but low risk doesn’t mean there are no hypos at all, the individual CGM graphs should still be evaluated,” Katarina says.
Users can also download summary reports for various time periods from the app or from the CLARITY website in order to see combined trends and more takeaways.
This article was published as part of a partnership between Beyond Type 1 and Dexcom.