DAV in the diabetes community refers to the ups and downs of blood sugar levels.
D = Diabetes
A = Arrow pointing up (hyperglycaemia — high blood sugar)
V = Arrow pointing down (hypoglycaemia — low blood sugar)
Put together, DAV captures the shape of life with diabetes: the constant movement between highs and lows, the never-quite-flat line on a CGM graph, the perpetual negotiation between too much and not enough.
Where does DAV come from?
The arrows themselves have been part of diabetes management for decades. Long before CGMs, insulin pumps used trend arrows to indicate whether blood sugar was rising or falling — giving people managing diabetes not just a number, but a direction. That directional information is crucial: a blood sugar of 7.0 mmol/L (126 mg/dL) means something very different if it's heading sharply upward versus holding steady.
The diabetes community adopted the arrow shorthand organically. Over time, D-A-V emerged as a visual and linguistic representation of that experience — the D of diabetes, flanked by the arrow going up (A) and the arrow going down (V). A kind of typographic EKG for the condition.
As CGM technology became more widespread — with systems like the FreeStyle Libre, Dexcom and Eversense displaying real-time glucose trends — the arrows became even more central to daily management. Most people living with diabetes now check their trend arrow as instinctively as they check the number itself.
What the arrows actually mean in practice
CGMs typically display trend arrows alongside glucose readings. These indicate the rate and direction of change:
- ↑ (single arrow up) — rising moderately, roughly 1–2 mmol/L (18–36 mg/dL) per 15 minutes
- ⇈ (double arrow up) — rising rapidly, more than 2 mmol/L (36 mg/dL) per 15 minutes
- → (flat arrow) — stable and holding steady. The holy grail.
- ↓ (single arrow down) — falling moderately
- ⇊ (double arrow down) — falling rapidly. Treat now. Don't wait.
In hybrid closed-loop systems like CamAPS FX, the algorithm reads these trends continuously and adjusts insulin delivery automatically — reducing the cognitive burden of chasing arrows manually. But understanding what the arrows mean remains important for anyone managing diabetes, regardless of their technology setup.
I'm greater than my highs and lows
The phrase most associated with DAV in the diabetes community is "I'm greater than my highs and lows" — a reminder that blood sugar numbers are information, not a measure of worth. A high reading doesn't mean you've failed. A low doesn't mean you've done something wrong. The arrows tell you what your body needs right now. That's all they mean.
It's a message worth holding onto, especially in a world where diabetes management is still sometimes framed as a test you pass or fail. You are not your CGM graph. You are a person living with a complex condition, doing 180 extra decisions' worth of work every day. The highs and lows are part of that. They don't define you.
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