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HELP! How can I monitor my child's blood sugar?


A Continuous Glucose Monitor, known as a CGM, could be just what you need. A CGM is a device attached to the body that gives continuous blood glucose (blood sugar) readings. The use of a smart phone app allows you to check your child's blood glucose when they are nowhere near you, such as when they are at school, after school activities, spending the night at a friends or upstairs playing in their room. Instead of pricking fingertips all day you can just swipe your smart phone. You can let them practice with your smart phone so they are ready to go at whatever age you decide your child is old enough for their own smart phone.


How do CGMs work?


CGMs have a sensor that is either placed on your child's body with a sticky pad and is disposable or is implanted into the body. The disposable sensors are replaced based on manufacturer's guidelines, usually every 7-12 days. The sensor provides an estimate of the glucose level in the fluid between the cells in your child's body. The sensor uses a transmitter to send information to a software program on a smartphone or a receiver. Some insulin pumps can receive blood glucose information directly from CGMs and automatically make insulin adjustments.


How to choose which type of CGM to use?


There are two general categories of CGMs: real-time CGMS and intermittently scanned CGMs.


  • Real-Time CGM: automatically sends blood glucose readings to your smart phone and provides audible alerts when your child's blood sugar is out of range. These alerts can also be programmed to sound on another person's smart phone as a backup alert.

  • Intermittently Scanned CGM: requires you to scan the CGM with your smart phone or a transmitter. The intermittently scanned CGM is often easier to set up and use than real-time monitors and may be more affordable if your insurance doesn't cover real-time CGMs.


There are other differences between the two types of monitors. Your child's doctor and/or diabetes educator can discuss pros and cons of the two types of monitors.


Time In Range (TIR) is a new way to monitor your child's blood glucose with the use of the CGM. You and your child's doctor will work together to determine the upper and lower limits where your child's blood glucose should fall. CGMs can continuously give feedback on your child's TIR. Armed with this data you and your child can monitor triggers for hypoglycemia (low blood sugars) and hyperglycemia (high blood sugars) such as foods eaten, fluids taken in, exercise, taking tests at school, medications and many other daily events. The CGM will show time spent in range, low, or high over a specific amount of time. This range is usually shown in an easy to read graph. You should have a goal to read your child's TIR daily or weekly. This information can help you teach your child how to control their blood sugars which can help avoid other health care problems as they grow.


Your child's doctor will give you guidelines of when you may need to double check your child's CGM reading with a glucose meter and fingerstick.


References

Assessed and Endorsed by the MedReport Medical Review Board

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