Q: We’re interested in possibly having our son use a continuous glucose monitor. What are the pros and cons?
A: A continuous glucose monitor (CGM) provides information about blood sugar levels on an ongoing basis, 24 hours a day. A CGM device consists of a sensor placed under the skin, a transmitter, and a cell-phone-sized external monitor to view glucose levels. The monitor is usually worn attached to a belt or clothing waistline, much like an insulin pump.
CGMs measure the level of glucose in the fluid directly beneath the skin (called interstitial fluid). Readings are similar to blood sugar level measurements taken by a glucometer, but not the same. For this reason, using a CGM does not replace finger pokes and routine blood sugar checks.
So why wear one? Because it delivers continuous readings (some devices measure glucose 288 times a day), this extra layer of information can help identify fluctuations and trends that could otherwise go unnoticed, including revealing high or low blood sugar levels between regularly scheduled finger pokes. A CGM can also be set to sound an alarm when the child’s glucose goes above or below a preset range. This can be helpful for catching a low or high even before any physical symptoms are noticed or while the person is sleeping. When a low or high is detected, the wearer then double-checks it by using a glucometer.
For younger kids in the preschool and early elementary age range, there is usually not much resistance in wearing a CGM. Kids in this age group tend to have an easier time “going with the flow” when it comes to introducing different or new elements to their diabetes care. Explaining that a CGM is one more thing you can use to take good care of them is usually enough to gain compliance. Getting used to wearing a CGM is similar to the adjustment of wearing a pump.
For older kids, especially tweens and teens, introducing a CGM is often more of a tough sell, especially when they are told that wearing one won’t reduce the need for glucometer checks. If they already wear a pump, this is one more piece of equipment to deal with, and if they can’t see a clear-cut benefit, they may be resistant. Explaining the helpfulness of the extra information provided by a CGM may just get you a “yeah, and?” response on the part of an older child.
If you do face resistance, pick your battles. The teen years aren’t easy, especially when it comes to maintaining good blood sugar management practices. You can always revisit the CGM issue again at a later time, or ask your diabetes educator to help you make the case.
--Shirley Goodman, R.N., C.D.E., is a staff diabetes educator in the pediatric endocrinology department at the Ann & Robert H. Lurie Children’s Hospital of Chicago.
How Other Parents Deal
“We had some issues adjusting to a CGM and what I call ‘yet another device’ syndrome. However, when the alarm went off one day out of the blue and a meter check confirmed that her number had gone low, suddenly, it didn’t feel like so much of an extra burden to use. We were able to correct the low before the usual symptoms even showed up, because it was caught so early.”
--Brooke, mom of 14-year-old Maddie
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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