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"/>

The CGM Blog

A Parent's Guide to Treating Type 1 Diabetes in Children

Type 1 diabetes (T1D), formerly called juvenile diabetes or insulin-dependent diabetes, is the most common form of diabetes for children and young people1. As a parent of a child living with diabetes you want them to be healthy, you also want to ensure that the decisions you make now help your child avoid health complications2 in the future.

 

At the same time, you want your child to have autonomy and the freedom to experience an active childhood. By exploring the most effective ways to manage T1D, you are more equipped to educate your child on their diabetes management and empower them to lead a healthy, balanced life.

What Does Diabetes Management Look Like?

Managing type 1 diabetes can be complex, where every day is different from the last. However, it’s still possible for your child to find stability and confidence in how they manage their condition.

 

To better manage your child’s T1D, it’s helpful to first have a good understanding of what you’re trying to achieve. Several factors affect blood glucose, such as sleep quality, stress, dehydration, meal timing, and even sunburns to name only a few.3 While navigating these factors, keep in mind what you’re aiming for:

 

     Regulating glucose levels in terms of metrics like A1C or time in range (TIR). 4

     Reducing the frequency of low blood sugar, also known as hypoglycemia.5

     Limiting glucose variability, or swings from high (hyperglycemia) to low (hypoglycemia), caused by fluctuations in blood sugar levels.6

 

Better diabetes management isn’t about reaching all three perfectly. It’s about maintaining a healthy balance with all of them through various daily decisions, including diet and exercise. These three goals are also just a few of the many considerations when managing diabetes each day.

 

There are also technologies available that can assist you and your child to achieve this balance, with the additional benefit of not needing painful routine fingersticks* or sticking by your child’s side 24/7.

How Can I Help Better Manage My Child’s Diabetes?

 

 

No Routine Fingersticks

Most children with T1D have to take several fingerstick tests per day with a blood glucose monitor to keep track of their glucose levels. These fingersticks can be painful, time-consuming, and uncomfortable for kids and young adults to do in public.

 

Fingersticks only provide a snapshot of glucose levels for that particular moment in time. While this is valuable information to discover where your child’s current blood sugar levels are, it doesn’t offer a detailed picture of how often or how quickly their glucose is swinging high or low.

 

There are continuous glucose monitoring (CGM) systems that can be worn on the body for several days in a row, continuously measuring your child’s glucose levels through a discrete sensor. The Dexcom G6 Continuous Glucose Monitoring (CGM) System, for example, allows you to keep track of their current glucose levels and can alert you of highs and lows throughout the day and night, without the need for routine fingersticks.*

 

By using wearable sensors and reducing fingersticks*, you can relieve some of the inconvenience of remembering to do fingerstick tests consistently. At the same time, you can access more information about your child’s glucose levels and what activities impact them.

 

Use Remote Monitoring

When you have a child living with T1D, one of your main concerns may be the assurance that their glucose levels are stable when you’re not together. Whether they’re at school, soccer practice, or a sleepover, you want to be able to keep track of your child’s glucose levels from afar while still giving them the freedom to be a kid.

 

Fortunately for parents, CGM technology allows remote monitoring of glucose levels. For example, Dexcom G6 sends real-time glucose readings from your child’s sensor to a compatible smart device up to every 5 minutes. That data can then be shared with others using the Dexcom Follow app.

 

This means an older child can regularly monitor their glucose on their smartphone while their parents can also receive that data on theirs. Dexcom Follow allows your child to share their glucose value, speed, and direction with you. Parents can even customize alerts to be notified when their child’s glucose reaches a certain level.

 

Through remote monitoring, you and your child can manage their T1D together, even when you’re apart. You can have a little more peace of mind knowing their glucose data is not only in the palm of their hands but in yours, too.

 

Be Proactive

Identifying hypoglycemic or hyperglycemic events when they happen — through tactics like remote monitoring — can be crucial for your child’s health. However, managing diabetes requires you to be persistent and proactive so you can prevent them before they happen.

 

Diet and exercise are a few of the simplest ways for your child to be proactive about their diabetes. Diabetes Canada suggests that every child or adolescent with T1D should consult with a registered dietitian to understand which foods will keep their glucose levels balanced. They also suggest that your child learn what adequate physical activity looks like for them and how smoking and substance abuse can negatively impact their condition.7

 

Additionally, CGM technology can notify the user of the display device before a serious low (below 3.1 mmol/L), whether that’s your or your child. Dexcom G6 can send a predictive Urgent Soon Low alert to a compatible smart device or G6 receiver up to 20 minutes before a potential hypoglycemic event. This can give you time to take action and make an appropriate treatment decision to help your child avoid going low. Dexcom G6 also offers the ability to customize notifications to inform you or your child when their glucose levels shift out of their target range. Be sure to first speak with your healthcare team about what your child’s target range could be, and then set your alerts to stay in the know.

 

A 2021 study showed that the use of CGM by children ages two to seven led to fewer hypoglycemic and hyperglycemic events and less glucose variability. Plus, the participants and their parents reported feeling less burdened by their diabetes care and less worried about hypoglycemia or hyperglycemia by the end of the study.8

How Can I Educate & Empower My Child to Manage Their T1D?

As your child gets older, you want them to have the tools and knowledge to be in charge of their own diabetes management. CGM devices can be an effective way to help in this time of transition.

 

Indicated for anyone as young as two years old, the Dexcom G6 can help your child to better understand and recognize what impacts their glucose patterns — from the foods that make levels rise to the activities that make them fall. Over time, they can then have greater control over the treatment decisions that will positively impact their condition.

 

Dexcom G6 also helps to create a partnership between you and your child. Since you both can have access to their glucose data, you can work together to proactively manage their glucose levels each day. And with an easy-to-wear§ sensor and transmitter, your child can wear it day and night, with no routine fingersticks* or scanning required.

 

Put the Power of CGM in Your Hands

Type 1 diabetes can be life-altering for children and young adults, as well as their caregivers. However, advances in glucose monitoring technology offer families the opportunity to work together to manage diabetes as a team. Many are learning how the Dexcom G6 can assist them with understanding their child’s unique condition and guiding their child to make good decisions with their diabetes care. Understandably, you’ll have questions along the way. Our team of Account Specialists can help you find out more about insurance coverage and how you can empower yourself and your child to take control of their diabetes management and lead a healthy, active life.

 

*If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.

† For a list of compatible smart devices, please visit dexcom.com/compatibility.

‡ Requires the Dexcom Follow app and an internet connection. Followers should always confirm readings on the Dexcom G6 CGM app or receiver before making treatment decisions.

§ Dexcom Using Your G6 Guide

 

1 “Access to Continuous Glucose Monitors in Pediatric Diabetes Populations Improves Glycemic Control, Reduces Hypoglycemia and Improves Satisfaction with Diabetes Care and Technology Use,” American Diabetes Association, June 10, 2019, accessed July 5 2021, https://www.diabetes.org/newsroom/press-releases/2019/access-to-continuous-glucose.

2 “Diabetes and Health Complications: What to Know, What to Do, What to Ask.” diaTribe, June 29, 2021. https://diatribe.org/diabetes-and-health-complications-what-know-what-do-what-ask.

3 “10 Surprising Things That Can Spike Your Blood Sugar,” Centers for Disease Control and Prevention (Centers for Disease Control and Prevention, April 23, 2021), https://www.cdc.gov/diabetes/library/spotlights/blood-sugar.html.

4 Monica Andrade Lima Gabbay et al., “Time in Range: a New Parameter to Evaluate Blood Glucose Control in Patients with Diabetes,” Diabetology & Metabolic Syndrome (BioMed Central, March 16, 2020), https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-020-00529-z

5 “Hypoglycemia (Low Blood Glucose),” Hypoglycemia (Low Blood Glucose) | ADA (American Diabetes Association), accessed July 23, 2021, https://www.diabetes.org/healthy-living/medication-treatments/blood-glucose-testing-and-control/hypoglycemia.

6 J. Hans DeVries, “Glucose Variability: Where It Is Important and How to Measure It,” Diabetes (American Diabetes Association, May 1, 2013), https://diabetes.diabetesjournals.org/content/62/5/1405.

7 Type 1 Diabetes in Children and Adolescents, Wherrett, Diane K. et al. Canadian Journal of Diabetes, Volume 42, S234 - S246

8 Strategies to Enhance New CGM Use in Early Childhood (SENCE) Study Group. A Randomized Clinical Trial Assessing Continuous Glucose Monitoring (CGM) Use With Standardized Education With or Without a Family Behavioral Intervention Compared With Fingerstick Blood Glucose Monitoring in Very Young Children With Type 1 Diabetes. Diabetes Care. 2021;44(2):464-472. https://care.diabetesjournals.org/content/44/2/464