Monitoring of Pediatric Type 1 Diabetes

Abstract

Regular self-monitoring of blood glucose levels, and ketones when indicated, is an essential component of type 1 diabetes (T1D) management. Although fingerstick blood glucose monitoring has been the standard of care for decades, ongoing rapid technological developments have resulted in increasingly widespread use of continuous glucose monitoring (CGM). This article reviews recommendations for self-monitoring of glucose and ketones in pediatric T1D with particular emphasis on CGM and factors that impact the accuracy and real-world use of this technology.

Keywords: blood glucose self monitoring; continuous glucose monitor; diabetes management; ketone; type 1 diabetes (T1D).

Figure 1

An example of how CGM metrics are displayed in a standardized ambulatory glucose profile (AGP). (A) Average glucose, (B) Time very low (<54 mg/dL), (C) Time low (<70 mg/dL), (D) Time in target range (70–180 mg/dL), (E) Time high (>180 mg/dL), (F) Time very high (> 250 mg/dL), (G) Coefficient of variation, (H) Percentage of time CGM is active. In the top figure, the hatched area shows the target range; composite data for 14-days are shown as median (orange line), interquartile range (blue shaded area), 10 and 90th percentiles (green dashed line). Individual days are shown below.