Glucose Monitoring In Children With Diabetes

Glucose Monitoring In Children With Diabetes

Glucose monitoring is important for children and young people with diabetes. 

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Key points to remember about glucose monitoring in children with diabetes

  • glucose monitoring measurements are important for children and young people with diabetes

What do I need to know about glucose monitoring measurements in my child with diabetes?

Glucose monitoring measurements are important for children and young people with diabetes to:

  • monitor daily blood glucose control and allow insulin adjustment
  • detect high or low glucose levels so that treatment can be given if needed
  • monitor and treat diabetes during exercise and illness

Monitor glucose levels 4 to 6 times every day

Children and young people with type 1 diabetes should monitor their glucose levels 4 to 6 times every day, or more if needed. Specific times for testing vary for individual children and young people. So, discuss a plan for testing with your specialist diabetes team.

Keep a record of glucose levels 

Keep a record of the glucose levels in a log book or download them into a computer programme on a regular basis. Depending on the treatment required, children and young people with type 2 diabetes may be able to monitor glucose levels less frequently. All children and young people with diabetes should keep a log book record of their glucose levels.

Target ranges for blood glucose levels

These are generally:

  • before meals, 4 to 7 mmol/L
  • after meals, 5 to 10 mmol/L
  • at bedtime, 6 to 10 mmol/L
  • at 3am, 5 to 8 mmol/L

Your diabetes team may give you individualised targets. These may differ slightly to those above.

Video about how to do a blood glucose finger prick test 

See a video about how to do a blood glucose finger prick test and more information and videos about glucose monitoring at the Starship Children's Hospital website

Thumbnail image of a video still showing someone doing a blood glucose finger prick test

What do I need to know about continuous glucose monitoring and flash glucose monitoring in my child with diabetes?

Continuous glucose monitors (CGM) or flash glucose monitors (FGM) are devices that monitor glucose levels in people with diabetes. The devices are another tool for the management of diabetes. They can be helpful in minimising the number of finger-pricks your child needs. They can also help you to see trends in your child's glucose levels. Some devices allow remote monitoring. But, many families manage their child's or young person's diabetes well without CGM or FGM.

How the devices work

Continuous glucose monitors (CGM) and flash glucose monitors (FGM) use sensors which are inserted into the fatty layer under the skin. With FGM, you can get a glucose reading by holding a reader or a smart phone over the sensor. In CGM, a transmitter sends data constantly to a receiver, a compatible insulin pump or a smart device (such as a phone or tablet).

Sensor glucose readings are taken from interstitial fluid, not from blood. Interstitial fluid is the fluid that surrounds the cells of your tissue below your skin. Glucose moves from blood vessels and capillaries first and then into interstitial fluid. When rising or falling quickly (for example, after a meal and/or insulin) sensor glucose will be a bit behind the changes in glucose monitoring. So, it will almost always be a little different. It is important to check glucose levels by finger-prick if symptoms don't match sensor glucose, or you have concerns. One of the real benefits of using continuous or flash glucose monitoring with sensors is that it enables you to see patterns and trends which can be harder to see with intermittent finger-prick glucose testing. CGM allows families to set alarms for high and low glucose levels.

Limitations of these devices

These devices are currently not funded in New Zealand, and cost is a barrier for many. As mentioned in the section above, there can be some variation between the readings from continuous or flash glucose monitoring and blood glucose obtained from finger-pricks. This difference depends on the individual and the device. There will be times when you need to confirm the result with a finger prick blood glucose test.

See more information about CGM and FGM devices in the links below. 

What do I need to know about glucose monitoring meters for my child with diabetes?

In New Zealand, the CareSens range of glucose monitoring meters and test strips are funded. For more information about these meters and test strips, see the link to the Pharmac website below.

See the Starship website for more information about glucose monitoring systems

Acknowledgements

The content on this page has been approved by the Clinical Network for Children and Young People with Diabetes, Paediatric Society of New Zealand.

This page last reviewed 07 April 2022.

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