For many pediatric health conditions, labs, ongoing monitoring and treatment adjustments happen in the clinic. However, when it comes to diabetes, much of the monitoring and adjustments happen between clinic visits. In addition to keeping up with busy schedules, family time and homework, children and teens with diabetes and their caregivers must monitor the condition around the clock, adjusting activity level, diet and treatment as needed. Continuous glucose monitoring (CGM) paired with accessible education can help pediatric patients and their families successfully navigate this complex condition wherever life takes them.
A diagnosis of diabetes often comes with questions and worries. Arkansas Children's endocrinologists and diabetes specialists work closely with families to equip them with the essential skills and knowledge for effective diabetes management. During this process, clinicians and caregivers discuss treatment options, including the potential benefits of CGM beyond glucose monitoring, such as fewer finger sticks, increased autonomy for adolescents and options for remote monitoring.
“All patients are good candidates for continuous glucose monitoring,” said Daniel Mak, M.D., pediatric endocrinologist and medical director of the Center for Obesity and its Consequences in Health Clinic at Arkansas Children’s Hospital. “In specific populations, continuous glucose monitoring may be crucial. That’s especially true for very young children and patients who are non-verbal or have difficulty communicating symptoms.”
The American Diabetes Association (ADA)-certified program at Arkansas Children’s Hospital offers a robust educational program for families and community stakeholders that extends to team members within the hospital.
For families, providing accessible diabetes education ensures they understand their child's condition and builds comfort with condition management and related technology, such as CGM devices. In addition, education empowers caregivers to make decisions confidently and competently while recognizing when to reach out to the care team.
Still, education must go beyond the home, particularly during the school year. To help keep children and teens with diabetes healthy in the community, the multidisciplinary team at Arkansas Children's Hospital offers educational opportunities and resources for school nurses.
Even with careful monitoring, diabetes-related illnesses and other unrelated illnesses and injuries can happen. When children need to be hospitalized, continuity of diabetes care is essential. To address potential gaps in glucose monitoring during hospitalization, endocrinologists and diabetes specialists have developed in-house team member education and pathways for inpatient continuous glucose monitoring.
Research shows strong evidence that CGM improves condition management and outcomes for children and teens with diabetes. The benefits go beyond the data.
"Continuous glucose monitoring can improve blood sugar control and, with better blood sugar control in the long term, reduce diabetes-associated risks," Dr. Mak said. "Our team embraces technology as a tool to improve blood sugar control and quality of life for our patients."
Despite the known benefits of CGM - improving blood glucose management and outcomes for children and teens with diabetes - it is not always available for all patients. The cost of insurance coverage may present challenges for some families. Receiving insurance approval for a CGM device often requires maintaining detailed blood glucose logs. Any gaps in the logs may lead to months-long delays in approval.
The Arkansas Children’s Hospital diabetes team actively works to address barriers and improve access to CGM for all families.
"We advocate for equal access to this technology for all our patients," Dr. Mak said. "Our diabetes team works with state and national organizations, including JDRF [formerly named the Juvenile Diabetes Research Foundation], to promote access to CGM and improve care for patients with Type 1 diabetes."
Our board-certified pediatric endocrinologists provide comprehensive care for children with many endocrine disorders.
More