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Using trend arrow data from a real-time continuous glucose monitoring system improves glucose control in pediatric patients with type 1 diabetes, according to an article published in the Journal of the Endocrine Society.
Using previously published and presented methods, researchers examined trend arrow data from the Dexcom G5® Mobile continuous glucose monitoring system (Dexcom G5, Dexcom, Inc., San Diego, CA) to develop a safe and practical approach for adjusting insulin dose in pediatric patients (ages 2 years and older) with type 1 diabetes who are treated with multiple daily injections or insulin pump therapy.
Rather than using percentage or corrective values, the authors divided insulin dose adjustments into the following 5 insulin sensitivity ranges that correspond with pediatric developmental stages:
- 125: highly sensitive; often used in toddlers/preschoolers
- 75 to <125: sensitive; often used in young school-age children
- 50 to <75: fairly sensitive; generally used in older school-age children
- 25 to <50: less sensitive; often used in young, early pubertal teens
- <25: least sensitive; generally used in pubertal teens.
Patients or parents/caregivers can calculate the insulin dose using standard information (ie, current glucose value, insulin-to-carbohydrate ratio, and correction factor) and then add or subtract insulin based on trend arrow data and the patient’s insulin sensitivity range.
It is important to note that this approach should be used only for premeal boluses and for dose adjustments at least 3 hours following a meal. In addition, this approach may not apply to insulin dosing decisions at bedtime, with exercise, and during sick day management.
The authors concluded that this simplified approach may help pediatric patients and their caregivers improve glucose control while using their continuous glucose monitoring system.
Disclosure
This publication was supported by an unrestricted educational grant from Dexcom, Inc., San Diego, California, the manufacturer of Dexcom G5 CGM.
Reference
Laffel LM, Aleppo G, Buckingham BA, et al. A practical approach to using trend arrows on the Dexcom G5 CGM system to manage children and adolescents with diabetes. J Endocr Soc. 2017;1:1461-1476.
