| Description |
Managing Type 1 Diabetes Mellitus (T1DM) is a challenge for the newly diagnosed patient, especially for the newly diagnosed pediatric patient. T1DM is an irreversible disease process with many risks associated, such as, hypoglycemic events, diabetic ketoacidosis, and increased risk of infection. How best to manage care is of paramount importance for the patient and the caregiver, therefore, the most up-to-date technology should be utilized to provide personalized care plans that will help T1DM pediatric patients avoid many of the short term dangers and long term comorbidities that result from unmanaged glucose levels. This state of the science review takes into consideration the current standard of care for diabetic patients, advancements in continuous glucose monitoring (CGM) technology, and proven tangible benefits, as well as, barriers for use in the newly diagnosed T1DM pediatric patient. Some of the benefits with CGM use are: lower HbA1c levels, decreased episodes of hypoglycemia and hyperglycemia levels, increases in time spent in optimal glycemic range, and an increase in patient satisfaction in their management of diabetes. While there are many benefits to CGM usage, there are barriers to CGM use in the pediatric population. Based on the state of the science review, concern for insurance coverage and cost of the device and supplies are two of the most often cited reasons for reluctance to recommend or use a CGM. Provider and caregiver perceptions are also factors influencing the adoption and compliance of utilizing technology in diabetes care. Some clinicians are more willing to promote CGM usage compared to others. There are also personal perceived barriers and disparities in CGM use in pediatrics such as: limited trust in the device, alarm fatigue, difficulty setting up the monitor, short sensor duration, and daily calibration. The barriers to CGM use should be eliminated to allow for this innovative device to be included in the new standard of care for a T1DM pediatric patient. |
