Can CGM help my daughter manage type 1 diabetes?

Question

Hello doctor,

I am reaching out on behalf of my 13-year-old daughter, who was diagnosed with type 1 diabetes two years ago. We have been managing her condition with insulin therapy, using a combination of long-acting and rapid-acting insulins. However, recently, her blood sugar levels have become harder to control, with more frequent highs, especially after meals. Her HbA1c has increased to 8.1%, up from 7.2% six months ago, despite closely following her insulin regimen. She has been feeling more tired than usual and has complained of headaches and increased thirst.

I am concerned about the long-term impact of these fluctuations on her health, especially as she is still growing. We have been thinking about switching her to a continuous glucose monitoring system (CGM) to better track her sugar levels, but I am not sure if this would help stabilize her readings or if we need to consider adjusting her insulin doses. Could you provide advice on how to improve her blood sugar control and whether a CGM would be a good option for her at this stage?

Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

It is essential to review her insulin doses (increase by two units and check sugar levels after two hours of a meal), especially around meals, as she may need higher doses of rapid-acting insulin to cover carbohydrate intake more effectively.

Switching to a continuous glucose monitoring (CGM) system is a great idea.

A CGM can provide real-time data on her blood sugar levels, alerting you to highs and lows, and enabling more precise insulin dosing.
It can also help identify patterns, such as post-meal spikes, which might suggest a need to adjust her insulin-to-carbohydrate ratio.

The ability to track blood sugar trends overnight or between meals can significantly improve overall diabetes management and provide peace of mind.

In addition to insulin adjustments, paying attention to her diet, especially the types and timing of carbohydrates, can help with better control.

Engage her healthcare team to make necessary insulin regimen changes, and discuss CGM options to see if it is the right fit for her needs at this stage of growth.

I hope this has helped you. Please feel free to reach out to me again in case of further queries.

Thank you.