Key points to remember about glucose monitoring in children with diabetes

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

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

Blood glucose 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 blood glucose levels 4 to 6 times every day

Children and young people with type 1 diabetes should monitor their blood 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 blood glucose levels 

Keep a record of the blood 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 blood glucose levels less frequently. All children and young people with diabetes should keep a log book record of their blood 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 blood glucose monitoring at the Starship Children's Hospital website [1]. 

[1]

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) measure glucose levels in the fluid surrounding the body's cells. This fluid is called interstitial fluid. 

Both CGM and FGM devices use a sensor which goes into the fatty layer under the skin. With FGM, you can get a glucose reading by holding a reader 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). Both types of devices can show trends in glucose levels. CGM allows setting of hyper/hypoglycaemia alarms.

Limitations of these devices

These devices are currently not funded in New Zealand, and cost is a barrier for many. Another limitation of CGM and FGM systems is that when you measure glucose levels from the interstitial fluid rather than blood, there can be a delay in the CGM/FGM reading. This is because it takes time for glucose to travel from the bloodstream into the interstitial fluid. This delay varies depending on the individual and the device. There will be times when you need to confirm the result with a finger prick blood glucose test. You might need to do this, for example, if glucose levels are very high or low, or your child is sick.

See 'CGM and FGM devices' under External links and downloads below.

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

In New Zealand, the CareSens range of blood glucose meters and test strips are funded. For more information about these meters and test strips, see the link to the Pharmac website below (under External links and downloads).

See the Starship website for more information about glucose monitoring systems [2].