Continuous Glucose Monitoring Versus Self-monitoring of Blood Glucose in Children with Type 1 Diabetes—The Pros and Cons

Type 1 diabetes is a disease that affects about 150,000 youths in the US.^1,2 It is characterized by an absence of insulin production by the β-cells of the pancreas.¹ Patients with type 1 diabetes must administer insulin, either via injection or insulin pump, to achieve near-normal glucose metabolism and avoid life-threatening ketoacidosis.¹ Self-monitoring of blood glucose (SMBG) is a cornerstone of modern diabetes treatment.¹ Monitoring of blood glucose provides the data necessary to make daily management decisions related to food intake, insulin do

Type 1 diabetes is a disease that affects about 150,000 youths in the US.^1,2 It is characterized by an absence of insulin production by the β-cells of the pancreas.¹ Patients with type 1 diabetes must administer insulin, either via injection or insulin pump, to achieve near-normal glucose metabolism and avoid life-threatening ketoacidosis.¹ Self-monitoring of blood glucose (SMBG) is a cornerstone of modern diabetes treatment.¹ Monitoring of blood glucose provides the data necessary to make daily management decisions related to food intake, insulin dose, and physical exercise. In addition, monitoring enables patients to avoid acute complications of type 1 diabetes, namely hypo- and hyperglycemia and diabetic ketoacidosis.^1,3,4 Finally, healthcare providers use blood glucose data to identify glycemic patterns, to educate patients, and to adjust insulin.5 Monitoring has been made easier in modern diabetes therapy with the introduction of home blood glucose monitors, which allow patients to check their glucose levels quickly and provide an accurate measure of capillary glucose concentrations. The recent introduction of continuous glucose monitoring (CGM) devices, which measure glucose concentrations subcutaneously in interstitial fluid, offers patients an alternative to traditional SMBG, the relative benefit of avoiding multiple finger-sticks to measure glucose levels, and a wealth of glucose data. Both SMBG and CGM technologies offer clear advantages and disadvantages in diabetes management and both have empirical support demonstrating their efficacy related to promoting better long-term glycemic control (e.g., glycated hemoglobin [HbA_1c]).^6–8

The purpose of this article is to provide an overview of the technologies and the research supporting their use in the management of youth with type 1 diabetes in order to weigh their relative pros and cons.

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