CGMs and Preschoolers?

cdninct · #1 10-17-2011, 11:19 PM

I read other people's posts about CGMs with jealousy. I would really like to have one for my 3-year-old son to see how he is trending and where he is at between checks (getting a bit more sleep at night would be swell, too!). Our clinic has never said no outright, but the staff seem to take as a given the belief that he is too young.

How young were your kids when they started? How did they react to yet another device? My son has no problem with the pump (site changes and wearing it all the time). Are there good reasons to wait? I know the device is only approved for older kids, but I understand that a prescription should take care of that. We've got our check-up in a couple of weeks, and I am trying to decide whether to push now or wait.

Thanks!

lisamustac · #2 10-18-2011, 08:14 AM

My son started using the dexcom around 3. His endo was right on board with us when I mentioned it. You are right that it is FDA approved for kids a little older but with a prescription you can get it.

My son gives me less problem with a dexcom change then the pump site. We can also get a good two weeks out of the sensor so we are really only changing it twice a month.

I think younger kids benefit more from a Cgm because they can't express if they are feeling a high or low. I was very concerned to sick another needle in my baby but I will tell you it has been a very useful tool in keeping him healthy. We wouldn't notice any symptoms until he was really low

now we catch them before it gets to that point.

If you feel it is something that would help you out I would start talking to the endo about it now.

hawkeyegirl · #3 10-18-2011, 08:21 AM

My son was 4 when we started it. We love it, and I can't imagine doing this without it.

In my opinion, the younger the better to get them started. Older kids can be stubborn about using it, but for my son, it's just part of what we do.

champ81 · #4 10-18-2011, 12:45 PM

Our daughter will be 5 on sunday and is very small. We have the MM pink pump and would love to beable to start the CGM to help get better numbers.. Where does your child put the CGM??? WE only do infusion sets in the butt right now and we sure Sure T....

Lance · #5 10-18-2011, 12:55 PM

The CGM is a really valuable tool with young ones. Being able to see trends, and head off spikes and quick drops is fantastic. It also adds a lot of peace of mind when he's in preschool.

hawkeyegirl · #6 10-18-2011, 01:26 PM

Quote:

Originally Posted by champ81

Our daughter will be 5 on sunday and is very small. We have the MM pink pump and would love to beable to start the CGM to help get better numbers.. Where does your child put the CGM??? WE only do infusion sets in the butt right now and we sure Sure T....

When he started pumping, we only used his bottom for infusion sets. When we started CGM two months later, we moved sites to his tummy and put the CGM on his bottom. Basically, you can put an infusion set anywhere you could do a shot, so tummy, legs, arms, bottom.

Lisa P. · #7 10-18-2011, 01:35 PM

I think Selah was 3.

It does not work for us the way it does for some here, it is not something we can dose or correct from, it is often wildly wrong, so there's my disclaimers -- I think that in small kids where the bg goes up and down quickly the CGMS has a harder time tracking things. I think endos are cautious because it would be dangerous to put a toddler on a CGMS if the parent did not recognize these limitations and tried to use it is if it were right on all the time.

However, it is an absolutely life-changing tool even with all its flaws. It has changed the way we live and the way we manage her diabetes. It has helped us get out and live more. And I believe it has probably saved us at least one glucagon shot or hospital trip.

For example, the other night Selah was just post pancake dinner -- I'd never have been looking for a low just after pancakes. CGMS tells me she's not going up, she's lower than she should be, clued me in. She threw up minutes later. Again, sometimes that would drive her bg up but the CGMS clued us in that it didn't this time, so we could spend our time giving her carbs and getting the glucagon ready for a mini-dose if necessary. We were able to slow and reverse the low. I don't know if we'd have seen it soon enough to catch it without the CGMS, since she was really dropping fast (like, 30 points every 5 minutes starting at 150).

We just went back to MDI from the pump. I think carrying the pump was a factor for her. But she's never complained about the CGMS sensor being on, doesn't bug her at all. You don't have to connect and disconnect, worry about yanking tubing, carry around a pouch all the time with the CGMS (I carry the receiver).

Good luck with your decision. I'll also mention that our endo discouraged us from getting the CGMS, he said the technology just wasn't there yet for small kids, and I think we may still be one of the few with small kids in the practice with CGMS. But he still wrote the script for it and the letters of necessity, because he's that kind of doctor -- he advises, gives his opinion straightforwardly, but he doesn't think he's in charge of our diabetes choices. Great guy. So I'd ask your endo to help if you think it's important, just because they don't love it doesn't mean they won't help you get it. Just make sure they know you won't use it improperly, that will help.

cdninct · #8 10-18-2011, 02:02 PM

Quote:

Originally Posted by hawkeyegirl

When he started pumping, we only used his bottom for infusion sets. When we started CGM two months later, we moved sites to his tummy and put the CGM on his bottom. Basically, you can put an infusion set anywhere you could do a shot, so tummy, legs, arms, bottom.

Did you do the tummy with Sure-Ts? I am just concerned about the needle jabbing him all the time!

hawkeyegirl · #9 10-18-2011, 02:15 PM

Quote:

Originally Posted by cdninct

Did you do the tummy with Sure-Ts? I am just concerned about the needle jabbing him all the time!

We did, for a while. We found that it was actually less likely to get bumped around on the tummy than on his bottom. We later switched to Silhouettes, but the SureTs were fine on his tummy while we used them.

cdninct · #10 10-18-2011, 02:33 PM

Quote:

Originally Posted by Lisa P.

It does not work for us the way it does for some here, it is not something we can dose or correct from, it is often wildly wrong, so there's my disclaimers -- I think that in small kids where the bg goes up and down quickly the CGMS has a harder time tracking things. I think endos are cautious because it would be dangerous to put a toddler on a CGMS if the parent did not recognize these limitations and tried to use it is if it were right on all the time.

I can see how that would be a big concern for an endo. I think I have a pretty good handle on what I want it for--trending, looking for patterns, and testing rates when necessary. I would still expect to test nearly as often as before (skip the occasional snack, perhaps, and cut down on night checks, if it proves to be reliable).

I think the endo's office realizes that I understand the limits of the technology, but I will still make it clear to them. I think their big concern is just free space given his size and pain level. I think I will push more this time and see what they say. Typically, they don't say no, like your endo, but I'm willing to listen to their concerns.

Thanks!