Pediatric Diabetes Educators' Role in Successful Continuous Glucose Monitoring.

Technological advances in the management of type I diabetes have opened a new era of treatment involving real-time continuous glucose monitoring (RT-CGM). RT-CGM systems offer both adults and children with diabetes a view of glucose levels and trends over time versus the conventional "snap shot" of 4 to 6 glucose readings daily obtained with conventional glucose meters. However, the amount of glucose data provided by the RT-CGM can overwhelm both clinicians and families. As these devices become more readily available, pediatric diabetes educators are faced with the new challenge of providing families adequate education to ensure successful utilization of RT-CGM. The Diabetes Research in Children Network (DirecNet) has extensive experience with multiple RT-CGM devices, and has collectively trained approximately 279 families to use these devices. The DirecNet nurse educators have identified key educational concepts, characterized common roadblocks to effective utilization of RT-CGM, and formulated a successful curriculum for teaching and troubleshooting CGM devices. Key educational pieces include indications for wear, technical familiarity with the device, the inherent differences in interstitial and capillary glucose monitoring, clinical decision making with real-time feedback, and analyzing data from retrospective downloads. Common roadblocks to successful RT-CGM include lack of personal investment of the child or family, rigid expectations of RT-CGM exactly mirroring blood glucose levels, high level of anxiety surrounding the amount of data involved, and intolerance to wearing the device. The DirecNet education plan includes these salient teaching points taught over time and may be used by clinicians to implement successful RT-CGM in their own clinical setting. [ABSTRACT FROM AUTHOR]