The use of technologically advanced systems to monitor the sugar levels of students with Type 1 diabetes around the clock have increased dramatically over the last several years.
Henry Rodriguez, MD
Approximately 50 percent of children with Type 1 diabetes under age 18 use continuous glucose monitor systems (CGM for short), according to the American Diabetes Association (ADA) – and the percentage is expected to grow as the technology becomes less expensive, easier to use, and mounting evidence shows that CGM can help reliably control blood sugar at a lower cost than “finger-stick” devices. The CGM systems actually measure sugar in the thin layer of fluid surrounding skin cells, providing a good reflection of blood sugar levels.
Henry Rodriguez, MD, is medical director of the USF Diabetes & Endocrinology Center, which has conducted school nurse trainings in diabetes management for Hillsborough County. He is also a co-chair of the national ADA Safe at Schools Working Group that will soon release guidelines for the use of CGM and sensors in school settings.
Dr. Rodriguez says that school systems in Florida and across the country must be better equipped to respond to the latest generation of CGM devices that measure sugar levels with sensors and wirelessly send that information to a receiver or the patient’s cell phone app. The student’s real-time data can also be shared with several followers, including a school nurse and a parent or guardian. Some of the newer FDA-approved devices can predict hypoglycemia (low blood sugar) and provide alerts to avert it. Some can even communicate with insulin pumps and adjust insulin delivery to assist in preventing high and low blood sugars.
The CGM includes a sensor (fine electrode) the width of a hair placed under the skin with a transmitter clipped onto a plastic base. The hand-held receiver can be kept in a pocket or bag. Through an app, a cell phone can take the place of the receiver, offering the opportunity to share data wirelessly or through cell service.
“Children spend a large part of their day at school, so our school systems will have to come to terms with helping manage the chronic care needs of students with diabetes who wear these newest devices,” Dr. Rodriguez said, “particularly those who aren’t old enough to do self-care.”
That means making sure that the diabetes medical management plans required for individual students are updated to keep pace with changes in standards of diabetes care – and incorporate provisions for CGM agreed upon by parents/caregivers and school staff to improve coordination of care, he said.
As many as 25 million Americans have been diagnosed with diabetes, with more than 700,000 new cases appearing each year.
