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Table 1 Common problems seen when starting CGM in children and adolescents, and potential solutions

From: The role of continuous glucose monitoring in the care of children with type 1 diabetes

Problem Potential solution
• Painful sensor insertions. • Apply a lidocaine-based cream 45 to 60 minutes prior to insertion.
• Apply a cool pack prior to insertion (may increase the risk of bleeding at the insertion site).
• Sensors do not adhere to the skin or cause irritation. • Different tapes and wraps may need to be used.
• Tegaderm, or a moleskin tape (Duoderm), can be placed under the sensor and transmitter to act as a barrier.
• Too many “nuisance alarms” that do not agree with SMBG. • Explain the concept of “lag time” upfront.
• Limit calibration to times when blood glucose levels are not changing rapidly.
  • Lower alarm threshold to 70 mg/dL, and use only the low glucose alarm when first starting CGM.