title: Skin and adhesive issues with continuous glucose monitors: a sticky situation.
abstract: The purpose of this article is to describe challenges associated with successful use of continuous glucose monitoring (CGM) by young children with type 1 diabetes (T1D) and to detail the techniques and products used to improve the duration of sensor wear. The DirecNet Study Group conducted 2 studies in 169 children with T1D between the ages of 1 and 9 years who were instructed to wear a CGM device daily. Problems related to skin irritation and sensor adhesiveness in these young children presented challenges to daily use of the CGM. Study coordinators instituted a variety of techniques using commercially available products to attempt to overcome these problems. Three primary factors that contributed to reduced CGM use were identified: the limited body surface area in smaller children, ambient temperature and humidity, as well as the type and duration of physical activity. Using supplemental products to minimize the impact of these factors resulted in improved adherence and reduced skin irritation. Achieving satisfactory adhesion of the CGM sensor and transmitter may involve finding the right supplemental product or combination of products through trial and error. Optimizing adhesion and minimizing skin irritation can significantly improve duration of use and tolerability of CGM devices by young children.
authors.affiliation: Nemours Children's Clinic, Pediatric Endocrinology, Jacksonville, FL, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Englert
authors.affiliation: Jaeb Center for Health Research, Tampa, FL, USA direcnet@jaeb.org.
authors.forename: Katrina
authors.initials: K
authors.lastname: Ruedy
authors.affiliation: University of Iowa, Pediatric Endocrinology, Iowa City, IA, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Coffey
authors.affiliation: University of Iowa, Pediatric Endocrinology, Iowa City, IA, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Caswell
authors.affiliation: Yale University, Pediatric Endocrinology, New Haven, CT, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Steffen
authors.affiliation: Department of Pediatrics, Washington University, St. Louis, MO, USA.
authors.forename: Lucy
authors.initials: L
authors.lastname: Levandoski
mesh_terms: D000269:Adhesives / Q000009:adverse effects*; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D001830:Body Surface Area; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D004777:Environment; D005260:Female; D006801:Humans; D006813:Humidity; D007223:Infant; D008297:Male; D009043:Motor Activity; D012867:Skin / Q000293:injuries*; D013696:Temperature
chemical_list: D000269:Adhesives
keywords: CGM; adhesive; children; irritation