Recent improvements in CGM wearability and performance characteristics may have reduced these barriers in this age-group. The burdens associated with data overload, the disruptions to sleep and activities from device alarms, and the inclination (on the part of parents and medical care providers) to avoid hypoglycemia at all costs created barriers to effective CGM use ( 12). Only 24% of young children in the T1D Exchange Registry achieved an HbA 1c <7.5% (58 mmol/mol) ( 10).Īt the time we began this study, there were no data demonstrating improved glycemic control with continuous glucose monitoring (CGM) use in young children ( 1, 11) and no randomized controlled trials of CGM compared with BG monitoring (BGM) of 6 months’ duration in very young children. Recent evidence indicates that, possibly due to the pervasiveness of parental fear of hypoglycemia, particularly overnight ( 9), the overwhelming majority of young children with type 1 diabetes currently have suboptimal glycemic control. Yet, emerging data indicate that hyperglycemia also adversely impacts central nervous system structure and function in young children ( 1, 6– 8), creating a need for a paradigm shift in diabetes management. Traditional management in young children has emphasized avoidance of hypoglycemia based on scant data on adverse central nervous system outcomes related to youth experiencing recurrent seizure/loss of consciousness ( 3– 5). These variations may result in acute complications of severe hypoglycemia and severe hyperglycemia and even lead to diabetic ketoacidosis (DKA). Care of these children is difficult due to their unpredictable behaviors and eating patterns, inability to articulate symptoms of out-of-range blood glucose (BG) levels ( 1, 2), and frequent intercurrent illnesses. Management of type 1 diabetes in youth is challenging, with considerable demands placed on families of young children. Wong, Saleh Adi, Sarah Corathers, Nicole Sheanon, Cathy Fox, Tammy Weis, Sarah MacLeish, Jamie Wood, Terri Casey, Wendy Campbell, Paul McGuigan, Kupper Wintergerst, Sara Watson, Suzanne Kingery, Gwen Pierce, Heather Ruch, Lauren Rayborn, Manuel Rodriguez-Luna, and Amy Deuser Paul Wadwa, Greg Forlenza, Shideh Majidi, Guy Alonso, Isabel Weber, Michelle Clay, Emily Simmons, Brandon Nathan, Muna Sunni, Jessica Sweet, Beth Pappenfus, Anne Kogler, Marrissa Ludwig, Brittney Nelson, Anne Street, Darcy Weingartner, Anastasia Albanese-O’Neill, Michael Haller, Janey Adams, Miriam Cintron, Nicole Thomas, Jennifer Kelley, Jill Simmons, George William, Faith Brendle, Robin Goland, Kristen Williams, Rachelle Gandica, Sarah Pollak, Emily Casciano, Elizabeth Robinson, Steven Willi, Pantea Minnock, Diana Olivos, Cathy Carchidi, Brian Grant, Jenise C. Collaborators: Strategies to Enhance New CGM Use in Early Childhood (SENCE) Study Group:, Lori Laffel, Kara Harrington, Anat Hanono, Nisha Naik, Louise Ambler-Osborn, Alan Schultz, Linda DiMeglio, Stephanie Woerne, Heather Jolivette, Heba Ismail, Megan Tebbe, America Newman, Megan Legge, William Tamborlane, Michelle Van Name, Kate Weyman, Jennifer Finnegan, Amy Steffen, Melinda Zgorski, Daniel DeSalvo, Marisa Hilliard, Kylie DeLaO, Cicilyn Xie, Wendy Levy, R.

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