Continuous Glucose Monitor in Children With Poorly Controlled Diabetes

Inclusion Criteria

• Clinical diagnosis of diabetes for at least 6 months, type 1 or type 2 diabetes.
• Treated at UT Health Science Center pediatric diabetes clinic for at least the previous 3 months.
• HgbA1c >8.5% (equivalent to average BG of >205 mg/dL for past three months).
• Supportive family with willingness to self monitoring blood glucose values at least 4 times per day during study.
• Supportive family with willingness to participate in continuous glucose monitoring (CGM) for at least 48 hours including self monitoring blood glucose values at least 4 times per day, documenting meals, carbohydrates eaten, insulin dose given, exercise, and hypoglycemic symptoms.
• Attend proposed clinic, nutritional, and CGM follow up visits.
• Pump or multiple daily injection (MDI) insulin therapy (3-4 injections minimum daily). If on pump, on pump for at least the past 3 months. Current insulin regimen involves basal/ bolus therapy with no plans to switch the modality of insulin administration during the study (e.g., injection user switching to a pump, pump user switching to injections).
• Hypoglycemic unawareness.
• English or Spanish primary language.

Exclusion Criteria

• Medications known to affect glycemic control (oral steroids, growth hormone, psychotropics).
• Documented concomitant chronic disease known to affect glycemic control.
• 3 or more incidents in the last 12 months of severe hypoglycemia with documented blood glucose below 50mg/dL (if possible), resulting in unconsciousness, hospitalization or third party assistance, where recovery follows treatment with glucose or glucagon or similar.
• 3 or more incidents in the last 12 months of diabetic ketoacidosis (DKA).
• Reported alcohol or drug abuse.
• Documented cutaneous allergy to latex products.
• Documented eating disorders or morbid obesity as assessed by the investigator.
• Any other medical, social or psychological condition that, in the investigator's opinion, makes the patient unable to comply with the study protocol and all study procedures.
• Home use of CGM in the past 6 months.