Table 1.

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

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.