If your child has diabetes, you have a lot to keep track of — what foods they eat, how much exercise they get, and of course, their blood sugar levels. Because blood sugar levels can change frequently — depending on the food, stress, time of day, etc — this can be challenging.
Dexcom G6 continuous glucose monitoring allows you to consistently measure your child’s blood sugar levels — without any finger pokes.
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Key features of Dexcom G6 continuous glucose monitoring:
- Provides continuous real-time readings that help you and your child manage blood sugars based on the current reading and the expected reading.
- Measures interstitial (tissue fluid) glucose every 5 minutes and provides information about changes in the glucose levels as they are occurring. Without a Dexcom G6, blood glucose monitoring should be done with a meter about 3 to 6 times a day. But this doesn’t give a complete picture of where your child’s blood sugars are throughout the entire day — or how and when they change.
- Indicates rising, falling, or stability of blood sugars according to arrows called “rate of change” arrows. This information can be used to make decisions about your child’s treatment.
- Helps decrease the number of low blood sugars and high blood sugars that your child experiences, and in turn, increases the time that their glucose levels are within their target range.
How Do I Use My Child’s Dexcom G6?
The guidelines below will help you use your child’s Dexcom G6 in order to make decisions about their insulin dosing using the current glucose values and how they are changing. You’ll do this by looking at the current glucose value, the direction of the arrows, and the number of arrows (rate of change of the glucose level) that are displayed on the Dexcom G6.
To use your Dexcom G6 for insulin dosing, do the following:
- You can calibrate using a fingerstick blood glucose to ensure the accuracy of the sensor, but this is not required
- Look at the current glucose on the Dexcom G6
- Look at the arrows, which indicate glucose rate of change
- Determine what the expected blood sugar is based on the arrows and the current reading (see table below)
Calculations Table
You can determine your child’s pre-meal calculations for insulin doses according to the predicted glucose, which you can determine using the rate of change arrows.
| Dexcom G6 Arrow | Anticipated glucose in 30 minutes (mg/dL ) |
|---|---|
| Two arrows up ↑↑ | Current glucose + more than 90 mg |
| One arrow up ↑ | Current glucose + 60-90 mg |
| Angled arrow up ↗ | Current glucose + 30-60 mg |
| Straight arrow → | SCurrent glucose |
| SAngled arrow down ↘ | SCurrent glucose minus 30-60 mg |
| SOne arrow down ↓ | SCurrent glucose minus 60-90 mg |
| STwo arrows down ↓↓ | SCurrent glucose minus more than 90 mg |
Remember, there are starting recommendations, and can be modified to be more individualized as needed.
For meals and other insulin doses, use your child’s insulin to carbohydrate ratios, correction factors, and target ranges as determined by your child’s physician.
Target Glucose Values
| Age | Daytime | Bedtime/Overnight | Correction Target | Treat low when less than: |
|---|---|---|---|---|
| Younger than 2 years old | 90-200 | 130-200 | 150 | 90 |
| 2 to 5 years old | 280-180 | 2100-180 | 2150 | 280 |
| 5 years or older | 70-150 | 90-150 | 120 | 70 |
If your child’s sensor glucose is low, you should confirm with a finger stick blood glucose measurement and then treat the low with fast-acting carbohydrates as directed. Don’t give insulin until your child’s glucose has corrected based on their target values.
Do not return to using the Dexcom G6 for dosing until the rate of change arrow has stabilized (is straight) to prevent further lows.
Once you have treated the low blood sugar and the blood sugar has returned to a safe level in their target range, calculate the dose based on food and glucose. Give your child insulin for all the carbohydrates they have eaten after treating the low. Do not give insulin for the carbohydrates used to treat the low.
Look at the Dexcom G6 arrow and make the following adjustments to the glucose on the Dexcom G6 screen:
For current glucose on the screen with up arrows, add the following:
- Two arrows Up ↑↑ : add 90 mg/dL to current glucose
- One arrow Up ↑ : add 60-90 mg/dL to current glucose
- Angled arrow up ↗ : add 30-60 mg/dL to current glucose
- Straight arrow → : use current glucose
For current glucose on the screen with down arrows, subtract the following:
- Two arrows down ↓ ↓: subtract 90 mg/dL from current glucose
- One arrow down ↓: subtract 60-90 mg/dL from glucose
- Angled arrow down ↘: subtract 30-60 mg/dL from glucose
- Straight arrow →: use current glucose
Here are some examples of Dexcom G6 readings and adjustments:
- Dexcom reads 200 with single arrow up ↑: Use anticipated glucose of 260 (200 + 60) insulin dosing.
- Dexcom reads 125 with angled arrow up ↗: Use anticipated glucose of 155 (125 + 30) for insulin dosing.
- Dexcom reads 195 with angled arrow down ↘: Use anticipated glucose of 165 (195 – 30) for insulin dosing.
- Dexcom reads 105 with single arrow down ↓: This predicts a glucose of 45 (105 – 60). Treat the low blood sugar following Children’s Hypoglycemia Guidelines and wait to dose until blood sugar is within normal age range
- Dexcom reads 300 with two arrows up ↑↑: Consider checking fingerstick blood glucose to confirm glucose rise. May use anticipated glucose of 390 (300 + 90) for insulin dosing.
Using Your Child’s Dexcom G6 With An Insulin Pump
If your child is wearing an insulin pump, be sure you enter their readings (the adjusted reading) into the pump at mealtimes.
High Alerts
- If you get a high alert during the day, make certain your child took their pre-meal insulin. If they didn’t, your child should take the amount of insulin they should have received for carbs and the correction
- If they did take their pre-meal insulin, make sure it has been 2.5 – 3 hours before taking a correction dose for the high glucose.
Low Alerts
- If you get a low alert, treat with about 7.5-15 grams as instructed by your child’s physician based on glucose.
- If a low is predicted, treat with 7.5-15 grams of carbohydrate-based on anticipated glucose.
Getting Accurate Blood Sugar Readings From Your Dexcom G6
For the first 2 weeks of using the sensor, you should check your child’s blood sugar with a glucose meter anytime a high or low alert goes off. This will help ensure you are
comfortable with how the sensor is working.
For lifetime use of the Dexcom G6:
- Always check your child’s blood sugar with a fingerstick if their symptoms are not consistent with the Dexcom G6 sensor reading.
- A fingerstick blood glucose meter reading should be used to make insulin dose decisions if the Dexcom G6 is not showing both a glucose reading and a directional arrow.
- Do a fingerstick blood glucose if the CGM reading is not rising 20 minutes after treating a low.
Additional Tips to Get the Most Out of Your Dexcom G6
Calibration of your Dexcom G6
A calibration of the Dexcom G6 sensor using a fingerstick blood glucose may be done to ensure the accuracy of the sensor but is not required.
Remember, you should always check a blood sugar with a fingerstick if symptoms are not consistent with Dexcom G6 reading.
When you calibrate your Dexcom G6:
- Use the same meter for each calibration as each meter has a different accuracy.
- Wash your hands before every fingerstick calibration.
- Only calibrate when the trend arrow on your Dexcom G6 is stable (horizontal).
- Once you check a fingerstick, calibrate the Dexcom G6 right away.
- Dexcom G6 accuracy (with fingerstick blood glucose) is generally within:
- 30% if the Dexcom G6 is reading greater than 70mg/dL
- 30 point difference if the Dexcom G6 is reading less than 70mg/dL
Insulin Stacking
Avoid stacking of insulin. Corrective doses of insulin should not be given any more frequently than every 2.5 to 3 hours — unless ketones are present. If ketones are moderate or large, additional insulin may be needed up to every 2 hours based on your child’s physician’s instructions.
Dexcom G6 Phone Application
The phone application for the Dexcom G6 needs to be open at all times on the phone in order for it to transmit information. If your child is using the receiver, followers and Clarity will not be able to see your child’s blood sugars automatically.
Need Additional Help With Your Dexcom G6? Contact Dexcom CARE?
The Dexcom CARE team of trainers and certified diabetes educators (CDEs) are available to
help you learn more about your child’s Dexcom CGM system. They provide live, interactive support as you discover the value of CGM. They can provide advanced learning education at your convenience.
You can call them using their toll-free phone number: 877-339-2665. They are available to assist you Monday through Friday from 8 a.m. to 8 p.m. PST and Saturday from 8 a.m. to 4 p.m. PST.
Do you still have questions about your child’s Dexcom G6? Contact the diabetes team at Children’s Diabetes Center, Children’s Nebraska at 402-955-3871 for more information about managing your child’s blood sugar levels with Dexcom.