Daily Management

When my son Makar was four years old and diagnosed with Type 1 Diabetes, I remember thinking: Will he ever be able to play sports?

Fast forward five years, and he’s skating three times a week with his travel hockey team, competing in tournaments across multiple states, and honestly? He’s thriving. Not despite his T1D—but managing it well while doing something he loves.

After 21 years of parenting two kids with Type 1 Diabetes, I’ve learned that T1D and sports aren’t mutually exclusive. They’re not even particularly difficult together once you understand the mechanics of how exercise affects blood sugar and plan accordingly. My daughter played soccer and ran track. Makar lives and breathes hockey. Both have had completely normal, athletic childhoods.

The secret? It’s not about preventing your child from playing sports. It’s about learning to manage their diabetes while they play—and that’s absolutely doable.

Why Sports Are Good for Kids with Type 1 Diabetes

Let me start here, because this is important: Your T1D child should play sports. Full stop.

Physical activity is one of the most powerful tools we have for managing diabetes over the long term. Here’s why:

Better insulin sensitivity. Exercise makes your child’s body more responsive to insulin, which can mean more stable blood sugars overall and potentially lower insulin doses over time.

Improved cardiovascular health. Kids with T1D have a higher risk of cardiovascular disease, but regular exercise significantly reduces that risk.

Mental health benefits. The confidence, social connection, and sense of accomplishment that come from being part of a team or pursuing a sport can’t be overstated—especially for a kid managing a chronic illness.

Better long-term glucose management. Kids and teens who are active typically have better A1Cs and fewer complications down the road.

Normalcy. And honestly? The biggest benefit might be this: sports let your kid be a kid. Not a diabetic kid. Just a kid who plays hockey and checks her blood sugar, not a kid whose whole identity is wrapped up in her diabetes.

I’m not going to pretend there aren’t logistical challenges. There absolutely are. But they’re manageable challenges, and every single one of them has solutions that we’ve tested and refined over years of experience.

Understanding Blood Sugar During Exercise

Before we talk about strategies, you need to understand what exercise does to your child’s body.

Aerobic exercise (running, soccer, basketball, hockey, cycling) causes blood sugar to drop—sometimes dramatically. During steady aerobic activity, your child’s muscles burn glucose rapidly, and their body uses insulin more efficiently. If your child is on a pump, they might need 30-50% less insulin during aerobic exercise.

Anaerobic exercise (sprinting, weight lifting, intense intervals) can actually cause blood sugar to rise in the short term because the body releases counter-regulatory hormones (adrenaline, cortisol) that increase glucose production. But it’s usually followed by a longer period of increased insulin sensitivity afterward.

Mixed sports (like hockey) are tricky because they combine both. Hockey is largely aerobic with sprints and intensity bursts mixed in, which means Makar’s blood sugar can do somewhat unpredictable things during a game.

Post-exercise delayed hypos are the real wildcard. This is when your child’s blood sugar drops 4-12 hours after exercise ends, sometimes dramatically. This happens because the muscles are still pulling glucose to refill their glycogen stores, and the body’s insulin sensitivity remains elevated. This is why we often see lows overnight after a hockey game or tournament day.

Understanding these patterns in your child specifically is key. Every kid’s body is slightly different, and what works for Makar might need adjustment for another child. But these are the general principles you’re working with.

Pre-Game Preparation Checklist

Game days require planning. Here’s what we do before Makar hits the ice:

2-3 hours before game time:

• Check blood sugar. We want him between 150-200 mg/dL when he starts playing.
• If he’s trending low, give a small snack (15g carbs) and recheck in 15 minutes.
• If he’s trending high, we might reduce his pre-activity insulin slightly, or do nothing and let the exercise bring it down.
• Ensure Omnipod is securely placed. (More on placement below.)
• Check Dexcom is working and we have our phone/receiver.

45 minutes to 1 hour before:

• Have him eat a balanced pre-activity snack. For Makar, this is usually something like:
• Half a bagel with peanut butter, or
• A granola bar + cheese stick, or
• Apple with almond butter
• We aim for 20-30g carbs + some protein/fat, which won’t spike his blood sugar but will sustain him through the activity.
• Reduce basal insulin if he’s using an insulin pump. On Omnipod 5, we use the “Exercise” activity setting if available, which automatically reduces basal rates during the selected time window.

15 minutes before:

• Final blood sugar check with Dexcom (or finger stick if needed).
• Have fast carbs accessible on the sidelines (juice box, glucose tablets, regular soda).
• Make sure the coach or team staff knows he has diabetes and has easy access to his emergency supplies.

Right before the game:

• One last Dexcom check. We want visibility into what his blood sugar is doing.

What to Pack in the Sports Bag

I learned the hard way what we actually need. Here’s the non-negotiable list:

• Dexcom receiver or phone (with high-volume alarms enabled—you need to hear them over crowd noise)
• Omnipod supplies (extra pod, batteries if applicable, adhesive patches, tape)
• Fast-acting carbs: Juice boxes, glucose tablets, fruit pouches, regular soda, honey packets
• Sustained carbs: Granola bars, pretzels, fruit, crackers
• Protein sources: Cheese sticks, nuts, peanut butter packets
• Blood sugar meter and strips (backup in case Dexcom fails)
• Finger-stick lancets
• Wet wipes (clean hands before checking blood sugar)
• Glucagon kit (hopefully never needed, but required)
• Insulin pen or backup pump supplies (if using a pump backup system)
• Carb counting reference (I have a laminated card in Makar’s hockey bag)
• Medical ID bracelet (always, everywhere)

We also keep a “game day box” at home that travels to every tournament. It has everything we might need for a full day of hockey, including backup supplies for if something fails.

Pump Management During Sports: Why Tubeless Wins

One of the biggest advantages we’ve found with Omnipod is that it’s completely tubeless. For hockey specifically, this is huge.

With a traditional tubed insulin pump, Makar would need to either:

• Disconnect before getting on the ice (meaning his basal insulin would stop), or
• Keep the pump connected and worry about the tubing getting caught on his hockey stick or other equipment, or
• Worry about the pump site getting hit during a check or collision.

With Omnipod, there’s no tubing to worry about. The pod is just stuck to his body. But—and this is critical—placement matters, especially for a contact sport like hockey.

The arm was our first instinct. But during hockey? His pod slipped off his arm multiple times during his first season. It doesn’t take much—a hard check, the aggression of getting dressed in bulky gear, the friction inside his uniform—and suddenly the pod is partially detached and not working properly.

Now, we place his pod on the back of his thigh, slightly above his buttocks. This spot is protected. It’s not going to get hit during play, it’s not subject to the friction of gear rubbing against it, and Makar is completely comfortable there. We haven’t had a pod failure from dislocation since we switched to this spot.

On game days, we use extra athletic tape to secure the pod. We tape around the edges and sometimes over the top of the adhesive patch, giving it extra insurance against movement. Some parents use adhesive overlays designed for pumps (like Skin Tac or SecureWear patches), which are also excellent.

Omnipod’s tubing-free design also means adjustments are easier. If Makar’s blood sugar is dropping too fast during a game, I can quickly reduce his basal rate using the app on my phone from the sidelines. With a traditional pump, that would require him to pull the pump out of whatever pocket he’s stashed it in and make adjustments.

For swimming, gymnastics, or other sports, you might need different placements—but the principle is the same: put the pod somewhere it won’t get hit, won’t rub excessively, and will stay secure.

Monitoring Your Child During Games

This is where Dexcom becomes your best friend.

The Dexcom G6 gives you real-time insight into your child’s blood sugar trend.

During Makar’s games, I’m not watching the score as much as I’m watching his glucose curve. My phone is in my hand, and I have high and low alarms set to wake the dead (seriously—I have them at maximum volume). When I see the arrow pointing up, I relax a little. When I see the arrow pointing down, I’m mentally preparing to get some carbs in him at first intermission.

Here’s what I watch for:

• Downward trending arrows during play? Typically, I wait until a whistle or stoppage and get him a small carb. A sip of regular soda, a few glucose tablets. I don’t panic over a single arrow—hockey is supposed to lower his blood sugar. But if I see multiple down arrows, I’m intervening.
• Flat or upward trending during play? I usually don’t need to do anything. The exercise will keep bringing him down.
• Sharp drop below 100? I’m pulling him aside and getting fast carbs in immediately. Blood sugar is dropping too fast, and we need to interrupt that momentum.
• Above 200 during play? I might give him water to drink, but I typically don’t inject insulin during a game. The exercise will bring that down.

The key is frequent monitoring and small, preventive adjustments rather than waiting for a low to happen and doing a dramatic rescue. Prevention is always easier than crisis management.

Communication with the coaching staff is non-negotiable. Before every season, we have a conversation with the coach about T1D, what we’re doing to manage it, and when he or she should pause play to let Makar check his blood sugar or have a snack. Most coaches are incredibly supportive once they understand what’s happening.

Dealing with Hypos During Sports

We used to have frequent low blood sugars during hockey. Makar would come off the ice shaky, frustrated, and depleted. It was stressful for all of us.

Now? We’ve learned to manage them so they rarely happen.

Here’s what changed:

Better carb loading before the game. The pre-game snack is specifically designed to sustain him through 60-90 minutes of hockey without dropping too low.

Proactive pump adjustments. Once we figured out Makar’s pattern (his blood sugar drops about 30-50 mg/dL every 20 minutes of hockey), we adjusted his pre-game insulin strategy. If he’s going into a game at 180, that’s actually fine—he’ll end up around 130 by the end of the first period.

Intermission snacks. Between periods, Makar has a quick carb snack. Not something complicated—just 10-15g carbs. A few pretzels, a piece of fruit, a small juice box. This bridges him through the next period.

Ongoing monitoring with Dexcom. We catch concerning trends before they become emergencies.

Understanding his specific pattern. Every kid is different. Some kids’ blood sugar drops linearly during exercise. Others stay stable for 30 minutes and then drop off a cliff. Knowing Makar’s specific pattern lets us predict and prevent.

Here’s how to figure out your child’s pattern:

1. During a low-stakes practice or friendly game, pay close attention to their blood sugar trend throughout the activity.
2. Note the starting blood sugar, the trend, and the ending blood sugar.
3. Do this several times to see if there’s a consistent pattern.
4. Once you see the pattern, adjust your pre-activity strategy accordingly.

For Makar, it took about 3-4 games before we had enough data to really understand what his body was doing. Now, it’s second nature.

Post-Game Lows: The Delayed Hypo Problem

Here’s the thing about sports that surprised me, even after 21 years of managing diabetes: the biggest blood sugar challenges often happen 4-12 hours after the activity ends.

This is called “delayed post-exercise hypoglycemia,” and it happens because muscles are still refilling their glycogen stores and the body’s insulin sensitivity remains elevated long after your kid gets off the ice.

For Makar, this typically means:

• He plays hockey at 5:30 PM and comes off the ice at 7 PM with a blood sugar of 140 (totally fine).
• We have dinner, we relax, his blood sugar is stable all evening.
• At 11 PM, he’s at 85 and dropping.
• At 1 AM, he’s at 52.
• We’re waking up to alarm him, giving him juice, and managing a low in the middle of the night.

How to manage this:

Reduce basal insulin for 8-12 hours after intense activity. On Omnipod 5, we reduce his basal rate by 20-30% starting about 4 hours after the game ends and continuing until bedtime. Some parents reduce it further overnight if their child tends to have severe overnight lows.

Have a post-activity meal plan. A light snack with protein and complex carbs 1-2 hours after activity (like a sandwich with peanut butter, or pasta with cheese) helps sustain blood sugar without spiking it.

Check at bedtime, even if you normally don’t. After a game day, Makar’s Dexcom alarm goes off before bed. This is our chance to catch a declining trend early.

Sleep with Dexcom alerts on high volume. I still do this on game nights, even though Makar is 9 and pretty stable now. The peace of mind is worth a potentially interrupted night’s sleep.

Consider a temporary basal rate reduction overnight. If your pump allows it, set an overnight basal rate that’s 25-40% lower than normal. This gives his blood sugar room to drop without you having to panic.

This is one area where having a CGM (continuous glucose monitor) makes an enormous difference. You can see the trend happening and intervene before it becomes a dangerous low. Without a CGM, you’re basically gambling with overnight lows after sports.

Specific Sports Considerations

Every sport interacts with diabetes differently. Here’s what we’ve learned:

Hockey (Makar’s sport):

• Intense, mixed aerobic and anaerobic activity.
• High injury risk means you want the pump securely placed (we use the thigh).
• Games are shorter but higher-intensity than something like soccer (which is 90 minutes of constant aerobic activity).
• Delayed lows are real and require overnight monitoring.
• Pack extra carbs because games can run over with OT.

Soccer:

• Sustained aerobic activity means relatively predictable blood sugar dropping.
• Subs give you opportunities to check blood sugar and have snacks.
• Field is big, so communication with the coach about blood sugar checks is important.
• Usually lower injury risk than hockey, so pump placement is more flexible.

Swimming:

• Water resistance means you might need to remove your pump or use a waterproof case.
• Many families disconnect the pump for swimming and do a manual injection before and after.
• Fast-acting carbs need to be completely waterproof (glucose tablets in a waterproof container, not juice boxes).
• Chlorine exposure doesn’t affect sensors, but adhesive patches can loosen.

Gymnastics and cheer:

• High-intensity bursts (like vault or tumbling) followed by rest.
• You might see small blood sugar spikes from the adrenaline, but overall, activity duration is shorter than team sports.
• Tight uniforms mean pump placement might need to be on the abdomen or back of the arm (with extra tape).

Cross country and track:

• Sustained aerobic activity, very predictable blood sugar dropping.
• Races are usually short (under 30 minutes), but training runs are longer.
• You might need to provide sports drinks or gels on really long runs to prevent lows.
• Post-activity delayed lows are very common.

Baseball and softball:

• Shorter total activity time with bursts of intensity.
• Lots of standing around between plays, so carbs might not be needed during the game.
• More flexibility in when blood sugar checks happen (before at-bats, between innings).

The principle for any sport: Understand the intensity and duration, predict the blood sugar impact, and adjust accordingly.

Managing Your Own Stress and Emotions

I want to be real here for a minute. Watching your T1D child play sports is emotionally complicated.

You’re watching them do something they love. You’re proud. You’re also hypervigilant, watching their CGM, ready to spring into action if their blood sugar drops, worried about what happens on the field if you’re not there to monitor.

Some of this is unavoidable. But some of it can be managed:

Trust your child’s understanding of their own body. Makar knows what a low feels like. He knows to tell me if he’s feeling shaky or dizzy. He’s old enough to recognize his own symptoms.

Train backup monitors. A coach, assistant coach, or a team parent who understands the basics of T1D can be your backup eyes during games. You don’t have to be the only person paying attention.

Use technology to your advantage. Dexcom’s share feature means I can watch Makar’s blood sugar from my phone even if I’m not at the game. A parent at the hockey rink can give me real-time updates.

Accept that occasional lows will happen. They’re not a failure. They’re a data point. Figure out what went wrong, adjust, and move on.

Give yourself grace on the emotional side. It’s okay to feel anxious about your child playing sports with T1D. It’s also okay to recognize that the anxiety doesn’t need to stop them from playing.

When to Sit Out

There are times when your T1D child should not play.

Severe blood sugar instability in the days leading up to the activity. If your child has had 4+ unexplained lows in the past 24 hours, something is wrong. Playing sports is not the time to figure out what.

Ketones present. If your child has tested positive for ketones (a sign of diabetic ketoacidosis beginning), they should sit out until cleared by their doctor.

Uncontrolled high blood sugar. If your child’s blood sugar is consistently above 250 and climbing, exercise might make it worse before it gets better. Wait until it’s coming down.

Illness. Sick days are off days. Flu, strep throat, stomach bugs—these are times to rest, hydrate, and focus on recovery, not competition.

Extreme emotional distress. If your child is having a really hard diabetes day emotionally and just wants to rest, it’s okay to let them. Sports are supposed to be fun, not another source of stress.

Most of the time? Your T1D child should be playing. But these exceptions exist, and it’s important to recognize them.

FAQ

Q: Will my child’s blood sugar be unpredictable during sports?

A: Not unpredictable forever. There’s definitely a learning curve—maybe the first 5-10 times your child plays a new sport, you’ll be gathering data. But once you understand their body’s response to that specific activity, it becomes quite manageable. Makar’s blood sugar during hockey is now more predictable than his baseline—I can predict almost exactly where he’ll be at the end of the second period.

Q: Do I need a continuous glucose monitor to manage sports?

A: No, but it makes a huge difference. You could manage with finger-stick testing, but you’d need to check much more frequently, and you’d miss the trend information that tells you whether blood sugar is dropping quickly or holding steady. Dexcom (or another CGM) is worth the investment if your child is active in sports.

Q: What if my child’s school sports team doesn’t support diabetes management?

A: Have a conversation with the coach and athletic director about accommodations. If they’re unwilling to work with you, escalate to the school administration. Your child has a legal right to manage their medical condition during school activities (Section 504 Plan—more on that in another article). Don’t let a coach’s lack of understanding prevent your child from participating.

Q: Can my child use an insulin pump while swimming?

A: Yes, but you have options. Some families use waterproof pump cases (like a flip belt). Others disconnect the pump for the duration of the swim and use a manual insulin injection before getting in the water. Talk to your endocrinologist about what’s best for your child’s insulin regimen.

Q: How much extra insulin should my child take before sports to prevent lows?

A: There’s no universal answer. Some kids need to reduce their insulin before activity. Others need a small dose of insulin before intense activity to prevent blood sugar spikes from adrenaline. Work with your endocrinologist to develop a strategy specific to your child and the sport they’re playing.

Q: What if my child has a severe low during a game?

A: This is why you carry fast carbs and have a glucagon kit. Treat the low with 15g of fast carbs (juice, glucose tablets, regular soda). Recheck blood sugar in 15 minutes. If your child is unconscious or unable to swallow, use the glucagon kit and call 911. Severe lows during sports are rare when you’re monitoring with a CGM and being proactive, but they can happen, and that’s why you’re prepared.

Q: Should my T1D child avoid competitive sports?

A: Absolutely not. If your child loves a sport, they should play it. T1D is not a barrier to competition. Some of the most accomplished athletes in the world have Type 1 Diabetes. Your child can too.

Important Disclaimer

This article is based on the author’s personal experience managing Type 1 Diabetes in two children. It should not be considered medical advice. Every child’s diabetes is unique, and management strategies should be developed in close collaboration with your child’s endocrinologist and diabetes care team. Always follow your healthcare provider’s recommendations, and adjust these strategies based on your child’s individual needs, blood sugar patterns, and medical history.

Katerina has 21 years of experience parenting kids with Type 1 Diabetes. Her daughter was diagnosed at age 2; her son Makar at age 4. She uses Omnipod 5 insulin pumps and Dexcom G6 continuous glucose monitors for both children and is passionate about helping other parents see T1D as manageable—not limiting.

The first time I traveled with a newly diagnosed child, I packed enough diabetes supplies for six months. We were going for a weekend. I had backup supplies for my backup supplies, a printed letter from our endocrinologist, and a level of anxiety that made airport security look relaxed by comparison.

Twenty-one years later, traveling with T1D is routine. We have flown, driven cross-country, stayed in hotels, camped, and traveled internationally — all with two diabetic kids. It takes planning, but it should never stop your family from going anywhere.

This guide covers everything: packing, flying, driving, time zones, hotel stays, and the things I learned by making every mistake first.

The Golden Rule of T1D Travel

Bring twice as many supplies as you think you need. Keep them in two separate bags.

If one bag is lost, stolen, or left behind, you still have a full backup. This rule has saved us more than once.

Packing List: Diabetes Supplies for Travel

Carry-On Bag (ALWAYS with you — never checked luggage)

• Insulin — enough for the trip plus 3 extra days
• Insulin pens or syringes (backup, even if using a pump)
• Blood glucose meter + test strips + lancets
• CGM sensors — enough for the trip plus 1 extra
• CGM transmitter (backup if available)
• Pump supplies — infusion sets, pods, reservoirs (enough plus 2 extra)
• Pump charger or batteries
• Fast-acting sugar: glucose tabs, juice boxes, gummy bears
• Glucagon emergency kit
• Ketone test strips
• Alcohol swabs
• Medical ID bracelet (worn, not packed)
• Letter from endocrinologist (for TSA and international travel)
• Insurance card and pharmacy info
• Snacks: cheese sticks, nuts, protein bars, crackers

Checked Bag (Backup supplies)

• Extra insulin (keep in insulated bag with ice pack)
• Extra test strips, lancets, syringes
• Extra CGM sensors
• Extra pump supplies
• Extra snacks and fast-acting sugar

Never put insulin in checked luggage on a plane. The cargo hold temperature can freeze or overheat insulin, destroying it.

Flying with T1D

TSA and Airport Security

Type 1 Diabetes supplies are medically exempt from normal TSA restrictions. You are allowed to bring through security:

• Insulin in any form (vials, pens, cartridges)
• Syringes and needles (with insulin)
• Juice boxes and liquid glucose for treating lows (even over 3.4 oz)
• Insulin pumps (worn on the body)
• CGM devices (worn on the body)
• Glucagon kits
• All other diabetes supplies

How to make it smooth:

1. Tell the TSA officer at the start: “My child has Type 1 Diabetes. We have medical supplies.”
2. Separate diabetes supplies into a clear bag or pouch so they are easy to show
3. Carry a letter from your endocrinologist — not always required, but helps if questioned
4. You can request a visual inspection of supplies instead of X-ray if you prefer
5. Insulin pumps and CGMs can go through metal detectors — check your manufacturer’s guidelines about body scanners

Pro tip: TSA PreCheck or Global Entry makes this much faster. The lines are shorter and officers are often more experienced with medical devices.

Insulin Pumps on Planes

Insulin pumps work normally on planes. The cabin is pressurized, so altitude changes do not affect insulin delivery. However:

• Air bubbles can expand at altitude. Check your pump tubing after takeoff and remove any air bubbles
• Omnipod users — your pod will work fine. No special precautions needed
• Set your CGM alerts slightly wider for travel days — stress and schedule changes cause unpredictable numbers

Time Zone Changes

This is the part that scares parents most, but it is simpler than you think.

For pump users: Change the pump clock to the new time zone when you arrive. The pump adjusts basal rates automatically. That is it.

For injection users (long-acting insulin like Lantus/Tresiba):

• Traveling east (shorter day): You may need a slightly smaller dose of long-acting insulin for the travel day
• Traveling west (longer day): You may need a slightly larger dose or a small supplemental dose
• Call your endo before the trip to get specific instructions for your child’s doses

General rule for time zone changes of 3+ hours: Adjust by 1–2 hours per day rather than all at once. Check blood sugar more frequently for the first 2–3 days.

Road Trips with T1D

Road trips are simpler than flying — no TSA, no time zones (usually), and you control the schedule. But they come with their own challenges.

Keep Insulin Cool

Insulin should stay between 36–86°F (2–30°C). A hot car can destroy insulin quickly. Never leave insulin in a parked car.

Solutions:

• Use an insulated cooler bag with a cold pack (not touching the insulin directly — wrap the cold pack in a cloth)
• FRIO cooling wallets work without ice — just soak in water and they keep insulin cool for hours
• Keep the diabetes supply bag in the air-conditioned passenger area, not the trunk

Snack Strategy

Pack a car snack box with:

• Low-carb options: cheese sticks, almonds, beef jerky, cucumber slices
• Medium-carb options: crackers with peanut butter, apple slices, granola bar
• Fast-acting sugar: juice boxes, glucose tabs (always accessible — front seat or child’s reach)

Stop Every 2–3 Hours

Long periods of sitting can cause blood sugar to rise. Regular stops for walking and stretching help. Plus, kids need bathroom breaks — high blood sugar means more frequent urination.

Check Blood Sugar More Often

Travel stress, different food, different schedule — all affect blood sugar. Check every 2–3 hours during a road trip, or keep a close eye on the CGM.

Hotel Stays

Set Up a Diabetes Station Immediately

First thing when you arrive: pick a spot (nightstand, desk) and set up your supplies — just like at home. Meter, insulin, fast-acting sugar, glucagon. Having everything in one place reduces middle-of-the-night panic.

Request a Mini Fridge

Most hotels will provide a mini fridge at no extra charge if you say it is for medical supplies (insulin). Call ahead or request at check-in.

Adjust for Activity Changes

Vacation usually means more walking, swimming, and activity than normal. This can cause lower blood sugar. Be prepared to:

• Reduce basal rates (pump users)
• Reduce long-acting insulin doses (injection users)
• Increase snacking
• Lower CGM low-alert threshold slightly

Keep the Room Number and Hotel Name Written Down

If your child is old enough to be in the pool or activity area without you, make sure they have:

• The hotel name and room number
• Your cell phone number
• Fast-acting sugar on them
• Their CGM or meter accessible

International Travel

Before You Go

1. Call your insurance — ask about coverage abroad and how to handle emergencies
2. Get a letter from your endo on official letterhead — include diagnosis, medications, device serial numbers, and a statement that all supplies are medically necessary. Have it translated if traveling to a non-English-speaking country
3. Research pharmacies at your destination — in many countries, insulin is available over the counter at pharmacies. Know the brand names used locally (Humalog may be called something different)
4. Check voltage — if your pump or meter needs charging, bring a travel adapter

Carry On the Plane (International Flights)

All the same rules as domestic, but stricter about documentation. Some countries require a doctor’s letter. Some require prescriptions for syringes. Research your specific destination’s requirements.

Travel Insurance

Strongly recommended for international travel with a T1D child. Look for policies that cover:

• Emergency medical treatment
• Medical evacuation
• Lost or stolen medical supplies
• Trip cancellation for medical reasons

Blood Sugar Challenges During Travel

Why Blood Sugar Goes Crazy During Travel

• Stress and excitement — raises blood sugar
• Different foods — unknown carb counts
• Schedule changes — meals at unusual times
• Activity changes — more or less than normal
• Time zones — disrupts insulin timing
• Dehydration — airport/car/plane air is dry, raises blood sugar

How to Handle It

• Check blood sugar more often (every 2–3 hours minimum)
• Stay hydrated — carry a water bottle
• Keep snacks and fast-acting sugar within reach at all times
• Accept that numbers will not be perfect on travel days
• Focus on safety (avoiding dangerous lows and highs) rather than perfect control
• Return to normal routine as quickly as possible at your destination

Emergency Preparation

Know Before You Go

• Location of the nearest hospital or urgent care at your destination
• Local emergency number (911 in US, 112 in Europe, etc.)
• Pharmacy location near your hotel
• Your endo’s after-hours number (save in your phone)

What If You Run Out of Supplies?

• Insulin: In the US, you can buy ReliOn insulin (regular and NPH) at Walmart without a prescription for about $25. It is not the same as your child’s insulin but works in an emergency. In many other countries, insulin is available at pharmacies without a prescription.
• Test strips: Most pharmacies carry common meter brands
• Syringes: Available at most pharmacies (laws vary by state/country)
• CGM sensors: Contact the manufacturer’s emergency line — they can sometimes ship to your location

Frequently Asked Questions

Can I bring insulin through airport security?
Yes. Insulin and all diabetes supplies are medically exempt from TSA liquid restrictions. Tell the officer you have medical supplies.

Will the X-ray machine damage my insulin or CGM?
Standard walk-through metal detectors are fine. For body scanners (millimeter wave), check your CGM/pump manufacturer’s guidelines. Most say they are safe, but you can always request a pat-down instead.

What if my child’s pump pod falls off during travel?
Replace it with a spare. Always carry at least 2 extra infusion sets or pods. If you run out, switch to manual injections using backup insulin pens/syringes until you can get more supplies.

How do I handle restaurant meals in a foreign country?
Use a translation card that explains your child’s diabetes in the local language. Stick to simple meals where you can see the ingredients. Use a carb counting app. When in doubt, estimate conservatively and check blood sugar 2 hours after eating.

Should I adjust insulin for the plane ride?
Most children do not need adjustments for short flights. For long international flights (8+ hours), check blood sugar every 3–4 hours, stay hydrated, and treat any highs or lows normally. The routine is the same — just the setting is different.

My child is scared to travel with diabetes. What do I say?
Normalize it. “We are bringing your diabetes supplies just like we bring toothbrushes. Diabetes travels with us and it does not stop us from having adventures.” Let them help pack their supplies — it gives them a sense of control.

This article is part of our Daily Management series on doublet1dmom.com.

Disclaimer: This article is for informational purposes only and is not medical advice. Always consult your child’s endocrinologist before making changes to diabetes management during travel.

Carb counting is the single most important skill you will learn as a T1D parent. More important than understanding insulin types. More important than reading CGM graphs. Because every insulin dose your child receives is based on one thing: how many grams of carbohydrates they are about to eat.

And yet, when my daughter was diagnosed, no one sat me down and properly taught me how to do it. I was handed a photocopied sheet with a few food examples and told to “count the carbs.” That was it.

It took me months of mistakes — too much insulin, too little insulin, blood sugar roller coasters — before I got comfortable. This guide is what I wish someone had given me on day one.

What Are Carbohydrates and Why Do They Matter?

Carbohydrates are one of three macronutrients in food (along with protein and fat). When your child eats carbs, the body breaks them down into glucose (sugar), which enters the bloodstream.

In a person without diabetes, the pancreas automatically releases the right amount of insulin to handle that glucose. In your child with T1D, the pancreas does not make insulin — so you have to calculate and deliver the right amount manually (or through a pump).

More carbs = more insulin needed.
Fewer carbs = less insulin needed.

This is why counting carbs accurately matters. Too much insulin for too few carbs = low blood sugar. Too little insulin for too many carbs = high blood sugar.

The Basic Formula

Your endocrinologist will give your child an insulin-to-carb ratio (ICR). This tells you how many grams of carbs one unit of insulin covers.

For example:

• ICR of 1:10 means 1 unit of insulin covers 10 grams of carbs
• ICR of 1:15 means 1 unit of insulin covers 15 grams of carbs
• ICR of 1:20 means 1 unit of insulin covers 20 grams of carbs

The math:
Total carbs in the meal ÷ ICR = insulin dose

Example: Your child eats 45 grams of carbs. Their ICR is 1:15.
45 ÷ 15 = 3 units of insulin.

That is the entire concept. Everything else is about accurately counting those carbs.

How to Count Carbs: 4 Methods

Method 1: Read the Nutrition Label

This is the most accurate method for packaged foods.

Look at two things:

1. Serving Size — how much food is one serving?
2. Total Carbohydrates — how many grams of carbs are in one serving?

Important: Look at Total Carbohydrates, not just “Sugars.” Your child’s body converts ALL carbs to glucose — starches, fiber, and sugars. Some parents subtract fiber (since it is not fully digested), but check with your endo first.

Example: A box of crackers says:

• Serving Size: 16 crackers
• Total Carbohydrates: 22g

If your child eats 8 crackers, that is half a serving = 11g carbs.

Method 2: Use a Food Scale

A kitchen food scale is your best friend. Weighing food is far more accurate than eyeballing portions.

How to use it:

1. Place the food on the scale
2. Read the weight in grams
3. Look up the carbs per 100g for that food (apps or Google)
4. Calculate: (weight in grams × carbs per 100g) ÷ 100 = total carbs

Example: Your child has a banana that weighs 120g. Bananas have about 23g carbs per 100g.
(120 × 23) ÷ 100 = 27.6g carbs.

Buy a food scale. It costs $10–$15 and will be the best diabetes investment you make.

Method 3: Use a Carb Counting App

Several apps make carb counting much easier:

• Calorie King — the gold standard for US foods, includes restaurant meals
• MyFitnessPal — huge database, barcode scanner
• Figwee — visual portion guide, great for kids
• Carbs & Cali — UK-focused but excellent database

Most apps let you scan the barcode of packaged foods, which pulls up the nutrition info instantly.

Method 4: Memorize Your Child’s Top 20 Foods

After a few weeks, you will notice your child eats the same 15–20 foods on rotation. Memorize the carb counts for these foods and everything gets faster.

Make a list. Stick it on your fridge. Here are common kids’ foods to start:

Foods That Are Tricky to Count

Some foods are harder to count accurately. Here are the ones that trip up most parents:

Pizza

Pizza is the nemesis of carb counting. The crust is carbs, the sauce has carbs, and the high fat content slows digestion — meaning blood sugar rises slowly at first, then spikes hours later. Many parents use an extended bolus (split dose) for pizza.

Estimate: 30–36g per large slice, but the delayed spike often needs extra insulin 2–3 hours later.

Rice and Pasta

Portion sizes are deceptive. One cup of cooked rice looks like a small amount but packs 45g of carbs. Always weigh or measure these. Leftover rice and pasta (cooled and reheated) may have slightly lower glycemic impact due to resistant starch, but count the same carbs.

Fruit

Natural sugars in fruit hit fast. A medium apple has 25g of carbs. Grapes and watermelon spike blood sugar quickly. Berries (strawberries, blueberries) are lower in carbs and slower to spike.

Restaurant Food

This is the hardest. No nutrition labels, inconsistent portions, hidden sauces and sugars. Use a carb counting app, estimate conservatively, and check blood sugar 2 hours after eating. Over time, you will learn your child’s go-to restaurant meals.

“Sugar-Free” Foods

Sugar-free does not mean carb-free. Many sugar-free products use sugar alcohols (maltitol, sorbitol, erythritol) which still affect blood sugar — some more than others. Maltitol in particular can spike blood sugar almost as much as regular sugar. Always check the label.

Common Carb Counting Mistakes

Mistake 1: Ignoring Serving Sizes

The label says 15g carbs — but that is per serving. If your child eats three servings, that is 45g. Always check the serving size first.

Mistake 2: Forgetting Liquid Carbs

Milk, juice, smoothies, chocolate milk, sports drinks — these all have carbs that hit fast. A glass of orange juice (1 cup) is 26g of fast-acting carbs. Many parents forget to count beverages.

Mistake 3: Eyeballing Instead of Measuring

“A cup of rice” can vary wildly depending on how you scoop it. Use measuring cups or a food scale until you can estimate accurately. Even experienced T1D parents measure tricky foods.

Mistake 4: Not Counting Sauces and Condiments

Ketchup (4g per tablespoon), BBQ sauce (9g per tablespoon), honey mustard (10g per tablespoon), teriyaki sauce (7g per tablespoon) — these add up fast, especially with kids who love to dip.

Mistake 5: Counting Net Carbs Instead of Total Carbs

The keto community uses “net carbs” (total carbs minus fiber). For T1D insulin dosing, most endocrinologists recommend using Total Carbohydrates. Ask your endo what they prefer.

Carb Counting for Different Ages

Toddlers and Preschoolers (2–5 years)

Unpredictable eaters. They say they are hungry, you dose insulin, then they refuse to eat. This is every T1D parent’s nightmare.

Strategy: Give insulin AFTER the meal (or partway through) so you know exactly how much they ate. Talk to your endo about timing — some recommend dosing after for young kids. Accept that accuracy will be rough at this age. Prioritize safety over perfection.

School-Age Kids (6–12 years)

Start teaching them to recognize carb-heavy foods. Let them help read labels and use the food scale. By age 8–10, many kids can estimate simple meals on their own with guidance.

Strategy: Pack lunches with consistent, known carb counts. Send a carb cheat sheet with your child to school. Work with the school nurse to verify carb counts for cafeteria meals if your child eats school lunch.

Teenagers (13+)

Teens want independence. They will eat at friends’ houses, fast food restaurants, and school cafeterias without you. Teach them to use carb counting apps. Let them make mistakes and learn — while keeping safety nets in place (CGM alerts, pump limits).

Strategy: Focus on the foods they eat most. If they eat Chipotle three times a week, learn those carbs cold. Perfection is not the goal — getting within 10–15g of the actual carb count is realistic and effective for good blood sugar management.

Quick Carb Estimation Guide (When You Cannot Count Exactly)

Sometimes you cannot weigh food or read a label — birthday parties, restaurants, travel. Use these visual estimations:

• Your child’s fist = approximately 1 cup (use for rice, pasta, cereal)
• Your child’s palm = approximately 3 oz of protein (usually 0g carbs)
• Your thumb = approximately 1 tablespoon (use for peanut butter, sauces)
• A tennis ball = approximately 1 medium fruit (15–25g carbs)
• A deck of cards = approximately 3 oz (for bread: about 1 slice)

The 10g rule: When in total doubt, estimate meals in multiples of 10g. A small snack is probably 10–15g. A medium meal is probably 30–45g. A large meal is probably 50–70g. This rough estimation is better than no estimation.

When to Give Insulin: Before, During, or After the Meal?

Standard recommendation: Give insulin 10–15 minutes before eating. This gives insulin time to start working before carbs hit the bloodstream.

For unpredictable eaters (toddlers): Give insulin during or after the meal. You lose the pre-bolus advantage, but you avoid the nightmare of insulin on board with no food eaten.

For high-fat meals (pizza, burgers): Consider splitting the dose — part before the meal, part 1–2 hours after. The fat slows digestion, causing a delayed blood sugar rise. An extended bolus on a pump does this automatically.

For fast-acting carbs (juice, candy, white bread): Pre-bolus 15–20 minutes before if blood sugar is in range. These foods spike blood sugar very fast.

Always ask your endocrinologist about the best insulin timing strategy for your child’s specific situation.

Tools That Make Carb Counting Easier

1. Kitchen food scale ($10–$15) — the single best tool
2. Measuring cups and spoons — for when you cannot use a scale
3. Calorie King app or book — comprehensive food database
4. MyFitnessPal app — barcode scanner is a game-changer
5. A carb cheat sheet on your fridge — your child’s top 20 foods with carb counts
6. A logbook — track what your child eats and the resulting blood sugar to learn patterns
7. Your endocrinologist — they can review your logs and help fine-tune your counting

Frequently Asked Questions

Do I need to count carbs for every single thing my child eats?
Yes, if it has carbs. Even small amounts add up. A handful of crackers here, a sip of juice there — it all affects blood sugar. The exception is foods with essentially zero carbs: meat, fish, eggs, cheese, and most non-starchy vegetables.

What about protein and fat? Do they affect blood sugar?
Yes, but slowly and less predictably. Large amounts of protein (more than 30–40g in a meal) can raise blood sugar 3–5 hours later. High-fat meals slow digestion and cause delayed spikes. For now, focus on carbs — protein and fat counting is advanced level.

My child’s blood sugar still spikes even when I count carbs correctly. Why?
Several reasons: insulin timing (try pre-bolusing earlier), the type of carb (fast-acting carbs spike faster), stress, hormones (puberty and growth spurts), or the carb count might be slightly off. Track patterns in your logbook — they will reveal the cause.

How accurate do I need to be?
Within 5–10 grams for most meals is realistic and effective. Perfection is impossible. Even professional dietitians estimate. The goal is consistency, not perfection.

Should I put my child on a low-carb diet?
That is a decision for you, your child, and your endocrinologist. Children need carbs for growth, energy, and brain development. Restricting carbs can help reduce blood sugar swings, but extreme restriction is not recommended for growing kids. A balanced approach — choosing quality carbs, reasonable portions, and accurate counting — works for most families.

When will this get easier?
Within 2–3 months, you will be able to estimate most of your child’s regular meals quickly and accurately. Within a year, carb counting will feel automatic for everyday foods. You will always need to think harder for new foods and restaurants — but it becomes second nature for the daily routine.

This article is part of our Daily Management series on doublet1dmom.com.

Disclaimer: This article is for informational purposes only and is not medical advice. Always consult your child’s endocrinologist or dietitian for personalized carb counting guidance.

By Katerina | Double T1D Mom | Updated March 2026

If someone asked me to name the single device that changed our T1D life the most, the answer is instant: a Continuous Glucose Monitor.

When my daughter was diagnosed in 2003, CGMs didn’t exist for everyday use. I checked her blood sugar by finger prick 10–12 times a day — setting my alarm for midnight, 2 AM, and 5 AM. Every single night. For years.

When my son was diagnosed in 2021, we got a CGM within weeks. The difference was like going from a flip phone to a smartphone. Suddenly I could see his blood sugar in real time — on my phone, from anywhere. I could see trends before they became emergencies. I could sleep.

If your child doesn’t have a CGM yet — fight for one. If you’re choosing between them — this guide is for you.

What Is a CGM and How Does It Work?

A Continuous Glucose Monitor is a small sensor — about the size of two stacked coins — that sits on your child’s skin (usually the arm or belly). A tiny flexible filament goes just under the skin and measures glucose levels in the interstitial fluid every 1–5 minutes.

The reading is sent wirelessly to a receiver, a phone, or a smartwatch. You can see your child’s current blood sugar, whether it’s going up or down (trend arrows), and a graph of the past several hours.

Most CGMs also send alerts — high alert, low alert, urgent low alert, and signal loss. These alerts are what let you sleep at night. If your child’s blood sugar drops below a set threshold, your phone alarm will wake you.

A CGM does not replace finger pricks entirely — you’ll still need them occasionally to calibrate or double-check. But instead of 10+ pricks a day, you might do 1–2.

The Three Main CGMs for Kids in 2026

1. Dexcom G7

Sensor wear time: 10 days Warm-up time: 30 minutes Calibration required: No (factory calibrated) Compatible phones: iPhone and Android Share/Follow feature: Yes — up to 10 followers can see data in real time Age approval: FDA-approved for age 2+ Pump integration: Works with Omnipod 5, Tandem t:slim X2, and DIY Loop systems

What I love: Dexcom has been the gold standard for accuracy in pediatric CGM use for years — and the G7 continues that tradition. The Share feature is a lifesaver: I can see my son’s blood sugar on my phone while he’s at hockey practice. His coach could see it too if I wanted. The alerts are customizable and loud enough to wake you at 3 AM.

The G7 is smaller than previous Dexcom models and has a much faster warm-up — 30 minutes versus 2 hours for the G6. For a kid who doesn’t want to wait, this matters.

What I don’t love: The adhesive can be an issue on active kids. My son plays hockey, sweats constantly, and the sensor sometimes peels at the edges by day 5–6. We use overlay patches (SkinGrip or GrifGrips) and it stays the full 10 days, but it’s an extra step.

Cost is also higher than Libre — even with insurance, copays for Dexcom tend to be the highest of the three options.

Best for: Families who want the highest accuracy, real-time sharing with multiple caregivers, and insulin pump integration. If your child is on Omnipod 5 or Tandem, Dexcom is the natural choice.

2. FreeStyle Libre 3

Sensor wear time: 14 days Warm-up time: 60 minutes Calibration required: No (factory calibrated) Compatible phones: iPhone and Android Share/Follow feature: Yes — LibreLinkUp app for caregivers Age approval: FDA-approved for age 2+ Pump integration: Limited — not yet integrated with major pump systems in the US

What I love: The Libre 3 sensor is tiny — the smallest CGM on the market. For a young child or a teen who’s self-conscious, this matters. It’s also the most affordable CGM option, which is a real factor for families paying out of pocket or with high-deductible insurance plans.

14-day wear time means fewer sensor changes — my son hated change days, so less frequent changes would have been a plus. The Libre 3 now reads every minute and sends data continuously (unlike earlier Libre versions that required scanning).

What I don’t love: Accuracy can be slightly less consistent than Dexcom, especially on the first day of a new sensor and during rapid blood sugar changes. For an active kid whose glucose swings fast during sports, this can mean the CGM lags behind reality.

The LibreLinkUp sharing app works but isn’t as polished as Dexcom’s Share/Follow system. Alert customization is more limited.

The biggest limitation: Libre 3 doesn’t integrate with insulin pumps in the US market as of early 2026. If your child is on a pump or you’re planning to switch to one, this is a significant consideration.

Best for: Budget-conscious families, kids who want the smallest possible sensor, and families not currently using an insulin pump. Also great as a “first CGM” for newly diagnosed families.

3. Medtronic Guardian 4

Sensor wear time: 7 days Warm-up time: 2 hours Calibration required: No (factory calibrated) Compatible phones: iPhone and Android Share/Follow feature: Yes — CareLink Connect app Age approval: FDA-approved for age 2+ Pump integration: Works with Medtronic 780G pump

What I love: If your child is on a Medtronic insulin pump (like the 780G), the Guardian 4 integrates seamlessly. The pump and CGM “talk” to each other, automatically adjusting insulin delivery based on CGM readings. This closed-loop system can significantly improve Time in Range.

The Guardian 4 is a major improvement over previous Medtronic sensors — no more manual calibrations, better accuracy, and easier insertion.

What I don’t love: Seven-day sensor life is the shortest of the three options. That means more frequent sensor changes — which for a young child means more “poke days” and potentially more tears.

The 2-hour warm-up is the longest. During warm-up, you’re flying blind — back to finger pricks. For comparison, Dexcom G7 is 30 minutes and Libre 3 is 60 minutes.

Medtronic’s ecosystem is more closed — it only works with Medtronic pumps. If you’re on Omnipod or Tandem, Guardian isn’t an option for pump integration.

Best for: Families already using or planning to use a Medtronic insulin pump. The pump-CGM integration is the main selling point.

Head-to-Head Comparison

What Really Matters: A Parent’s Perspective

After using CGMs for years across two children, here’s what I’ve learned matters most:

Accuracy During Lows

This is non-negotiable. When your child is dropping fast — during a hockey game, in the middle of the night, at school — you need the CGM to be accurate. All three modern CGMs are good, but Dexcom has consistently scored highest in clinical accuracy studies, especially during hypoglycemia.

Alerts That Actually Wake You

At 3 AM, when your child’s blood sugar is dropping and you’re in deep sleep, the alert needs to be loud enough and persistent enough to wake you. Dexcom’s “Urgent Low Soon” predictive alert is particularly valuable — it warns you before the low actually happens, giving you time to act.

Adhesive Durability on Active Kids

If your child is an athlete, this matters more than you think. A sensor that falls off during a game is useless. We’ve used extra adhesive patches with every CGM — it’s just part of the routine. My son puts on a SkinGrip patch before every hockey practice, and his Dexcom stays put through two hours of intense skating.

But I’ll be honest: overlay patches alone are not always enough for high-intensity sports, especially on the arms where there’s constant movement and friction. For hockey, we also use medical-grade athletic tape on top of the patch — it adds an extra layer of security during games and practices. If your child plays contact sports, I highly recommend this extra step.

Adhesive Allergies — A Real Problem Nobody Warns You About

Here’s something most CGM guides don’t mention: your child may be allergic to the sensor adhesive. This is more common than you’d think, and it can range from mild redness to painful blistering rashes.

My daughter is allergic to virtually every type of adhesive used on CGM sensors and pump pods. We learned this the hard way — red, irritated skin every time we placed a new sensor.

The solution: we use barrier products between the sensor adhesive and her skin — medical-grade barrier films, sprays, or wipes (like Skin Tac, Cavilon, or FlexiFix tape as an underlayer). These create a protective layer so the adhesive never touches the skin directly.

If your child develops redness, itching, or a rash under the sensor, don’t ignore it — and don’t assume it means they can’t wear a CGM. Try different barrier products, try a different CGM brand (each uses different adhesive formulations), and talk to your endo about options. The right sensor for your child is one that works for their body in every way — accuracy, comfort, and skin tolerance.

Sharing With Caregivers

Whether it’s a babysitter, grandparent, school nurse, or hockey coach, other people need to see your child’s blood sugar when you’re not there. Dexcom’s Share/Follow is the most mature platform for this. Libre’s LibreLinkUp works but has occasional lag. Medtronic’s CareLink Connect is functional but less intuitive.

Insurance Coverage

The best CGM is the one your insurance will cover. Before your heart is set on one device, call your insurance and ask: “Which continuous glucose monitors are covered for pediatric Type 1 Diabetes?” Some plans only cover one brand. Some require prior authorization. Some won’t cover any CGM at all (in which case, appeal — and keep appealing).

Our CGM Journey

We started with Dexcom G6 when my son was diagnosed in 2021. It was life-changing — I went from checking his finger 10 times a day to glancing at my phone. Nighttime lows went from terrifying surprises to managed alerts.

We tried Libre briefly when dealing with an insurance gap. It worked well but I missed the Dexcom sharing features and the predictive alerts.

Now both of my kids use Omnipod 5 with Dexcom G6 — the pump and CGM work together as an automated insulin delivery system, adjusting basal insulin automatically based on CGM readings. Their Time in Range improved dramatically since switching to this setup.

My advice to newly diagnosed families: get any CGM first. Don’t let the “perfect” be the enemy of the “good.” Even the most basic CGM is a massive improvement over finger pricks alone. You can always switch later.

How to Get a CGM for Your Child

1. Ask your endocrinologist to prescribe a CGM at your next appointment. If they don’t bring it up, you bring it up.
2. Check your insurance. Call the number on the back of your card and ask about CGM coverage for pediatric T1D. Get the answer in writing if possible.
3. If insurance denies it, appeal. Have your endo write a letter of medical necessity. Mention nighttime hypoglycemia risk, hypoglycemia unawareness (if applicable), and the need for real-time monitoring in a young child who cannot recognize low symptoms.
4. Consider manufacturer assistance programs. Dexcom, Abbott (Libre), and Medtronic all have financial assistance programs for families who qualify.
5. Don’t give up. Some families get denied 2–3 times before approval. Each appeal with more documentation increases your chances.

Related: → Your Child Was Just Diagnosed with Type 1 Diabetes — What to Do First [Related: → How to Download and Read Your Child’s CGM Reports] [Related: → CGM Adhesive Tips — How to Make Sensors Stay on Active Kids]

Frequently Asked Questions

At what age can my child wear a CGM? Dexcom G7, Libre 3, and Guardian 4 are all FDA-approved for children age 2 and older. Some endocrinologists prescribe CGMs off-label for younger children on a case-by-case basis. My son started wearing one at age 4.

Does a CGM hurt? The insertion is a quick pinch — most kids say it’s less painful than a finger prick. The sensor sits on the surface and is not noticeable after insertion. My son sometimes forgets his is even there.

Can my child swim or shower with a CGM? All three CGMs are water-resistant. Swimming, showering, and sweating are generally fine. For extended water exposure (long swim practices), an overlay patch helps keep the sensor secure.

How accurate are CGMs compared to finger pricks? Modern CGMs are within about 8–10% of a finger prick reading in most conditions. However, there’s typically a 5–15 minute delay because CGMs measure interstitial fluid, not blood directly. During rapid changes (like after a meal or during exercise), the CGM may lag behind actual blood sugar.

Will insurance cover a CGM? Most insurance plans cover at least one CGM brand for children with Type 1 Diabetes, though coverage varies widely. Many require prior authorization. If denied, appeal with documentation from your endocrinologist. Medicaid coverage also varies by state.

Can I see my child’s blood sugar on my phone? Yes — all three CGMs support remote monitoring through companion apps. You and other caregivers can see your child’s real-time blood sugar, trends, and alerts on your phone from anywhere.

→ New to T1D? Start here: What to Do After Your Child’s Diagnosis

→ Get the Free T1D Parent Starter Kit (PDF)

This article reflects my personal experience using CGMs with two children over 21 years. Product features and availability may change. Always consult your endocrinologist for device recommendations specific to your child. Read my full Medical Disclaimer.