The technology for managing type 1 diabetes has changed dramatically in the past five years. Where parents once relied on fingersticks multiple times a day and manual insulin injections, many children now wear devices that check glucose levels continuously and deliver insulin automatically.

If you're trying to figure out whether these systems are right for your child, what they do, and how to use them at school, here's what you need to know.

What Is a CGM?

A continuous glucose monitor (CGM) is a small sensor worn on the body that checks glucose levels every few minutes, day and night. It sends readings to a receiver or smartphone so you can see what's happening in real time, not just a snapshot from a fingerstick.

Most CGMs have three parts: a sensor (usually on the arm or abdomen), a transmitter that clips onto the sensor, and a device that displays the readings. Some systems let you share data with other phones, so you can check your child's numbers from another room or from work.

CGMs don't replace all fingersticks (you may still need to confirm readings before giving insulin or treating a low), but they reduce the number significantly.

What Is an Insulin Pump?

An insulin pump delivers insulin continuously through a small tube (called a catheter) inserted under the skin. You program the pump to give a steady baseline amount (basal insulin) and push a button to deliver extra doses at meals (bolus insulin).

Pumps don't check blood sugar on their own. They deliver insulin based on what you tell them.

What Is Automated Insulin Delivery?

Automated insulin delivery (AID) systems, sometimes called closed-loop systems or "artificial pancreas" technology, connect a CGM to an insulin pump. The system reads glucose levels and adjusts insulin delivery automatically, without you having to calculate doses or push buttons every time.

These systems don't run entirely on their own. You still enter carb counts at meals and confirm some decisions. But they handle the minute-to-minute adjustments that used to require constant manual attention.

The 2026 American Diabetes Association Standards of Care recommend AID as the preferred method for managing type 1 diabetes in children. That's a significant shift from five years ago, when these systems were brand new.

What Systems Are Available?

As of 2026, several AID systems are FDA-approved for children:

Tandem Control-IQ: Approved for ages 6 and up. Uses the Dexcom G6 or G7 CGM. The pump adjusts insulin automatically based on predicted glucose levels 30 minutes ahead.

Medtronic 780G: Approved for ages 7 and up. Uses the Guardian 4 CGM. The system can adjust basal insulin every five minutes.

Omnipod 5: Approved for ages 2 and up. A tubeless pump that sticks directly to the skin. Works with the Dexcom G6 CGM.

These are the major players, but options change every year. New systems enter the market, and existing ones get updated with better algorithms or lower age limits.

Is My Child a Candidate?

Most children with type 1 diabetes can use a CGM. Age restrictions vary by device (some are approved for children as young as 2), but the technology itself is accessible to most families.

Insulin pumps and AID systems have more considerations. Your child needs to wear the device all the time, which means managing site changes, dealing with adhesive on sensitive skin, and keeping the pump dry during baths or swimming. Some kids adapt quickly. Others find it intrusive or uncomfortable.

Your endocrinologist will consider:

• Your child's age and ability to participate in their own care
• How stable their blood sugar is with their current regimen
• Whether they have frequent lows or highs that are hard to predict
• Your family's comfort level with technology
• Insurance coverage and out-of-pocket costs

If your child is doing well with injections and a CGM, that's a valid approach. AID isn't mandatory. The recommendation is based on outcomes (studies show better time-in-range and fewer severe lows with AID), but it's still a choice.

What About School?

Getting a school to allow CGM use is usually straightforward. The device doesn't require a nurse to operate it: your child wears it, and it works on its own. Most schools allow students to carry a receiver or phone to check readings during class.

Your child's 504 plan should include:

• Permission to wear the CGM and carry the receiver or phone
• Permission to check readings anytime without asking
• Instructions for what to do if the CGM alarms (low or high alert)
• Backup plan if the CGM fails (fingerstick supplies in the nurse's office)

If your child uses an insulin pump, the 504 plan also needs to cover who can operate the pump if your child is too young to manage it independently. In most cases, that's you or a trained school nurse, not a teacher or aide unless they've received specific training.

For AID systems, the key issue is alarm management. The system will alert for predicted lows or highs, and the school needs a plan for responding. Some families set the system to deliver correction doses automatically and only call the nurse for extreme readings. Others prefer the nurse to review every alert.

You'll need to train school staff on what the system does and what requires intervention. The pump manufacturer usually provides training materials you can share.

What If the System Fails?

CGMs aren't perfect. Sensors can lose signal, fall off, or give inaccurate readings. Pumps can clog, run out of insulin, or have battery issues. AID systems can switch to manual mode if they lose the CGM signal.

Your backup plan should include:

• Extra sensors, transmitters, and pump supplies at school
• Insulin pens or syringes in case the pump stops working
• Written instructions for giving insulin manually
• A clear chain of communication (who calls you, when, and for what)

Most families keep a small "emergency kit" at school with everything needed to revert to fingersticks and injections if the technology fails.

How Much Does This Cost?

CGMs and insulin pumps are expensive. A CGM sensor lasts 7 to 10 days and costs $300 to $400 per month without insurance. An insulin pump costs $5,000 to $8,000 upfront, plus $200 to $300 per month for supplies.

Insurance coverage varies. Most plans cover CGMs and pumps for type 1 diabetes, but you'll likely have copays, deductibles, and prior authorization requirements. Some insurers restrict which brands they'll cover or require you to try one system before approving another.

If cost is a barrier:

• Contact the device manufacturer's patient assistance program. Most offer sliding-scale discounts or free supplies for families who qualify.
• Ask your endocrinologist's office about samples or loaner devices while you wait for insurance approval.
• Check whether your state has a CGM access law requiring Medicaid to cover the technology.

How Do I Get Started?

If you're interested in CGM or AID technology:

1. Talk to your child's endocrinologist. They'll assess whether the technology fits your child's needs and refer you to a diabetes educator for training.

What to Expect in the First Few Weeks

AID systems don't work perfectly on day one. The algorithm needs time to learn your child's patterns, and you'll need time to learn how the system responds.

In the first week or two:

• Expect more alarms than usual. The system is cautious until it builds a history.
• You'll still check fingersticks to confirm low or high readings.
• You may need to adjust settings with your endo's help.

Most families see significant improvement in time-in-range within a month. The overnight hours are usually the first to stabilize because the system handles basal insulin adjustments while your child sleeps, which is where manual management is hardest.

What If My Child Also Has Another Disability?

Managing diabetes alongside another disability (autism, intellectual disability, cerebral palsy) adds complexity. Communication barriers make it harder to recognize early signs of low blood sugar. Behavior changes that might signal a low can be misread as meltdowns or defiance.

This is where CGM technology becomes especially valuable. The system alerts you to lows before your child shows symptoms, which is critical when your child can't reliably tell you they feel off.

For children who can't operate a pump independently, AID systems reduce the number of manual interventions you need to make. The system handles most adjustments on its own, which means fewer interrupted activities and less time spent calculating doses.

Technology Changes Rapidly

This guide reflects what's available in 2026. By next year, new systems will be approved, age limits will drop, and algorithms will improve. The device your child uses now may not be the best option in two years.

The technology available today is significantly better than what existed five years ago. Waiting for the next iteration means your child misses the benefits of what's already here.

Talk to your endocrinologist about what makes sense for your child right now, with the understanding that you'll revisit the decision as the technology evolves.