Use of continuous glucose monitoring systems in pediatric patients in the perioperative environment: Challenges and machine learning opportunities

Table 1 Currently available continuous glucose monitoring systems used in children in the United States

Company	Dexcom, Inc	Abbott laboratories	Medtronic	Senseonics
Product	Dexcom G6	FreeStyle Libre 2	Guardian connect	Eversense
Approved age of use (years)	≥ 2	≥ 4	≥ 14	≥ 18
Sensor location	Abdomen	Upper arm	Abdomen or upper arm	Upper arm
Communication technique	Cloud-based wireless system	Bluetooth with smartphone. Uploads to cloud with app	Bluetooth to smartphone. Uploads to cloud	Bluetooth to smartphone. Cloud storage
Year of FDA approval	2018	2020	2018	2018
Special features	Glucose streaming to smartphone, customizable alarms, compatible with smartwatches	14-day wear, real-time alarms. Option for high and low glucose alerts	Predictive alerts (60 minutes before reaching low/high levels, real-time glucose values, predictive alerts, critical alerts customizable alerts)	Long wear sensor (up to 90 days in United States), real-time glucose data, alerts and alarms signaled with on-body vibration, customizable alarms through app
Ability to integrate with insulin pump	Yes	Some	Yes	Yes
Smartphone requirement	Dexcom Clarity	LibreView	Carelink	Eversense data management system pro
Pharmacologic interferences	Acetaminophen, hydroxyurea	Vitamin C	Acetaminophen	Acetaminophen, mannitol or sorbitol
Contraindications	MRI, X ray, diathermy	MRI, X ray, diathermy	MRI, X ray, diathermy	MRI, diathermy, lithotripsy
Device classification	Real-time glucose display	Intermittent scanned	Real-time glucose display	Implant
EHR compatibility potential	Yes	Yes	Yes	Yes

EHR: Electronic health record; MRI: Magnetic resonance imaging; FDA: Food and Drug Administration.