Fingertip to sensor: The evolution of glucose monitoring technologies in type 1 diabetes and their implications for pediatric nursing care: Narrative review.

OBJECTIVE

To examine the evolution of glucose monitoring technologies in type 1 diabetes, from fingertip testing to continuous glucose monitoring and automated insulin delivery systems, and evaluate their clinical, psychosocial, and nursing-related implications in pediatric diabetes care.

METHOD: The search was limited to English-language studies published between January 2020 and May 2026 and was conducted in the title, abstract, and keyword fields. A search was conducted in PubMed, Scopus, Web of Science, and Google Scholar databases. International guidelines, consensus reports, and institutional publications were also reviewed. The search included the keywords "type 1 diabetes," "continuous glucose monitoring," "CGM," "automated insulin delivery," "hybrid closed loop," "pediatric," "child," "adolescent," "nursing," "family experience," and "health equity." Original studies, randomized controlled trials, systematic reviews, real-world studies, and current guidelines focusing on pediatric populations were included.

RESULTS

Continuous glucose monitoring systems improve pediatric diabetes management by reducing hypoglycemia duration, revealing glycemic variability, and introducing metrics such as time in range into clinical practice. Automated insulin delivery and hybrid closed-loop systems further improve glycemic outcomes while reducing hypo- and hyperglycemia burden. However, alarm fatigue, data overload, device-related problems, and inequitable access remain challenges.

CONCLUSION

Continuous glucose monitoring and automated insulin delivery systems have transformed glycemic monitoring and treatment approaches in pediatric diabetes care while also reshaping the roles of pediatric nurses in data interpretation, family counseling, supporting technology adaptation, and digital care coordination.

IMPLICATIONS FOR PRACTICE: Pediatric nurses have assumed roles in data interpretation, family counseling, technology adaptation, and digital care coordination.