Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications

Continuous glucose monitoring (CGM) has become a key component in the management of pediatric type 1 diabetes mellitus (T1DM) since it offers real-time glucose data that facilitate tighter glycemic control and reduce acute complications. Accumulating evidence and international guidelines highlight the clinical efficacy, safety, and feasibility of CGM use in children, particularly those with high adherence. Regular CGM use is associated with significant reductions in glycated hemoglobin, fewer hypo- and hyperglycemia episodes, and improved quality of life for both patients and their caregivers. Recent advances in CGM technology-including improved accuracy, extended sensor wear, factory calibration, and customizable alerts-have enhanced their usability in pediatric populations. In addition to established CGM metrics such as time in range, time below range, and glycemic variability, a novel parameter-time in tight range (also referred as time in normoglycemia), defined as the percentage of time with blood glucose readings within 70-140 mg/dL-has emerged as a potentially more sensitive marker of optimal glycemic control in children. This review provides a comprehensive overview of CGM technologies, including device types, performance metrics, and clinical evidence supporting their use for pediatric T1DM. It also examines recent advancements in Korea such as expanded insurance reimbursement and clinical integration. As CGM becomes more accessible and technologically advanced, it is expected to play an increasingly central role in optimizing long-term outcomes for children and adolescents with T1DM.