Pediatric and adolescent patients (<18 years old) meeting the diagnostic criteria for Diabetic Ketoacidosis (DKA).

The Pediatric Diabetes Care Team at Tri-Service General Hospital has pioneered the integration of Real-Time Continuous Glucose Monitoring (rtCGM) into the standard acute treatment protocol for pediatric Diabetic Ketoacidosis (DKA) since 2021. By utilizing 24-hour continuous glucose trend monitoring, the medical team can precisely adjust insulin dosages and fluid strategies, significantly shortening metabolic correction time. This innovative approach not only optimizes acute intensive care efficiency but also introduces patients and their families to advanced technology early in their diagnosis. This early exposure significantly improves long-term adherence to glucose management devices, achieving an integrated care model that seamlessly transitions from the Emergency Room and PICU to long-term outpatient follow-up.

• First Acute-Phase Implementation: Implementing rtCGM within the first hour of PICU admission, filling a gap in current international guidelines.

• Precision Metabolic Correction: Using real-time trends to optimize treatment, reducing correction time by 60%.

• Zero-Hypoglycemia Safety: Leveraging predictive alerts to achieve 0% hypoglycemia during acute DKA management.

• Long-term Adherence Booster: Early adaptation increases long-term CGM usage and improves HbA1c outcomes.

• First Acute-Phase Implementation: Implementing rtCGM within the first hour of PICU admission, filling a gap in current international guidelines.

• Precision Metabolic Correction: Utilizing real-time trends to achieve a 10.48-hour correction time, significantly outperforming global clinical benchmarks.

• Zero-Hypoglycemia Safety: Leveraging predictive alerts to achieve 0% hypoglycemia during acute DKA management.

• Long-term Adherence Booster: Early adaptation increases long-term CGM usage and improves HbA1c outcomes.

• Shortened Correction Time: Avg. 10.48 ± 4.98 hrs (vs. 29.07 ± 3.44 hrs in non-CGM group).

• Improved Long-term Adherence: 72% of patients continued rtCGM use for over 6 months.

• Long-term Glycemic Control: Average HbA1c decreased to 6.76% at the first follow-up.

• Hypoglycemia: 0% (0/11 in rtCGM vs. 5/4 in Control).

• Other Complications: 0% (No Cerebral Edema/AKI).

• High Patient Satisfaction: Family medical satisfaction scores exceed 4.5/5.

• Increased Long-term Use: Post-discharge CGM adherence rate significantly rose to 72%.

• Enhanced Care Literacy: Real-time trends help families grasp diet/activity impacts on glucose.

• Stable Glycemic Control: Early CGM adaptation significantly improves long-term HbA1c.

Manuscript in preparation for submission.

• Quality Enhancement: Utilizing real-time trends to significantly shorten metabolic correction time, with precision and safety surpassing traditional fingerstick monitoring.

• Standard Setting: Pioneering the installation of monitoring systems upon admission for pediatric DKA, filling a gap in international guidelines and establishing standardized protocols.

• Efficiency Gains: Reducing DKA treatment duration and PICU stays while alleviating the clinical workload of frequent blood sampling for medical staff.

• Sustainability: Increasing long-term adherence through early technology adaptation, improving overall glycemic control and reducing the healthcare burden of future complications.