Swim safety for kids with continuous glucose monitors (CGMs)

Swimming is often a popular activity among kids as the weather gets warmer. But, for parents of children with diabetes, one common concern is whether swimming is possible while wearing a continuous glucose monitor (CGM). Soumya Adhikari, M.D., Pediatric Endocrinologist at Children's Health℠ and Associate Professor at UT Southwestern, shares information and tips on using a CGM while participating in water activities.

Can you wear a CGM while swimming?

Yes, swimming with a CGM is possible but it is important to consider several factors. Some CGM devices are designed to be water-resistant, allowing them to withstand some exposure to water. But not all CGMs have the same level of water resistance, so it is crucial to review the manufacturer's specifications provided with the device. When swimming, cover the monitor with the waterproof bandage supplied by the manufacturer and follow the guidelines to ensure the device remains reliable and accurate during water activities.

Most individuals wear one of two common CGM brands:

• Freestyle Libre 2 and Libre 3: The Freestyle Libre sensors are water resistant and may be immersed in up to 3 feet of water for up to 30 minutes. However, if you plan to go to the beach, it’s important to note that these have not been tested for use in salt water.

• Dexcom G6 and G7: These sensors are water resistant and may be immersed in up to 8 feet of water for about 24 hours.

What are the benefits of swimming with a CGM?

The glucose tracing that a CGM yields after a child leaves the water can help a parent understand what their child’s glucose does when they are active in the water. Over time, this allows you to make any needed adjustments in insulin and food intake before participating in water activities.

How can swimming help those with diabetes?

For kids with diabetes, finding a physical activity that supports their overall health and diabetes management is important. Swimming is a great option that offers many health benefits and can positively impact the lives of kids with diabetes. From improved metabolic health to enhanced physical fitness, swimming provides a number of advantages, such as:

• Enhancing insulin sensitivity: It improves the body's response to insulin, leading to more effective blood glucose control.

• Promoting a healthy weight: It contributes to weight management, which promotes better diabetes management.

• Reducing the risk of heart disease: It helps lower blood pressure, reduces the risk of heart disease and enhances circulatory system functions.

• Improving mental health: It reduces stress levels and enhances mood, providing kids with diabetes a much-needed mental boost.

Are there limitations to a CGM in water?

While CGMs are designed to withstand some water exposure, it's important to be aware of potential limitations.

• Variations in accuracy: Some devices may experience slight differences in accuracy when they get wet. This can occur because of water pressure and temperature, affecting the readings.

• Loss of signal: While your child is swimming, remember that water will temporarily interfere with the CGMs wireless communication. This may cause gaps in the data transmitted to the receiver or connected device, like a smartphone or insulin pump. Don’t rely on low glucose alerts to transmit to mobile receivers or phones while a child is in the water.

• Loss of adhesion: During long periods in the water, the CGM’s adhesive can become loose, shortening the wear time for individual sensors.

• Depth limits: Check the manufacturer's guidelines to determine if the CGM has depth limitations that can potentially lead to device damage or malfunction.

Tips for swimming safely with a CGM

To ensure a worry-free experience, here are a few tips to swim safely with a CGM:

1. Verify waterproof or water resistance

Confirm your child's CGM is designed to be water-resistant. Review the manufacturer's specifications and guidelines to ensure the device remains reliable in water.

2. Ensure the adhesive is secure

Before your child goes swimming ensure the CGM sensor and transmitter are securely attached to their skin and the adhesive is in good condition. You can use additional waterproof adhesive patches or tapes to help keep the device in place during water activities.

3. Check blood glucose levels often

It's essential to monitor your child's blood glucose levels closely before, during and after swimming to ensure they maintain a safe range. If necessary, consider taking additional fingerstick measurements for added accuracy.

4. Adjust as needed

CGMs are accurate. However, when possible, confirming CGM readings with fingerstick checks is important. Physical activity, like swimming, may affect your child's blood glucose levels, requiring adjustments to insulin doses or carbohydrate intake.

5. Alert the lifeguard

If your child swims in a public pool, let the lifeguards know about your child’s diabetes and the use of their CGM. Share any relevant instructions or emergency protocols to make sure they are aware.

6. Educate others

If your child swims with friends or is involved in organized swim lessons, let your child’s friends or swim teacher know about their diabetes and what to do if an emergency glucose fluctuation happens.

7. Consider a medical ID

Wearing a medical alert bracelet while swimming is always a good idea to alert others that you have diabetes in case of a medical emergency. Whether in the form of a bracelet, anklet or necklace, they can contain vital information for first responders.

Learn more

The Pediatric Diabetes Program at Children's Health offers around-the-clock care for children with type 1 and type 2 diabetes. Our award-winning program gives you and your child the tools you need to live the lives you want, even with diabetes. Learn more about our program and services.