Abstract
BackgroundContinuous glucose monitoring using subcutaneous sensors has been validated in adults and children with diabetes, and was found to be useful in the management of glucose control. We aimed to assess feasibility and reliability of a new continuous glucose monitoring system (CGMS) in a population of preterm neonates using a Clarke error grid (CEG) specifically modified for preterm infants.MethodsPreterm infants were recruited within 24 h from delivery. A subcutaneous sensor connected to a CGMS was inserted and maintained for 6 days. Data collected from CGMS were compared with data obtained using a glucometer. Management of the infants followed standard protocols and was not influenced by CGMS readings.ResultsTwenty patients (9 males) were included. Median (range) gestational age was 32 weeks (27–36) and median (range) birth weight was 1350 g (860–3360). Average CGMS recording time was 137 h, for a total of 449 paired glucose levels. CEG and modified CEG criteria for clinical significance were met.ConclusionCGMS is a safe and clinically adequate method to estimate glucose levels in preterm infants. As the glucose level can be evaluated in real time, this CGMS could be useful to reduce the number of heel sticks, to observe glycaemic trends and to promptly detect episodes of both hypo- and hyper-glycaemia.
Highlights
Preterm newborns are exposed to blood glucose levels fluctuations after birth, and their developing brain is thought to be more susceptible to episodes of both hypo- and hyper-glycaemia [1]
The following preterm infants at increased risk for neonatal dyslycemia were eligible for this study: intrauterine growth-restricted (IUGR) infants, small for gestational age infants (SGA), very low birth weight (VLBW) infants, extremely low birth weight (ELBW) infants, infants of diabetic mothers, maternal treatment with beta-blockers, tocolytics, oral hypoglycemic therapy, large for gestational age (LGA) infants, asphyxiated infants, septic infants, polycythaemic infants, infants with feeding difficulties
As pointed out by the same authors, the interpretation of these results in the setting of neonates with different interventional glucose levels needs to be cautious [15]. This is the first report of a comparison between blood glucose values obtained via continuous glucose monitoring system (CGMS) and via GTX using a modified Clarke error grid (CEG), more suitable for preterm infants in the first days of life
Summary
Continuous glucose monitoring using subcutaneous sensors has been validated in adults and children with diabetes, and was found to be useful in the management of glucose control. We aimed to assess feasibility and reliability of a new continuous glucose monitoring system (CGMS) in a population of preterm neonates using a Clarke error grid (CEG) modified for preterm infants. Preterm newborns are exposed to blood glucose levels fluctuations after birth, and their developing brain is thought to be more susceptible to episodes of both hypo- and hyper-glycaemia [1]. Such episodes, asymptomatic, usually occur during the first week of life and are often clinically relevant. The present study was designed to assess feasibility and reliability of this new CGMS in a population of preterm infants
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