Measurement of glucose levels in the newborn

Abstract

Accurate measurement of blood glucose levels in the newborn is important as hypoglycaemia and hyperglycaemia are common treatable conditions and there is evidence linking both with detrimental clinical outcomes. Point of care (POC) glucose testing provides rapid results with small sample volumes and therefore clinical care can be modified quickly if needed. However the common thresholds for the diagnosis of hypoglycaemia in the newborn (blood glucose < 2.0 mmol/l or < 2.6 mmol/l) and hyperglycaemia (blood glucose > 10 mmol/l) are at the limits of accuracy for many POC glucose analysers. Therefore although useful for screening, such devices cannot be relied upon for accurate diagnosis of hypoglycaemia. Stand alone local laboratory devices or glucose biosensors incorporated into blood gas analysers help to balance the benefits of POC testing with the accuracy of laboratory analyses. However these clinical methods all rely on intermittent blood sampling and there may be many hours between measurements, when both hypoglycaemia and hyperglycaemia may be undetected clinically. Less invasive and continuous methods of glucose monitoring are under development. Continuous glucose monitoring provides detailed information regarding glucose levels and has led to improvements in the care of patients with diabetes mellitus. These devices also have the potential to help provide improved glucose monitoring and management in the high risk neonate.