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Continuous glucose monitoring during therapeutic hypothermia for hypoxic ischaemic encephalopathy: a feasibility study
  1. Maria-Sofia Kalogeropoulou1,
  2. Lynn Thomson2,
  3. Kathryn Beardsall1,2,3
  1. 1 School of Clinical Medicine, University of Cambridge, Cambridge, UK
  2. 2 Paediatrics, Cambridge University, Cambridge, UK
  3. 3 Neonatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Kathryn Beardsall, Paediatrics, University of Cambridge, Cambridge, CB2 0QQ, UK; kb274{at}


Objectives Glucose dysregulation is common in infants with hypoxic ischaemic encephalopathy (HIE) and is likely to exacerbate cerebral injury. Infrequent measurement of glucose concentrations makes both identification and prevention of this risk challenging. Continuous glucose monitoring (CGM) has the potential to address both these challenges, but has not been explored in these infants. We aimed to evaluate the feasibility and potential impact of real-time CGM in term infants with HIE being treated with therapeutic hypothermia (TH).

Design Feasibility study.

Setting Tertiary-level neonatal unit, UK.

Patients Term infants with HIE undergoing TH.

Intervention A CGM sensor was inserted within 48 hours of birth and kept in situ for the first week of life. Clinical staff were blinded to the CGM recordings and clinical decisions were based on blood glucose assays.

Main outcome measures (1) Accuracy of CGM values during and post TH, (2) Per cent of time spent outside the clinical range (2.6–10 mmol/L), (3) Episodes of hypoglycaemia and hyperglycaemia, (4) Adverse effects.

Results The accuracy of CGM values during TH were comparable to those when infants were normothermic. There was wide variation in per cent time outside the target range (2.6–10 mmol/L) between infants (median 5%, range 0%–34%). CGM identified 44% of infants with ≥1 episode of hypoglycaemia (<2.6 mmol/L) and 50% with ≥1 episode of hyperglycaemia (>10 mmol/L). No adverse events were observed.

Conclusions This study demonstrates that CGM could be a useful adjunct for glucose monitoring in babies undergoing TH who are at risk of both hypoglycaemia and hyperglycaemia.

  • Neonatology
  • Intensive Care Units, Neonatal

Data availability statement

Data are available upon reasonable request. We are open to data sharing. Any requests should be directed to the corresponding author.

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Data availability statement

Data are available upon reasonable request. We are open to data sharing. Any requests should be directed to the corresponding author.

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  • Contributors The idea for the study was conceived by KB and planned by KB and LT. The study recruitment, data collection and data analyses were undertaken by LT and M-SK. All authors have reviewed and approved the final content and act as guarantors responsible for the overall content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.