Elsevier

The Journal of Pediatrics

Volume 157, Issue 2, August 2010, Pages 198-202.e1
The Journal of Pediatrics

Original Article
Continuous Glucose Monitoring in Newborn Babies at Risk of Hypoglycemia

https://doi.org/10.1016/j.jpeds.2010.02.003Get rights and content

Objective

To determine the usefulness of continuous glucose monitoring in babies at risk of neonatal hypoglycemia.

Study design

Babies ≥32 weeks old who were at risk of hypoglycemia and admitted to newborn intensive care received routine treatment, including intermittent blood glucose measurement using the glucose oxidase method, and blinded continuous interstitial glucose monitoring.

Results

Continuous glucose monitoring was well tolerated in 102 infants. There was good agreement between blood and interstitial glucose concentrations (mean difference, 0.0 mmol/L; 95% CI, -1.1–1.1). Low glucose concentrations (<2.6 mmol/L) were detected in 32 babies (32%) with blood sampling and in 45 babies (44%) with continuous monitoring. There were 265 episodes of low interstitial glucose concentrations, 215 (81%) of which were not detected with blood glucose measurement. One hundred seven episodes in 34 babies lasted >30 minutes, 78 (73%) of which were not detected with blood glucose measurement.

Conclusion

Continuous interstitial glucose monitoring detects many more episodes of low glucose concentrations than blood glucose measurement. The physiological significance of these previously undetected episodes is unknown.

Section snippets

Methods

We studied babies born at ≥32 weeks gestation who were at risk of hypoglycemia and admitted to the Waikato Hospital newborn intensive care unit. Babies remained in the study until they were no longer at risk of hypoglycemia or for 7 days, whichever came first. Babies were excluded from the study when there was a serious congenital abnormality or a skin condition that meant the continuous glucose monitor could not be attached. Whenever possible, consent was sought before birth from pregnant

Results

There were 102 babies enrolled in the study between December 2006 and February 2009 (Table I). One term baby had a seizure that was attributed to hypoglycemia before enrolling in the study. No other baby had any clinical signs that were attributed to neonatal hypoglycemia. Several babies were reported to be jittery, but none were hypoglycemic at these times.

The continuous glucose sensor was well tolerated for as long as 7 days. There were no infections, redness, or edema at the insertion sites.

Discussion

We determined the usefulness and reliability of continuous interstitial glucose monitoring in babies who were identified as being at risk of neonatal hypoglycemia and admitted to the newborn intensive care unit. Continuous glucose monitoring in this group of babies appears to be safe, well tolerated, and easy to use. There is good agreement between continuous interstitial and intermittent blood glucose measurements in 7 days of monitoring. Continuous glucose monitoring detects many more

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Supported by the Auckland Medical Research Foundation, the Waikato Medical Research Foundation, and the Rebecca Roberts Scholarship. The authors declare no conflicts of interest.

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