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Continuous glucose monitoring in preterm infants: evaluation by a modified Clarke error grid
Eloisa Tiberi1, Francesco Cota2, Giovanni Barone3
1Division of Neonatology, Department of Pediatrics, UniversityHospital "A.Gemelli" CatholicUniversity of the Sacred Heart, Rome, Italy. eloisatiberi@yahoo.it.
Insights
Continuous glucose monitoring systems (CGMS) are safe and effective for preterm infants, reducing heel sticks and improving glucose management. This technology aids in real-time glucose evaluation and detection of hypo- and hyperglycemia.
Area of Science:
- Neonatal Medicine
- Medical Technology
- Endocrinology
Background:
- Continuous glucose monitoring (CGM) is validated in adults and children with diabetes for glucose control.
- A new continuous glucose monitoring system (CGMS) was evaluated in preterm neonates.
- A modified Clarke error grid (CEG) was used for preterm infants.
Purpose of the Study:
- To assess the feasibility and reliability of a new CGMS in preterm neonates.
- To determine if CGMS data aligns with traditional glucose measurements in this population.
Main Methods:
- Subcutaneous sensors were inserted into preterm infants within 24 hours of delivery and maintained for 6 days.
- CGMS data was collected and compared with glucometer readings.
- Infant management followed standard protocols, independent of CGMS data.
Main Results:
- Twenty preterm infants (median gestational age 32 weeks) were included.
- Average CGMS recording time was 137 hours, with 449 paired glucose levels.
- The system met CEG and modified CEG criteria for clinical significance.
Conclusions:
- CGMS is a safe and clinically adequate method for estimating glucose levels in preterm infants.
- Real-time glucose evaluation via CGMS can reduce heel sticks.
- CGMS facilitates observation of glycemic trends and prompt detection of hypo- and hyperglycemia.
Background:
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) specifically modified for preterm infants.
Methods:
Preterm 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.
Results:
Twenty 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.
Conclusion:
CGMS 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.
