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Reliability of real-time continuous glucose monitoring in infants

Seiichi Tomotaki1,2, Katsuaki Toyoshima1, Tomoyuki Shimokaze1

  • 1Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|July 10, 2019
PubMed

Insights

Real-time continuous glucose monitoring (RT-CGM) in infants shows differences in accuracy at low glucose levels. Alarm settings should adjust based on glucose fluctuation for optimal hypoglycemia detection.

Area of Science:

  • Neonatal care
  • Medical device technology
  • Endocrinology

Background:

  • Neonatal hypoglycemia is a significant risk factor for neurological impairment.
  • Real-time continuous glucose monitoring (RT-CGM) offers continuous glucose data and alerts for timely intervention.
  • Reliability of RT-CGM at low glucose levels in infants remains under-investigated.

Purpose of the Study:

  • To investigate the accuracy of RT-CGM compared to blood glucose (BG) measurements at low glucose levels in infants.
  • To assess the optimal method for setting hypoglycemic alarms using RT-CGM in this population.

Main Methods:

  • Infants with challenging glycemic management were enrolled.
  • Mean Absolute Difference (MAD) and Mean Absolute Relative Difference (MARD) were calculated between BG and RT-CGM data.
  • Comparisons were made between low and high blood glucose fluctuation groups.

Main Results:

  • Analysis of 448 BG and RT-CGM data pairs from 12 infants revealed an overall MAD of 9.3 mg/dL and MARD of 11.5%.
  • At low glucose levels, MAD was 7.7 mg/dL and MARD was 16.2%.
  • Accuracy varied by glucose fluctuation: MAD/MARD were 6.8 mg/dL/7.8% in low fluctuation vs. 10.1 mg/dL/12.7% in high fluctuation groups.

Conclusions:

  • The accuracy of RT-CGM in infants is influenced by the degree of blood glucose fluctuation.
  • Adjusting hypoglycemic alarm settings based on observed glucose variability may improve clinical utility.
  • Further consideration of BG fluctuation is recommended for optimizing RT-CGM alarm strategies in neonates.
Abstract

Keywords:
alarmblood glucosehypoglycemianeonate

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