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Published on: February 24, 2023
Real time continuous glucose monitoring in neonatal intensive care
1University Department of Paediatrics, University of Cambridge, Box 116 Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; The Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Insights
Continuous glucose monitoring (CGM) reveals frequent, silent glucose issues in newborns, impacting outcomes. This technology shows promise for improving neonatal intensive care unit (NICU) glucose management.
Area of Science:
- Neonatal Medicine
- Endocrinology
- Medical Technology
Background:
- Hypoglycaemia and hyperglycaemia are prevalent in critically ill infants, linked to adverse outcomes.
- Current glucose monitoring is infrequent, leading to management controversies.
- Continuous glucose monitoring (CGM) is standard in adults/children for dysglycaemia management.
Purpose of the Study:
- To explore the role and potential of CGM in neonatal intensive care units (NICUs).
- To assess glucose regulation insights provided by CGM in newborns.
- To evaluate CGM's safety and efficacy in targeting glucose control in preterm infants.
Main Methods:
- Application of CGM technology in neonatal populations.
- Analysis of glucose variability and dysglycaemia patterns in newborns.
- Review of ongoing clinical trials investigating CGM in preterm infants.
Main Results:
- CGM demonstrates significant, often undetected, hypoglycaemia and hyperglycaemia in neonates.
- Baseline CGM data is crucial for assessing glucose dysregulation's long-term impact.
- Preliminary studies indicate CGM can be used safely to guide glucose control in preterm infants.
Conclusions:
- CGM offers valuable insights into neonatal glucose regulation, identifying silent dysglycaemia.
- Despite current technological limitations for NICU use, CGM holds significant future potential for neonatal care.
- Ongoing research and technological advancements are expected to enhance CGM's role in managing infant glucose levels.
Abstract:
Hypoglycaemia and hyperglycaemia are common in infants requiring intensive care and are associated with worse clinical outcomes. However, glucose levels are taken infrequently, and there remains controversy regarding optimal management. In adults and children continuous glucose monitoring (CGM) is now established as an important adjunct to caring for patients at risk from dysglycaemia. This technology is also increasingly providing insights into glucose regulation in the newborn, demonstrating significant periods of clinically silent hypoglycaemia and hyperglycaemia. This baseline data will be important to allow the significance of glucose dysregulation on long-term outcomes to be assessed. Small studies have also shown the potential for CGM to safely support targeting of glucose control in preterm infants, and a large multicentre trial is ongoing. Current technology is not specifically designed for use in NICU, but with rapid technological developments, CGM holds promise for the future care of babies in NICU.
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