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Continuous Glucose Monitoring Systems: Are They Useful for Evaluating Glycemic Control in Children with
Arpana Rayannavar1, Okan U Elci2,3, Lauren Mitteer1
1Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Hormone Research in Paediatrics
|March 26, 2020
Summary
Continuous glucose monitoring (CGM) is not reliable for detecting hypoglycemia in children with congenital hyperinsulinism (HI). CGM may help reduce unnecessary glucose meter checks during normal blood sugar levels.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Medical Device Technology
Background:
- Congenital hyperinsulinism (HI) requires vigilant glucose monitoring to prevent brain damage.
- Current intermittent plasma glucose measurements offer incomplete glycemic control assessment and may miss hypoglycemia.
Purpose of the Study:
- To evaluate the accuracy and effectiveness of the Dexcom G5® continuous glucose monitoring system (CGMS) for managing HI in children.
Main Methods:
- A 2-week observational study involving 15 children with HI using a blinded Dexcom G5® device.
- Paired data from CGMS and home glucose meters were analyzed using Bland-Altman analysis.
Main Results:
- CGMS demonstrated 86% sensitivity and 81.4% specificity for detecting hypoglycemia (<70 mg/dL).
- Low positive predictive values for hypoglycemia (50.3%) and severe hypoglycemia (14.8%) were observed.
- High negative predictive values (96.4% for <70 mg/dL, 99.1% for <54 mg/dL) indicate reliability in ruling out hypoglycemia.
Conclusions:
- CGMS is not a dependable method for hypoglycemia monitoring in HI due to frequent false positives.
- CGMS can be valuable in guiding the necessity of glucose meter checks, reducing unnecessary testing during normoglycemia.
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