Related Experiment Video

Updated: Nov 4, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

19.1K

Strict glycaemic control in very low birthweight infants using a continuous glucose monitoring system: a randomised

Alessandro Perri1, Eloisa Tiberi2, Lucia Giordano2

  • 1Child Health Area, University Hospital Agostino Gemelli Department of Woman and Child Health Sciences, Rome, Lazio, Italy alessandro.perri@policlinicogemelli.it.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|May 27, 2021
PubMed

Insights

A strict glycaemic control protocol using continuous glucose monitoring (CGM) significantly reduced dysglycaemic episodes in high-risk infants. This approach also increased the time infants spent in normal blood glucose ranges, improving overall metabolic stability.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Clinical Trial Research

Background:

  • Infants at high risk of dysglycaemia, particularly those born very low birth weight and receiving parenteral nutrition (PN), face significant metabolic challenges.
  • Effective glycaemic control is crucial in this vulnerable population to prevent adverse outcomes associated with blood glucose fluctuations.

Purpose of the Study:

  • To assess the efficacy of a stringent glycaemic control protocol, utilizing continuous glucose monitoring (CGM), in minimizing dysglycaemic episodes among high-risk neonates.
  • To determine if this protocol enhances the time infants spend within the euglycaemic range.

Main Methods:

  • A randomized controlled trial was conducted in a neonatal intensive care unit.
  • Eligible infants (<1500 g) receiving PN were randomized into two groups with different CGM alarm cut-offs.
  • A strict protocol guided glucose infusion rate adjustments based on CGM readings.

Main Results:

  • The intervention group, managed with the strict protocol, experienced significantly fewer dysglycaemic episodes (1 vs 3; p=0.005) and a lower incidence of infants with at least one episode (52% vs 83%; p=0.047).
  • Infants in the strict group showed a higher probability of maintaining normal glycaemic values (RR 2.87) and spent more time in euglycaemia (100% vs 98%; p=0.036).
  • The number needed to treat to avoid dysglycaemia episodes was 3.2.

Conclusions:

  • Continuous glucose monitoring (CGM) integrated with a protocol for adjusting glucose infusion effectively reduces dysglycaemia in very low birth weight infants on PN.
  • This strategy significantly increases the duration of euglycaemia, highlighting its clinical utility in neonatal metabolic management.
Abstract

Keywords:
endocrinologyneonatology

More Related Videos

Simple Continuous Glucose Monitoring in Freely Moving Mice03:25

Simple Continuous Glucose Monitoring in Freely Moving Mice

Published on: February 24, 2023

6.7K
Author Spotlight: Exploring the Long-Term Health Impacts of Intracytoplasmic Sperm Injection on Offspring06:11

Author Spotlight: Exploring the Long-Term Health Impacts of Intracytoplasmic Sperm Injection on Offspring

Published on: May 17, 2024

880

Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
3.7K
Glucose Homeostasis: Regulation of Blood Glucose01:02

Glucose Homeostasis: Regulation of Blood Glucose

Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
3.0K
Glucose Absorption Into the Small Intestine01:26

Glucose Absorption Into the Small Intestine

Complex carbohydrates consumed cannot be absorbed into the small intestine in their original form. First, they must be hydrolyzed to a monosaccharide form such as glucose or galactose. These monosaccharides are then transported across the intestinal membrane and into the blood via transcellular transport. The intestinal epithelial cells allow the movement of these monosaccharides with a defined 'entry' through membrane transporter proteins present on their apical membrane and...
33.5K
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
498
Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
2.3K
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
345