Glucose variability increases during minimally invasive procedures in very preterm infants

Area of Science:

• Neonatalogy
• Endocrinology
• Pediatrics

Background:

• Minimally invasive procedures, such as nappy changes, may induce stress in preterm infants.
• Continuous glucose monitoring (CGM) offers a quantitative method to assess neonatal stress during procedures by measuring glucose variability.

Purpose of the Study:

• To evaluate the impact of various neonatal procedures on glucose variability in very preterm infants.
• To determine if minimally invasive and non-invasive procedures affect glucose levels and variability.

Main Methods:

• Continuous glucose monitoring (CGM) was used for 5 days in preterm infants (≤32 weeks gestation or ≤1500g birthweight) starting on day 2.
• Data were analyzed for 30 minutes before and after recorded procedures, including heel sticks, venipunctures, nappy changes, and parental presence.
• The coefficient of glucose variation (CV), standard deviation (SD), and median glucose were assessed.

Main Results:

• Median glucose levels did not significantly change before and after procedures.
• Glucose variability, measured by CV and SD, increased significantly after heel pricks, venipunctures, and nappy changes.
• No significant difference in glucose variability was observed during parental presence.

Conclusions:

• Both non-invasive and minimally invasive neonatal procedures can elevate glucose variability in very preterm infants.
• These changes in glucose variability occur without significant alterations in mean glucose levels.