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The use of CGM to identify hypoglycemia and glycemic patterns in congenital hyperinsulinism

Martin Gariepy1, Niyoosha Yoosefi1, Carolina Silva2

  • 1Department of Pediatrics, University of British Columbia, Vancouver, Canada.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|November 21, 2023
PubMed

Insights

Continuous glucose monitoring (CGM) detected previously unrecognized hypoglycemia in children with congenital hyperinsulinism (HI). This technology aids in identifying glucose patterns and guiding treatment adjustments for better glycemic control.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders

Background:

  • Congenital hyperinsulinism (HI) poses risks for hypoglycemia and adverse neurologic outcomes, particularly in neonates.
  • Point-of-care testing (POCT) is standard for HI, but continuous glucose monitoring (CGM) shows promise in other pediatric diabetes populations.
  • Limited data exists on CGM use in children with HI.

Purpose of the Study:

  • To evaluate glycemic patterns in children with HI on stable therapy.
  • To determine the frequency of undetected hypoglycemia using Dexcom G6® CGM in this population.

Main Methods:

  • A pilot, observational study involving 10 children (3 months to 17 years) with diagnosed HI on stable medication.
  • Participants used standard POCT and wore a blinded Dexcom G6® CGM for 20 days.
  • Potential for unblinding CGM data in cases of severe hypoglycemia.

Main Results:

  • CGM identified 26 hypoglycemic events in 60% of participants.
  • A significant portion of hypoglycemia (45%) occurred between 0600 and 0800.
  • Medication dose adjustments were made for 30% of the study population based on CGM findings.

Conclusions:

  • CGM effectively detects hypoglycemia and glucose trends, especially during periods without POCT.
  • This data can inform medical management and medication adjustments in children with HI.
  • The study's small sample size limits generalizability.
Abstract

Keywords:
absolute relative difference (MARD)congenital hyperinsulinismcontinuous glucose monitoringhypoglycemia

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