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Improving Metabolic Stability in Preterm Infants Using Continuous Glucose Monitoring: A Randomized Study

Marcella Battaglini1, Andrea Calandrino1, Samuele Caruggi1

  • 1Neonatal Intensive Care Unit, Department of Maternal and Neonatal Health, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Neonatology
|April 15, 2026
PubMed

Insights

Real-time continuous glucose monitoring (CGM) significantly reduced hypoglycemia and hyperglycemia in preterm infants. However, it did not impact neurodevelopmental outcomes at two years corrected age.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Medical Technology

Background:

  • Preterm infants face significant risks from glycemic instability, impacting morbidity and neurodevelopment.
  • Continuous glucose monitoring (CGM) shows potential for minimizing glycemic fluctuations in this vulnerable population.

Purpose of the Study:

  • To evaluate if real-time CGM improves glycemic control in preterm infants compared to standard care.
  • To assess the impact of real-time CGM on neurodevelopmental outcomes in preterm infants.

Main Methods:

  • A single-centre, prospective, randomized trial involving preterm infants allocated to real-time CGM or standard care.
  • Glycemic management guided by real-time CGM data versus intermittent blood glucose measurements.
  • Neurodevelopmental assessment at two years corrected age using Griffiths Scales of Child Development.

Main Results:

  • Real-time CGM group showed significantly fewer episodes of hypoglycemia and hyperglycemia in the first week and at 32 weeks postmenstrual age.
  • Statistical significance (p=0.0001) was achieved for reduced glycemic extremes in the CGM group.
  • No significant differences in neurodevelopmental outcomes were observed between the groups.

Conclusions:

  • Continuous glucose monitoring (CGM) enables enhanced glycemic control strategies in preterm infants during the early neonatal period.
  • While effective for glycemic management, CGM did not demonstrate an effect on long-term neurodevelopmental outcomes in this study.
Abstract

Keywords:
Continuous glucose monitoringGlucose variabilityHyperglycemiaHypoglycemiaPreterm infants

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