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Continuous glucose monitoring in neonates at risk of hypoglycaemia: a feasibility study

Katrine Engen1, Kari Holte2, Mads Nikolaj Holten-Andersen3,4

  • 1Department of Pediatric and Adolescent Medicine, Innlandet Hospital Trust, Brumunddal, Norway kateng@me.com.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|June 16, 2026
PubMed

Insights

Continuous glucose monitoring (CGM) in at-risk neonates showed feasibility, detecting silent hypoglycaemic events. Further research is needed for approved neonatal CGM devices.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Medical Devices

Background:

  • Hypoglycaemia is a common neonatal condition with potential for long-term neurodevelopmental impairment.
  • Early detection and management of neonatal hypoglycaemia are crucial for preventing adverse outcomes.
  • Continuous glucose monitoring (CGM) offers potential for real-time glucose surveillance.

Purpose of the Study:

  • To assess the feasibility of utilizing continuous glucose monitoring (CGM) in high-risk neonates.
  • To evaluate the accuracy and performance of a CGM device in a neonatal population.
  • To identify silent hypoglycaemic episodes in at-risk infants.

Main Methods:

  • An observational feasibility study was conducted in a Level 2 neonatal unit in Norway.
  • Twenty-five infants at risk (maternal diabetes or large for gestational age) were included.
  • A blinded CGM device was applied to the neonate's thigh, recording tissue glucose, with comparison to capillary blood glucose measurements.

Main Results:

  • Tissue glucose readings were higher than blood glucose, with decreasing discrepancy over time (1.0 to 0.5 mmol/L).
  • Lowest tissue glucose levels were observed around 50 hours postnatal age.
  • CGM detected 49 silent hypoglycaemic events in 10 infants from 28 hours postnatal age; no significant skin harm was observed.

Conclusions:

  • CGM accuracy improved over time compared to capillary blood glucose, though the device had limitations below 2.2 mmol/L.
  • Hypoglycaemia occurred later than anticipated, with lowest glucose levels around 50 hours postnatal age.
  • CGM shows promise as a supplementary tool for neonatal glucose monitoring, highlighting the need for specifically approved neonatal devices.
Abstract

Keywords:
EndocrinologyIntensive Care Units, NeonatalNeonatologyPaediatrics

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