Continuous glucose monitoring in infants of very low birth weight

Abstract

Objectives: To evaluate the feasibility and efficacy of a continuous glucose monitoring system (CGMS) in a population of infants of very low birth weight (VLBW).

Study design: Infants weighing <or=1,500 g and of <or=32 weeks of gestation were recruited within 24 h of delivery. A subcutaneous sensor connected to a CGMS was inserted and maintained for 7 days or until dysfunction. Therapeutic management followed the usual standard protocols.

Results: 38 patients (21 male) were included over 17 months. Their mean gestational age was 27.5 +/- 2.0 weeks and their mean birth weight was 958.3 +/- 205.5 g. Their perinatal histories and complications during admission were unremarkable for extremely premature babies. Continuous monitoring lasted an average of 7.84 +/- 1.99 days per patient. Hyperglycaemia was detected in 22 (57.90%) patients and it lasted a mean of 20.33 +/- 30.13 h, while 14 (36.8%) presented with hypoglycaemia for a mean of 2.45 +/- 2.3 h.

Conclusions: The CGMS gave a safe and useful estimate of glucose levels in VLBW infants, revealing abnormal glucose levels at a much higher rate than expected by usual sampling. However, it was not able to provide real-time glucose concentration data. CGMS may be very useful in providing information on the role of hyper- and hypoglycaemia on short- and long-term outcomes in VLBW infants.