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Published in: Italian Journal of Pediatrics 1/2016

Open Access 01-12-2016 | Research

Continuous glucose monitoring in preterm infants: evaluation by a modified Clarke error grid

Authors: Eloisa Tiberi, Francesco Cota, Giovanni Barone, Alessandro Perri, Valerio Romano, Rossella Iannotta, Costantino Romagnoli, Enrico Zecca

Published in: Italian Journal of Pediatrics | Issue 1/2016

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Abstract

Background

Continuous glucose monitoring using subcutaneous sensors has been validated in adults and children with diabetes, and was found to be useful in the management of glucose control. We aimed to assess feasibility and reliability of a new continuous glucose monitoring system (CGMS) in a population of preterm neonates using a Clarke error grid (CEG) specifically modified for preterm infants.

Methods

Preterm infants were recruited within 24 h from delivery. A subcutaneous sensor connected to a CGMS was inserted and maintained for 6 days. Data collected from CGMS were compared with data obtained using a glucometer. Management of the infants followed standard protocols and was not influenced by CGMS readings.

Results

Twenty patients (9 males) were included. Median (range) gestational age was 32 weeks (27–36) and median (range) birth weight was 1350 g (860–3360). Average CGMS recording time was 137 h, for a total of 449 paired glucose levels. CEG and modified CEG criteria for clinical significance were met.

Conclusion

CGMS is a safe and clinically adequate method to estimate glucose levels in preterm infants. As the glucose level can be evaluated in real time, this CGMS could be useful to reduce the number of heel sticks, to observe glycaemic trends and to promptly detect episodes of both hypo- and hyper-glycaemia.
Literature
2.
go back to reference Finberg L. Dangers to infants caused by changes in osmolal concentration. Pediatrics. 1967;40:1031–4.PubMed Finberg L. Dangers to infants caused by changes in osmolal concentration. Pediatrics. 1967;40:1031–4.PubMed
3.
go back to reference Iglesias Platas I, Thio’ Lluch M, Alminana NP, et al. Continuous glucose monitoring in infants of very low birth weight. Neonatol. 2009;95:217–23.CrossRef Iglesias Platas I, Thio’ Lluch M, Alminana NP, et al. Continuous glucose monitoring in infants of very low birth weight. Neonatol. 2009;95:217–23.CrossRef
4.
go back to reference Cornblath M, Hawdon JM, Williams AF, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics. 2000;105:1141–5.CrossRefPubMed Cornblath M, Hawdon JM, Williams AF, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics. 2000;105:1141–5.CrossRefPubMed
5.
go back to reference Ho HT, Yeung WKY, Young BWY. Evaluation of ‘point of care’ devices in the measurement of low blood glucose in neonatal practice. Arch Dis Child Fetal Neonatal Ed. 2004;89:F356–9.CrossRefPubMedPubMedCentral Ho HT, Yeung WKY, Young BWY. Evaluation of ‘point of care’ devices in the measurement of low blood glucose in neonatal practice. Arch Dis Child Fetal Neonatal Ed. 2004;89:F356–9.CrossRefPubMedPubMedCentral
6.
7.
go back to reference Gross TM, Bode B, Einhorn D, et al. Performance evaluation of the MiniMed continuous glucose monitoring system during patient home use. Diabetes TechnolTher. 2000;2:49–56.CrossRef Gross TM, Bode B, Einhorn D, et al. Performance evaluation of the MiniMed continuous glucose monitoring system during patient home use. Diabetes TechnolTher. 2000;2:49–56.CrossRef
8.
go back to reference Harris DL, Battin MR, Weston PJ, et al. Glucose Monitoring in Newborn Babies at Risk of Hypoglycemia. J Pediatr. 2010;157:198–202.CrossRefPubMed Harris DL, Battin MR, Weston PJ, et al. Glucose Monitoring in Newborn Babies at Risk of Hypoglycemia. J Pediatr. 2010;157:198–202.CrossRefPubMed
9.
go back to reference Beardsall K, Ogilvy-Stuart AL, Ahluwalia J, et al. The continuous glucose monitoring sensor in neonatal intensive care. Arch Dis Child Fetal Neonatal Ed. 2005;90:F307–10.CrossRefPubMedPubMedCentral Beardsall K, Ogilvy-Stuart AL, Ahluwalia J, et al. The continuous glucose monitoring sensor in neonatal intensive care. Arch Dis Child Fetal Neonatal Ed. 2005;90:F307–10.CrossRefPubMedPubMedCentral
10.
go back to reference McGowan JE. Commentary, neonatal hypoglycemia. Fifty years later, the questions remain the same. Neorev. 2004;3(9):E363.CrossRef McGowan JE. Commentary, neonatal hypoglycemia. Fifty years later, the questions remain the same. Neorev. 2004;3(9):E363.CrossRef
11.
go back to reference Srinivasan G, Pildes RS, Cattamanchi G, et al. Plasma glucose values in normal neonates: a new look. J Pediatr. 1986;109:114–7.CrossRefPubMed Srinivasan G, Pildes RS, Cattamanchi G, et al. Plasma glucose values in normal neonates: a new look. J Pediatr. 1986;109:114–7.CrossRefPubMed
12.
go back to reference Sperling MA, Menon RK. Differential diagnosis and management of neonatal hypoglycemia. Pediatr Clin North Am. 2004;51(3):703–23.CrossRefPubMed Sperling MA, Menon RK. Differential diagnosis and management of neonatal hypoglycemia. Pediatr Clin North Am. 2004;51(3):703–23.CrossRefPubMed
13.
go back to reference Decaro MH, Vain NE. Hyperglycaemia in preterm neonates: what to know, what to do. Early Hum Dev. 2011;87S:S19–22.CrossRef Decaro MH, Vain NE. Hyperglycaemia in preterm neonates: what to know, what to do. Early Hum Dev. 2011;87S:S19–22.CrossRef
14.
go back to reference Clarke WL, Cox D, Gonder-Frederick LA, et al. Evaluating clinical accuracy of systems for self monitoring of blood glucose. Diabetes Care. 1987;10:622–8.CrossRefPubMed Clarke WL, Cox D, Gonder-Frederick LA, et al. Evaluating clinical accuracy of systems for self monitoring of blood glucose. Diabetes Care. 1987;10:622–8.CrossRefPubMed
16.
go back to reference Monsod TP, Flanagan DE, Rife F, et al. Do sensor glucose levels accurately predict plasma glucose concentrations during hypoglycemia and hyperinsulinemia? Diabetes Care. 2002;25:889–93.CrossRefPubMed Monsod TP, Flanagan DE, Rife F, et al. Do sensor glucose levels accurately predict plasma glucose concentrations during hypoglycemia and hyperinsulinemia? Diabetes Care. 2002;25:889–93.CrossRefPubMed
17.
go back to reference Caplin NJ, O’Leary P, Bulsara M, et al. Subcutaneous glucose sensor values closely parallel blood glucose during insulin-induced hypoglycaemia. Diabet Med. 2003;20:238–41.CrossRefPubMed Caplin NJ, O’Leary P, Bulsara M, et al. Subcutaneous glucose sensor values closely parallel blood glucose during insulin-induced hypoglycaemia. Diabet Med. 2003;20:238–41.CrossRefPubMed
18.
go back to reference Chee F, Fernando T, Van Heerden PV. Closed-loop glucose control in critically ill patients using continuous glucose monitoring system (CGMS) in real time. IEEE Trans InfTechnol Biomed. 2003;7(1):43–53.CrossRef Chee F, Fernando T, Van Heerden PV. Closed-loop glucose control in critically ill patients using continuous glucose monitoring system (CGMS) in real time. IEEE Trans InfTechnol Biomed. 2003;7(1):43–53.CrossRef
19.
go back to reference Ligtenberg JJ, de Plaa ME, Zijlstra JG. Continuous subcutaneous glucose monitoring: good enough to use in glucose regulation protocols? Crit Care. 2011;15:403. author reply 403.CrossRefPubMedPubMedCentral Ligtenberg JJ, de Plaa ME, Zijlstra JG. Continuous subcutaneous glucose monitoring: good enough to use in glucose regulation protocols? Crit Care. 2011;15:403. author reply 403.CrossRefPubMedPubMedCentral
Metadata
Title
Continuous glucose monitoring in preterm infants: evaluation by a modified Clarke error grid
Authors
Eloisa Tiberi
Francesco Cota
Giovanni Barone
Alessandro Perri
Valerio Romano
Rossella Iannotta
Costantino Romagnoli
Enrico Zecca
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2016
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-016-0236-9

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