Continuous Glucose Monitoring among Infants Born Very Preterm: Evidence for Accuracy in Neonatal Intensive Care

Jacopo Bonet; Silvia Guiducci; Giulia Res; Sabrina Brigadoi; Sarbattama Sen; Paolo Montaldo; Elena Priante; Nicola Santoro; Daniele Trevisanuto; Eugenio Baraldi; Chiara Dalla Man; Alfonso Galderisi

doi:10.1016/j.jpeds.2024.114416

Continuous Glucose Monitoring among Infants Born Very Preterm: Evidence for Accuracy in Neonatal Intensive Care

J Pediatr. 2024 Nov 22:278:114416. doi: 10.1016/j.jpeds.2024.114416. Online ahead of print.

Authors

Affiliations

¹ Department of Bioengineering, University of Padova, Padova, Italy.
² Department of Woman and Child's Health, University of Padova, Padova, Italy.
³ Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
⁴ Women & Infants Hospital of Rhode Island, The Warren Alpert Medical School, Brown University, Providence, RI.
⁵ Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy; Centre for Perinatal Neuroscience, Imperial College London, London, United Kingdom.
⁶ Department of Pediatrics, Yale University, New Haven, CT; Department of Medicine and Health Sciences, "V. Tiberio" University of Molise, Campobasso, Italy.
⁷ Department of Woman and Child's Health, University of Padova, Padova, Italy; Institute for Pediatric Research (IRP), Mass Spectrometry and Metabolomics Lab, Padova, Veneto, Italy.
⁸ Department of Woman and Child's Health, University of Padova, Padova, Italy; Department of Pediatrics, Yale University, New Haven, CT; Institute for Pediatric Research (IRP), Mass Spectrometry and Metabolomics Lab, Padova, Veneto, Italy. Electronic address: alfonso.galderisi@yale.edu.

PMID: 39579867
DOI: 10.1016/j.jpeds.2024.114416

Abstract

Objective: To evaluate the accuracy of a device for continuous glucose monitoring (CGM) among infants born preterm admitted to the neonatal intensive care unit.

Study design: We analyzed paired CGM sensor glucose (SG) and point-of-care blood glucose (BG) measurements collected in infants born at ≤32 weeks of gestation or with a birth weight ≤1500 g. CGM was initiated within 48 hours from birth and maintained for 5 days. BG was performed every 12 hours and used to calibrate the sensor. Measures of CGM accuracy were computed from SG and BG pairs.

Results: We included 501 SG-BG paired measurements from 51 infants (age 30.5 weeks [IQR 29.0-31.0 weeks], birth weight 1400 g [IQR 1100-1500 g] with at least 24 hours of CGM data. The mean absolute relative difference (MARD) between SG and point-of-care BG measures was 7.1% [IQR 5.6-9.3], corresponding to a difference of -5.6 mg/dL [95% CI -25 to +14 mg/dl]. The median sensor use was 96 hours [IQR 72-120] with 2.0 [IQR 1.7-2.4] calibrations per day.

Conclusions: Accuracy of SG measurements compared with BG measurements appears to be acceptable in a clinical study setting, with a negligible difference between SG and BG. Our data suggest that SG use may be clinically acceptable when the sensor is regularly calibrated.

Keywords: CGM; glucose monitoring; preterm infants.