Real-Time Continuous Glucose Monitoring Reduces the Duration of Hypoglycemia Episodes: A Randomized Trial in Very Low Birth Weight Neonates

Uettwiller, Florence; Chemin, Aude; Bonnemaison, E.; Favrais, Géraldine; Saliba, Élie; Labarthe, François

doi:10.1371/journal.pone.0116255

Cited by 55 publications

(73 citation statements)

References 27 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We used retrospective observational cross-sectional clinical data rather than longitudinal serial [11, 23, 24] or continuous glucose monitoring [25-27]. However, our glucose nadir study of AGA, nonasphyxiated, nonpolycythemic, and non-IDM newborns has the largest sample size ever examined and is the only one to compare nadirs in AGA fasted ELGAN, PT, and LPT newborns to the nadir in fasted FT newborns at a time when early feeding and routine use of glucose-containing solutions in labor were not standard of care.…”

Section: Discussionmentioning

confidence: 99%

Newborn Plasma Glucose Concentration Nadirs by Gestational-Age Group

Kaiser

Bai

Rozance³

2018

Neonatology

View full text Add to dashboard Cite

Background: The glucose concentrations and times to nadir for newborns of all gestational ages when intrapartum glucose-containing solutions are not routinely provided are unknown. Objective: To characterize and compare patterns of initial glucose concentration nadirs by gestational-age groups. Methods: A cross-sectional cohort study of 1,366 newborns born in 1998 at the University of Arkansas for Medical Sciences, appropriate for gestational age, nonasphyxiated, nonpolycythemic, and not infants of diabetic mothers, were included. Initial plasma glucose concentrations, before intravenous fluids or feedings, were plotted against time after birth for 4 gestational-age groups (full term [FT], ≥37–42 weeks; late preterm [LPT], ≥34 and < 37 weeks; preterm [PT], ≥28 and < 34 weeks; and extremely low gestational age newborns [ELGAN], 23 and < 28 weeks of gestation). Results: ELGAN had the earliest nadir at 61 ± 4 min, followed by PT newborns (71 ± 2 min), and then LPT and FT newborns at 92–93 min. The time to nadir for ELGAN and PT newborns was significantly earlier than for FT newborns. Glucose nadir concentrations for ELGAN, PT, and LPT newborns were significantly lower than for FT newborns. LPT newborns’ pattern of glucose paralleled those of FT newborns, with values approximately 5–6 mg/dL lower during the first 3 h. Conclusion: Plasma glucose nadirs occurred at different times among gestational-age groups during the early postnatal period as follows: ELGAN < PT < LPT ≈ FT. In order to potentially prevent low glucose concentrations at the time of the nadir, exogenous glucose should be provided to all newborns as soon as possible after birth.

show abstract

Section: Discussionmentioning

confidence: 99%

Newborn Plasma Glucose Concentration Nadirs by Gestational-Age Group

Kaiser

Bai

Rozance³

2018

Neonatology

View full text Add to dashboard Cite

show abstract

“…It has been reported that CGM has been used even in very low birth weight neonates to recognize hypoglycemia, thus providing more clinical indications for the use of FGM in future. [161718]…”

Section: Discussionmentioning

confidence: 99%

Feasibility and acceptability of ambulatory glucose profile in children with Type 1 diabetes mellitus: A pilot study

Rai

Hulse

Kumar

2016

Indian J Endocr Metab

View full text Add to dashboard Cite

Background:Insulin administration and self-monitoring of blood glucose (SMBG) are pillars in the management of diabetes in children. Introduction of continuous glucose monitoring (CGM) has made it possible to understand the glycemic profiles which are not picked up by SMBG. Recent advent of flash glucose monitoring with inbuilt software to obtain ambulatory glucose profile (AGP) has emerged as a novel method to study glycemic patterns in adults with Type I diabetes. However, the use of AGP in children is yet to be explored.Methods:AGP was used in 46 children with Type 1 diabetes mellitus. Feasibility was measured regarding data and sensor failure. Acceptability was measured using a questionnaire.Results:Forty-six children (22 girls and 24 boys) with a mean age of 10.07 years and mean diabetes duration of 3.4 years were included in the study. In this cohort, for 30 (65.21%) subjects, the sensor remained in situ for a complete duration of 14 days. Except for minor discomfort, AGP was well accepted by most of the children and their parents.Conclusion:AGP is a feasible option for monitoring glycemic status in children with diabetes with a high rate of acceptance.

show abstract

“…To monitor these avoidable hypoglycaemic episodes, recent studies have demonstrated the potential of CGM in premature neonates; technology originally developed for monitoring individuals with diabetes mellitus 5. Furthermore, studies in very preterm infants have shown reductions in glycaemic variability with CGM determined computer-guided glucose infusion rates 6. CGM has therefore been shown to be effective in both the monitoring and management of hypoglycaemia.…”

Section: Discussionmentioning

confidence: 99%

Perioperative continuous glucose monitoring in a preterm infant

Saha¹,

Beardsall

2018

BMJ Case Reports

View full text Add to dashboard Cite

Surgery in the neonatal period presents challenges, especially in preterm infants weighing <1 kg. Their small size, minimal reserves and physiological immaturity means attention to detail and careful monitoring is critical to avoid cardiovascular instability; maintaining fluid balance and metabolic stability is also problematic due to often limited vascular access and small blood volumes. Developments in technology have meant that cardiovascular parameters such as heart rate, blood pressure and oxygen saturations are all routinely and continuously monitored before and during surgery.We have been exploring the role of continuous glucose monitoring (CGM) for metabolic monitoring and management of glucose control in very preterm infants (24-32 weeks gestation). In this paper, we report on a preterm infant who uniquely underwent surgery while wearing a continuous glucose monitor, blinded to the clinical team. This case highlights the metabolic vulnerability of these babies and a possible role for real-time CGM during surgical procedures.

show abstract

Real-Time Continuous Glucose Monitoring Reduces the Duration of Hypoglycemia Episodes: A Randomized Trial in Very Low Birth Weight Neonates

Cited by 55 publications

References 27 publications

Newborn Plasma Glucose Concentration Nadirs by Gestational-Age Group

Newborn Plasma Glucose Concentration Nadirs by Gestational-Age Group

Feasibility and acceptability of ambulatory glucose profile in children with Type 1 diabetes mellitus: A pilot study

Perioperative continuous glucose monitoring in a preterm infant

Contact Info

Product

Resources

About