Serial investigation of continuous glucose monitoring in a very low birth weight infant with transient late-onset hyperglycemia

Abstract

Transient late-onset hyperglycemia was detected in a very low birth weight (VLBW) infant (gestational age 28 weeks, birth weight 1,082 g) by routine point-of-care glucose monitoring. The infant had no clinical symptom. Serial continuous glucose monitoring (CGM) was conducted for 3 days at 31, 35, and 39 weeks' post conceptual age. The difference values between the maximum and minimum blood glucose levels during the interval from one enteral feeding to the next enteral feeding were 32.3±14.3 mg/dL, 47.5±22.9 mg/dL, and 27.5±12.9 mg/dL for the 1, 2, and 3 CGM, respectively. The serial change in the values was statistically significant (p<0.01).CGM is widely used as a routine clinical practice, which is true even in VLBW infants. Hyperglycemic events detected by only once of CGM in otherwise healthy preterm infants have already been reported on larger numbers of patients. To our knowledge, this is the first report that the change of glucose intolerance in a VLBW infant with transient late-onset hyperglycemia was investigated by serial CGM.

Safety and accuracy of neonatal continuous glucose monitoring

“…In Japan, only a few cases have been reported, for tube-fed, very low birthweight infants and for hyperinsulinemic hypoglycemia. [6][7][8] We first examined the safety and accuracy of the FGM device in term neonates before using it in high-risk infants who need careful blood glucose management.…”

“…There are existing reports of continuous glucose monitoring devices used for neonates. In Japan, only a few cases have been reported, for tube‐fed, very low birthweight infants and for hyperinsulinemic hypoglycemia 6–8 …”

Continuous glucose monitoring in neonates: a review

“…Even fully enterally fed preterm babies may have large fluctuations in their glucose concentrations, varying from hypoglycaemia to hyperglycaemia within a day, and for several hours at a time [ 7 , 54 ]. In one study these fluctuations were related to feed tolerance [ 8 ], and in another study episodes of hyperglycaemia were more common in girls and those with fetal growth restriction [ 54 ].…”