Use of Long-Term Microdialysis Subcutaneous Glucose Monitoring in the Management of Neonatal Diabetes

Abstract

In neonatal diabetes mellitus (NDM), a rare genetic disorder, insulin therapy is required but the management is difficult. Frequent blood glucose determinations are necessary in most cases. Microdialysis subcutaneous glucose monitoring (MSGM) is feasible in neonates and has been proposed to reduce painful blood sampling and blood loss. We have applied long-term MSGM to a small-for-date female newborn with transient NDM. We found a good correlation of subcutaneous and blood glucose concentration over a wide range of values. MSGM enabled a reduction in blood glucose determinations during optimization of intravenous insulin treatment and initiation of continuous subcutaneous insulin infusion. We conclude that long-term MSGM is feasible and may reduce painful blood sampling and blood loss in NDM. Furthermore, long-term MSGM may hold a potential for avoiding hypoglycemic episodes and earlier discharge.

Micro- and nanobiosensors—state of the art and trends

“…A lot of different measurements were done in the past in basic research as well as in clinical research revealing insights into the dynamics of metabolic states. This was extended to glucose monitoring which is of outstanding importance for diabetic patients [70][71][72][73][74].…”

Pilot Investigation on Long-Term Subcutaneous Microdialysis: Proof of Principle in Humans

“…However, knowledge of the long-term performance of microdialysis is limited. Prolonged microdialysis sampling over several days has been used for endogenous compounds in humans (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) in neonatal (10,16,17) and adult (11,12,14,18) diabetic patients, in patients admitted for breast reconstruction with transverse rectus abdominis muscle flaps after mastectomy (13), in patients with ischemic heart disease (23), and in patients for neurochemical monitoring or on the neurosurgical ICU (19)(20)(21)(22). Some problems were reported, e.g., accidental removals of microdialysis catheters in agile infants (10,16), disturbances in perfusion flow (10), minor bleeding around the microdialysis catheter during microdialysis in one child (10), discontinuation because of obstruction of the inlet tubing of the catheter (12), or removal of a catheter because of a puncture of a small vein (16).…”