Continuous Glucose Monitoring in the Management of Neonates With Persistent Hypoglycemia and Congenital Hyperinsulinism

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2021 Aug 18

PMID 34407200

Citations 12

Authors

Myat Win

Rowan Beckett

Lynn Thomson

Ajay Thankamony

Kathryn Beardsall

Affiliations

Soon will be listed here.

Abstract

Background: Persistent hypoglycemia is common in the newborn and is associated with poor neurodevelopmental outcome. Adequate monitoring is critical in prevention, but is dependent on frequent, often hourly blood sampling. Continuous glucose monitoring (CGM) is increasingly being used in children with type 1 diabetes mellitus, but use in neonatology remains limited. We aimed to introduce real-time CGM to provide insights into patterns of dysglycemia and to support the management of persistent neonatal hypoglycemia.

Methods: This is a single-center retrospective study of real-time CGM use over a 4-year period in babies with persistent hypoglycemia.

Results: CGMs were inserted in 14 babies: 8 term and 6 preterm infants, 9 with evidence of congenital hyperinsulinism (CHI). A total of 224 days of data was collected demonstrating marked fluctuations in glucose levels in babies with CHI, with a higher sensor glucose SD (1.52 ± 0.79 mmol/L vs 0.77 ± 0.22 mmol/L) in infants with CHI compared with preterm infants. A total of 1254 paired glucose values (CGM and blood) were compared and gave a mean absolute relative difference of 11%.

Conclusion: CGM highlighted the challenges of preventing hypoglycemia in these babies when using intermittent blood glucose levels alone, and the potential application of CGM as an adjunct to clinical care.

Citing Articles

Continuous glucose monitoring in patients with inherited metabolic disorders at risk for Hypoglycemia and Nutritional implications.

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Clinical management of diazoxide-unresponsive congenital hyperinsulinism: A single-center experience.

Takasawa K, Iemura R, Orimoto R, Yamano H, Kirino S, Adachi E Clin Pediatr Endocrinol. 2024; 33(3):187-194.

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Clinical and Genetic Characteristics of Congenital Hyperinsulinism in Norway: A Nationwide Cohort Study.

Velde C, Molnes J, Berland S, Njolstad P, Molven A J Clin Endocrinol Metab. 2024; 110(2):554-563.

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Accuracy and impact on quality of life of real-time continuous glucose monitoring in children with hyperinsulinaemic hypoglycaemia.

Sivasubramanian M, Avari P, Gilbert C, Doodson L, Morgan K, Oliver N Front Endocrinol (Lausanne). 2023; 14:1265076.

PMID: 37822600 PMC: 10562688. DOI: 10.3389/fendo.2023.1265076.

Glucose variability in 6-12-month-old healthy infants.

Hauschild M, Monnard C, Eldridge A, Antoniou M, Bouthors T, Hansen E Front Nutr. 2023; 10:1128389.

PMID: 37502727 PMC: 10369064. DOI: 10.3389/fnut.2023.1128389.

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