Share on facebook
Share on twitter
Share on linkedin

Feasibility of Real Time Continuous Glucose Monitoring in Neonatal Intensive Care

Presented at the Neonatal Society 2017 Spring Meeting.

Thomson L, Howlett J, Bond S, Hovorka, R, Dunger DB, Beardsall K

University of Cambridge and University of Cambridge Addenbrookes Hospital NHS Trust, Cambridge Biomedical Campus, Cambridge, CB2 0QQ

Background: Extremely preterm infants are at high risk of glucose dysregulation and this is associated with increased mortality and morbidity. In these babies the desire to reduce frequency of blood sampling and handling means glucose monitoring is infrequent and controlling glucose levels is challenging. This study aimed to determine the feasibility of real time continuous glucose monitoring (CGM) to support glucose control in extremely preterm infants requiring intensive care.

Methods: A single center feasibility study (n=21) in infants with a birth weight <1200g. The enhanced enlite glucose sensor was inserted subcutaneously manually and connected to a transmitter sending data via bluetooth connection to a CGM reader device. CGM information was combined with a specifically designed paper based algorithm to guide glucose control. Accuracy of the CGM was assessed by comparison with blood glucose measurements from the point of care Stat Strip (Novobiomed) and the blood gas analyser (Radiometer). Safety was assessed in terms of episodes of hypoglycaemia (sensor or blood glucose <2.6mmol/l) and utility with a staff questionnaire. Cambridge Central Ethics committee provided approval for this study which is funded by the Efficacy and Mechanism Evaluation (EME) Programme, an MRC and NIHR partnership and equipment was provided by Medtronic.

Results: There were 21 babies recruited. Comparative data was available at 247 time points. The sensor performed well compared to the point of care blood glucose with mean difference 0.31 (95%CI 0.14, 0.49). Three babies were recorded clinically to have a single episode of hypoglycaemia (BG <2.6mmol/l >1 hour). In two of these it was the CGM that highlighted unanticipated falling glucose levels. The CGM data documented 3 babies each with a single episode (SG<2.6mmol/l >10 minutes), one of which was not detected clinically. Despite initial concerns about impact on workload the clinical staff reported a positive impact on clinical care.

Feasibility of Real Time Continuous Glucose Monitoring in Neonatal Intensive Care

Conclusion: CGM glucose values with enhanced enlite appear sufficiently accurate to be used to support clinical management in the preterm infant. Clinical staff reported a beneficial impact on patient care, but larger studies are required to determine impact on targeting glucose control.

Corresponding author: kb274@cam.ac.uk

The views expressed in this publication are those of the author(s) and not necessarily those of the MRC, NHS, NIHR or the Department of Health.

More to explorer

Summer Meeting 2021

24th and 25th June 2021 Hybrid event: Virtual meeting with a limited number of in-person attendees at the Royal Society of Medicine

2021 Spring Meeting

4th March 2021, Hybrid virtual event with some limited opportunity for attendance.

2020 Autumn meeting

The Neonatal Society 2020 Autumn Meeting was streamed online on 7th November at The Royal Society of Medicine in London.

Search by category
Scroll to Top

We use cookies to improve your experience on our website. By browsing this website, you agree to our use of cookies.