Real-time continuous glucose monitoring systems may be more accurate for detecting abnormal glucose levels compared with intermittent A-line blood glucose measurements in premature infants of mothers with diabetes, according to a study published in PLoS ONE.
Researchers identified 30 premature babies admitted to the neonatal intensive care unit (NICU) at Chung Shan Medical University Hospital, in Taichung, Taiwan, and placed them in 2 groups based on maternal diabetes status (mothers with diabetes, n=15; mothers without diabetes, n=15). The usefulness and reliability of a real-time continuous glucose monitoring system in detecting the incidence of hypoglycemia and hyperglycemia was investigated.
Study results demonstrated that 33.3% of the preterm infants studied had episodes of abnormal glucose levels between the checkpoint intervals of the intermittent A-Line blood sugar measurements. Infants of mothers with diabetes experienced a higher rate of hypoglycemia or hyperglycemia alarms during the 72-hour study period compared with infants of mothers without diabetes (73.3% and 40%, respectively). In addition, the study results revealed a sensitivity of 94.59% and specificity of 97.87% in the detection of abnormal blood glucose levels utilizing real-time continuous glucose monitoring systems.
Limitations of this study include its small sample size, inclusion of only 1 hospital, and limited generalizability as it was conducted in 1 hospital in 1 racial population.
The researchers concluded that real-time continuous glucose monitoring is comparable to traditional A-line intermittent blood glucose monitoring in identifying blood glucose levels in premature infants, but also has the ability to also detect the incidence of abnormal blood glucose levels undetected with intermittent A-line measurements. Further, real-time continuous glucose monitoring systems are a less invasive and painful monitoring method in preterm infants.
Clinicians should consider the use of real-time continuous glucose monitoring system in premature infants of mothers with diabetes during the first 72 hours after birth.
Saw H-P, Yao N-W, Chiu C-D, Chen J-Y. The value of real-time continuous glucose monitoring in premature infants of diabetic mothers [published online October 16, 2017]. PLoS ONE. doi:10.1371/journal.pone.0186486.