Objective Hypoglycaemia is common in neonates. Repeated hypoglycaemic episodes impose a risk of subsequent neurodevelopmental impairment. We aimed to assess the feasibility of using continuous glucose monitoring (CGM) in a group of infants at risk of hypoglycaemia. Design Observational feasibility study. Settings Level 2 neonatal unit, Norway. Patients Infants of mothers with diabetes or infants born large for gestational age. Interventions A blinded CGM-device was applied on the upper lateral thigh of the neonate shortly after birth to record tissue glucose during the infant’s admission at the postnatal ward. Capillary blood glucose screening samples were analysed by oxidase method. Main outcomes Accuracy of tissue glucose values. Tissue glucose variations during the first 3 days after birth. Number of silent hypoglycaemic events. Results We included 25 infants. Tissue glucose values were higher than blood glucose values but estimated discrepancy decreased from 1.0 mmol/L at 6 hours to 0.5 mmol/L at 18 hours of age. The lowest tissue glucose values were observed around 50 hours postnatal age. From 28 hours postnatal age until discharge, CGM detected 49 silent hypoglycaemic events in 10 infants. We observed no significant harm from the devices on skin or subcutaneous tissue. Conclusion Accuracy of tissue glucose increased with time in comparison to capillary blood glucose, but the device could not detect glucose values <2.2 mmol/L. Tissue glucose levels were lowest at ~50 hours postnatal age and hypoglycaemia occurred later than expected. CGM may be a feasible supplement, but approved CGM-devices for neonates are called for.
Engen et al. (Mon,) studied this question.