ESPE Yearbook of Paediatric Endocrinology

Cochrane Database Syst Rev. 2020 Dec 21;12:CD013309. doi: 10.1002/14651858.CD013309.pub2. PMID: 33348448.

This Cochrane review aimed to assess the use of continuous glucose monitoring (CGM) in preterm infants. It finds limited evidence to support the use of CGM devices to improve mortality or morbidity in preterm infants.

Both hypoglycaemia and hyperglycaemia are risk factors for adverse neurodevelopmental outcome in preterm infants. Abnormalities in glucose homeostasis in preterm infants are associated with permanent brain injury, retinopathy, sepsis, intraventricular haemorrhage and death (1). The routine detection of both hypoglycaemia and hyperglycaemia requires point of care glucometers with regular and frequent blood sampling usually by painful heel pricks. The use of CGM devices which measure subcutaneous glucose continuously for the detection of hypoglycaemia and hyperglycaemia could potentially reduce the frequency of blood sampling and help control blood glucose levels in preterm infants. However, the risks, benefits and accuracy of CGM are not known in preterm infants.

In this review, only 4 trials fulfilled the inclusion criteria – none reported neurodevelopmental outcomes for the preterm infants, and the patient numbers were small for trials with data on survival. Thus, the strength of evidence is limited in supporting the use of CGM devices to improve mortality or morbidity in preterm infants and the authors recommend that more research is needed on this topic.

Reference: 1. Hays SP, Smith EO, Sunehag AL. Hyperglycemia is a risk factor for early death and morbidity in extremely low birth-weight infants. Pediatrics. 2006 Nov; 118(5):1811–8.