ORIGINAL PAPER
The continuous glucose monitoring system correlates poorly with the glucose infusion rate
 
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Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
 
 
Submission date: 2024-10-28
 
 
Final revision date: 2024-11-27
 
 
Acceptance date: 2024-12-06
 
 
Publication date: 2025-03-07
 
 
Corresponding author
Aleksandra Buczyńska
Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
 
 
Pediatr Pol 2025;61(1):23-28
 
KEYWORDS
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ABSTRACT
Introduction::
Increased risk of death and morbidities have been observed among infants with very low birth weight (VLBW) who develop hyperglycaemia. The mechanisms of hyperglycaemia are multifactorial, and it has been speculated that one of the most common causes is a high glucose infusion rate (GIR). There is insufficient data concerning the relationship between GIR and glycaemia with the use of a continuous glucose monitoring system. Obtaining data on this connection can shed light on the pathophysiology of hyperglycaemia in VLBW infants. The aim of study was to evaluate the relationship between glucose delivery and the risk of hyperglycaemia in VLBW infants.

Material and methods::
Data from a total of 74 patients who participated in this continuous glucose monitoring study during their first week of life were analysed retrospectively. The median interstitial glucose concentration (IGC) was calculated for each patient, on each day, and the values were used to divide the patients into quartiles. The median gestational age was 28 weeks (interquartile range 27–31), mean birth weight was 1066 g (±267 g), 59.5% of the cohort was male, and antenatal steroids were administered to 47 (63.5%) subjects. The Median Clinical Risk Index for Babies II score was 7 (interquartile range 5–10), 6 (8.3%) patients were small for gestational age, 38 (52.0%) received surfactant, and 3 (4.0%) patients died before their seventh day of life.

Results::
No relationship was found between GIR and IGC during the first 7 days of life (Kruskal-Wallis test, p > 0.05).

Conclusions::
There was no association between GIR and the risk of hyperglycaemia during the first week of life.
REFERENCES (25)
1.
Alsweiler JM, Kuschel CA, Bloomfield FH. Survey of the management of neonatal hyperglycaemia in Australasia. J Paediatr Child Health 2007; 43:632-635.
 
2.
Beardsall K. Hyperglycaemia in the newborn infant. Physiology verses pathology. Front Pediatr 2021; 9: 8-16.
 
3.
Hays SP, Smith EO, Sunehag AL. Hyperglycemia is a risk factor for early death and morbidity in extremely low birth-weight infants. Pediatrics 2006; 118: 18111818.
 
4.
Ramel S, Rao R. Hyperglycemia in extremely preterm infants. Neoreviews 2020; 21: e89-97.
 
5.
Beardsall K, Vanhaesebrouck S, Ogilvy-Stuart AL, et al. Early insulin therapy in very-low-birth-weight infants. N Engl J Med Edinburgh (PM); Lut Dunstable Hosp N Engl J Med 2008; 35918359: 1873-1884.
 
6.
Alexandrou G, Skiold B, Karlen J, et al. Early hyperglycemia is a risk factor for death and white matter reduction in preterm infants. Pediatrics 2010; 125: e584-591.
 
7.
Chacko SK, Ordonez J, Sauer PJJ, Sunehag AL. Gluconeogenesis is not regulated by either glucose or insulin in extremely low birth weight infants receiving total parenteral nutrition. J Pediatr 2011; 158: 891-896.
 
8.
Beardsall K, Vanhaesebrouck S, Ogilvy-Stuart AL, et al. Prevalence and determinants of hyperglycemia in very low birth weight infants: cohort analyses of the NIRTURE study. J Pediatr 2010; 157: 715-719.e3.
 
9.
Tottman AC, Bloomfield FH, Cormack BE, et al. Relationships between early nutrition and blood glucose concentrations in very preterm infants. J Pediatr Gastroenterol Nutr 2018; 66: 960-966.
 
10.
Fernández-Martínez M del mar, Gómez-Llorente JL, Momblán- Cabo J, et al. Monitoring the incidence, duration and distribution of hyperglycaemia in very-low-birth-weight newborns and identifying associated factors. J Perinat Med 2020; 48: 631-637.
 
11.
Stensvold HJ, Lang AM, Strommen K, Abrahamsen TG, Ogland B, Pripp AH RA. Strictly controlled glucose infusion rates are associated with a reduced risk of hyperglycaemia in extremely low birth weight preterm infants. Acta Paediatr 2018; 107: 442-449.
 
12.
Beardsall K, Ogilvy-Stuart AL, Ahluwalia J, Thompson M, Dunger DB. The continuous glucose monitoring sensor in neonatal intensive care. Arch Dis Child Fetal Neonatal Ed 2005; 90: F307-10.
 
13.
Jagła M, Szymońska I, Starzec K, Kwinta P. Preterm glycosuria – new data from a continuous glucose monitoring system. Neonatology 2018; 114: 87-92.
 
14.
Szymońska I, Jagła M, Starzec K, Hrnciar K, Kwinta P. The incidence of hyperglycaemia in very low birth weight preterm newborns. results of a continuous glucose monitoring study – preliminary report. Dev Period Med 2015; 19: 305-312.
 
15.
Zamir I, Tornevi A, Abrahamsson T, et al. Hyperglycemia in extremely preterm infants – insulin treatment, mortality and nutrient intakes. J Pediatr 2018; 200: 104-110.e1.
 
16.
Burgess L, Morgan C, Mayes K, Tan M. Plasma arginine levels and blood glucose control in very preterm infants receiving 2 different parenteral nutrition regimens. J Parenter Enter Nutr 2014; 38: 243-253.
 
17.
Zhang T, Li C. Mechanisms of amino acid-stimulated insulin secretion in congenital hyperinsulinism. Acta Biochim Biophys Sin (Shanghai) 2013; 45: 36-43.
 
18.
Kalhan SC, Oliven A, King KC, et al. Role of glucose in the regulation of endogenous glucose production in the human newborn. Pediatr Res 1986; 20: 49-52.
 
19.
Sunehag AL, Haymond MW, Schanler RJ, et al. Gluconeogenesis in very low birth weight infants receiving total parenteral nutrition. Diabetes 1999; 48: 791-800.
 
20.
Lane RH, Crawford SE, Flozak AS, Simmons RA. Localization and quantification of glucose transporters in liver of growth-retarded fetal and neonatal rats. Am J Physiol Endocrinol Metab 1999; 276: E135-42.
 
21.
Perri A, Tiberi E, Giordano L, et al. Strict glycaemic control in very low birthweight infants using a continuous glucose monitoring system: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2021; 0: 1-6.
 
22.
Galderisi A, Facchinetti A, Steil GM, et al. Continuous glucose monitoring in very preterm infants: a randomized controlled trial. Pediatrics 2017; 140: e20171162.
 
23.
Krycer JR, Elkington SD, Diaz-Vegas A, et al. Mitochondrial oxidants, but not respiration, are sensitive to glucose in adipocytes. J Biol Chem 2020; 295: 99-110.
 
24.
Stanley CA, Rozance PJ, Thornton PS, et al. Re-evaluating “transitional neonatal hypoglycemia”: mechanism and implications for management. J Pediatr 2015; 166: 1520–5.e1.
 
25.
Jagła M, Szymońska I, Starzec K, Kwinta P. Impact of early glycemic variability on mortality and neurologic outcome of very low birth weight infants: Data from a continuous glucose monitoring system. Dev Period Med 2019; 23: 7-14.
 
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