Pediatrics, Division of Neonatology, Adnan Menderes University School of Medicine, Aydin, Turkey.
Pediatrics, Division of Pediatric Endocrinology, Adnan Menderes University School of Medicine, Aydin, Turkey.
Z Geburtshilfe Neonatol. 2021 Apr;225(2):155-160. doi: 10.1055/a-1209-3861. Epub 2020 Aug 3.
Effective treatment and close monitoring of hypoglycemia in children with congenital hyperinsulinemic hypoglycemia (CHH) is vital to prevent brain damage. The current use of capillary sampling schedules does not provide a comprehensive assessment of glycemic status and fails to detect asymptomatic hypoglycemia episodes.
To investigate the efficacy and accuracy of a real-time continuous glucose monitoring system (RT-CGMS) in neonates with CHH.
A sensor connected to RT-CGMS was inserted into the newborn patients and maintained for at least 6 days during their stay in the hospital. We compared the readings of CGMS with capillary blood glucose values using Bland-Altman analysis.
A total of 110 blood glucose values were compared to readings from the CGMS. All results were calculated and plotted for CGMS values at 0-4, 5-9, 10-14, 15-19, 20-24, and 25-29 min after capillary blood glucose sampling. CGMS readings were highly correlated with blood glucose values, especially during normoglycemia. In case of hypoglycemia, the mean difference between the CGMS and capillary glucose values was higher. Although the false positive rate for hypoglycemia was relatively high in CGMS, RT-CGMS may show some episodes of hypoglycemia earlier than blood measurement.
RT-CGMS is accurate during normoglycemia, and it can reduce the number of capillary blood samples in children with CHH.
有效治疗和密切监测先天性高胰岛素血症性低血糖（CHH）患儿的低血糖对预防脑损伤至关重要。目前使用毛细血管采样方案无法全面评估血糖状态，也无法检测无症状性低血糖发作。
研究实时连续血糖监测系统（RT-CGMS）在 CHH 新生儿中的疗效和准确性。
将与 RT-CGMS 相连的传感器插入新生儿患者体内，并在其住院期间至少维持 6 天。我们使用 Bland-Altman 分析比较 CGMS 读数与毛细血管血糖值。
共比较了 110 个血糖值与 CGMS 的读数。所有结果均进行了计算，并绘制了 CGMS 值在毛细血管血糖采样后 0-4、5-9、10-14、15-19、20-24 和 25-29 分钟时的结果。CGMS 读数与血糖值高度相关，尤其是在血糖正常时。在低血糖的情况下，CGMS 和毛细血管葡萄糖值之间的平均差异更高。尽管 CGMS 的低血糖假阳性率相对较高，但 RT-CGMS 可能比血液测量更早地显示一些低血糖发作。
RT-CGMS 在血糖正常时准确，可减少 CHH 患儿的毛细血管采血次数。
