Musso Valeria, Panfoli Isabella, Battaglini Marcella, Brigati Giorgia, Minghetti Diego, Andreato Chiara, Ramenghi Luca A
Pediatric and Neonatology Unit, Istituto Giannina Gaslini, 17100 Savona, Italy.
Department of Pharmacy (DIFAR), University of Genoa, 16132 Genova, Italy.
Antioxidants (Basel). 2022 Sep 29;11(10):1945. doi: 10.3390/antiox11101945.
Glycemic variability (GV) is common in preterm infants. In the premature population, GV is a risk factor for morbidity and mortality. Both hypo- and hyperglycemia can impair neurodevelopment. We investigated the impact of continuous versus intermittent tube enteral feeding on GV. In our prospective observational study, 20 preterm infants with a gestational age ≤ 34 weeks at either continuous or intermittent bolus full enteral feeding. For five days, continuous glucose monitoring (CGM) was utilized, which was achieved through the subcutaneous insertion of a sensor. A total of 27,532 measurements of blood glucose were taken. The mean amplitude of glycemic excursions did not differ between the two cohorts statistically. Continuous feeding resulted in higher positive values, increasing the risk of hypo- and hyperglycemia. Subjects who were small for their gestational age had a higher standard deviation during continuous feeding ( = 0.001). Data suggest that intermittent bolus nutrition is better for glycemic control than continuous nutrition. Nutritional management optimization of preterm infants appears to be critical for long-term health. In the future, CGM may provide a better understanding of the optimal glucose targets for various clinical conditions, allowing for a more personalized approach to management.
血糖变异性（GV）在早产儿中很常见。在早产人群中，GV是发病和死亡的危险因素。低血糖和高血糖都会损害神经发育。我们研究了持续管饲与间歇管饲对GV的影响。在我们的前瞻性观察研究中，20名胎龄≤34周的早产儿接受持续或间歇推注全肠内喂养。连续五天，通过皮下插入传感器进行持续葡萄糖监测（CGM）。共进行了27532次血糖测量。两组之间血糖波动的平均幅度在统计学上没有差异。持续喂养导致更高的正值，增加了低血糖和高血糖的风险。小于胎龄儿在持续喂养期间标准差更高（P = 0.001）。数据表明，间歇推注营养在血糖控制方面优于持续营养。早产儿的营养管理优化对长期健康似乎至关重要。未来，CGM可能有助于更好地了解各种临床情况下的最佳血糖目标，从而实现更个性化的管理方法。
