Ohishi Akira, Ueno Daizo, Fujita Tomoka, Segawa Yuki, Yamamoto Takuya, Fujisawa Yasuko, Iijima Shigeo
Maternal-Fetal and Neonatal Care Center, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Department of Regional Neonatal and Perinatal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Pediatr Int. 2023 Jan-Dec;65(1):e15616. doi: 10.1111/ped.15616.
Hypoglycemia is a significant problem for all neonates and requires minimally invasive and reliable monitoring. The primary objective of this study was to verify the safety and accuracy of the continuous glucose monitoring (CGM) of full-term neonates using Freestyle Libre, a flash glucose monitoring (FGM) device.
The study was conducted on 20 neonates. Shortly after birth, we placed the FGM sensor on the outside of the neonates' thighs. We scanned the CGM values at 60, 120, 180, and 360 min after birth and simultaneously obtained blood glucose values with plantar capillaries by heel puncture. The neonates wore the sensors for up to 6 h and then they were removed.
Of the 75 data points to be measured, 65 points (86.7%) were obtained by scan. There was no change in the sensor attachment site in 12 of 18 completed cases in this study but we observed slight induration in four cases (22.2%) and slight redness in one case (5.5%) at the sensor puncture site. A moderate correlation was observed between the CGM and blood glucose values. The CGM values tended to be low at 120, 180, and 360 min after birth, and tended to be high only at 60 min after birth.
The CGM device was safe to wear on the neonate and the CGM data correlated well with blood glucose levels. There was dissociation between CGM data and blood glucose levels in the acute period soon after birth when the blood glucose levels changed rapidly.
低血糖是所有新生儿面临的一个重要问题,需要微创且可靠的监测。本研究的主要目的是验证使用瞬感血糖仪(一种实时葡萄糖监测(FGM)设备)对足月儿进行连续葡萄糖监测(CGM)的安全性和准确性。
该研究对20名新生儿进行。出生后不久,我们将FGM传感器置于新生儿大腿外侧。在出生后60、120、180和360分钟扫描CGM值,并同时通过足跟穿刺采集足底毛细血管血糖值。新生儿佩戴传感器长达6小时,之后将其取下。
在需测量的75个数据点中,通过扫描获得了65个点(86.7%)。本研究中18例完成监测的病例里有12例传感器附着部位无变化,但我们观察到4例(22.2%)在传感器穿刺部位有轻微硬结,1例(5.5%)有轻微发红。CGM值与血糖值之间存在中度相关性。出生后120、180和360分钟时CGM值往往较低,仅在出生后60分钟时往往较高。
CGM设备佩戴在新生儿身上是安全的,且CGM数据与血糖水平相关性良好。在出生后血糖水平快速变化的急性期,CGM数据与血糖水平存在分离。