The continuous glucose monitoring system correlates poorly with the glucose infusion rate

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.