Continuous glucose monitoring in very low birth weight infants – a systematic review

Abstract

Introduction: Dysglycemic events are common occurrences in preterm infants. This imbalance of blood glucose levels could lead to an increased risk of death, sepsis, neurosensorial impairment, retinopathy of prematurity, among other unfavorable consequences. Continuous glucose monitoring (CGM) allows for early detection of dysglycemic events. This systematic review aims to assess the impact of CGM in glycemic values of preterm infants. 

Methods: We thoroughly searched several electronic databases from August 2020 to February 2021, we included randomized control trials regarding newborn infants with birth weight < 1,500 g, gestational age < 37 weeks, and postnatal life < 28 days, that compared intermittent methods vs continuous methods concerning glucose measurement. Primary outcomes were percentage of time spent in euglycemic range, number of dysglycemic episodes, and mortality. 

Results: Three studies were included after screening, comprising a combined total of 278 preterm newborns. Two studies reported an increase in time spent in euglycemic range in the CGM group (83% vs 71% and 94% vs 84%). There were limitations in study design of included studies, interventions and outcomes evaluated differed between included studies; as such, comparisons between studies were difficult. 

Conclusions: CGM allows for better glycemic control, reduces the number of painful readings, allows for early detection of dysglycemic events, and reduces time spent in dysglycemic states (both hyperglycemia and hypoglycemia) when combined with corrective measures. Further research needs to be conducted to evaluate the long-term impact of CGM in the neurosensorial and physical development of preterm infants.