Glucose Monitoring Shows Dysglycaemia in Premature Infants

TOPLINE:

In very low birth weight (VLBW) infants, continuous glucose monitoring (CGM) at 36 weeks of postmenstrual age (PMA) revealed subclinical dysglycaemia; male infants showed prolonged hyperglycaemia, and prior insulin therapy predicted extended hypoglycaemia.

METHODOLOGY:

• Researchers evaluated the prevalence of dysglycaemia in VLBW infants at 36 weeks of PMA through CGM and investigated associated risk factors.
• The prospective cohort included 35 VLBW infants (mean gestational age, 27.3 weeks; 65.7% female infants; mean birth weight, 929 g) who were assessed at 36 weeks from 2016 to 2019.
• CGM was performed at 36 weeks of PMA using a blinded Dexcom G4 sensor for 48 hours, with dysglycaemia defined as glucose concentrations > 8 mmol/L (hyperglycaemia) or < 2.6 mmol/L (hypoglycaemia) sustained for at least 30 minutes.
• Researchers analysed risk factors (sex and prior insulin therapy) against capillary glucose correlations.

TAKEAWAY:

• Overall, dysglycaemia was detected in 68.6% of infants; 28.6% of infants had hyperglycaemia alone, 17.1% had hypoglycaemia alone, and 22.9% had both.
• Male sex was linked to a longer duration of hyperglycaemia (B = 252.172; CI, 101.484-402.86; P = .002).
• Prior insulin treatment led to an increase in the duration of hypoglycaemia (B = 68.607; CI, 9.932-127.283; P = .023).
• Lower birth size and bronchopulmonary dysplasia were also associated with dysglycaemia.

IN PRACTICE:

“Male sex is associated with longer time spent in hyperglycemia and insulin treatment during the admission period is associated with longer time spent in hypoglycemia nearing term age. It is possible that these infants may require more rigorous monitoring of their glucose concentrations even when nearing term age,” the authors wrote.

SOURCE:

This study was led by Itay Nilsson Zamir, Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden. It was published online on June 27, 2025, in the European Journal of Pediatrics.

LIMITATIONS:

The single-centre study design and small sample size may have limited generalisability. The CGM device used (Dexcom G4) had a higher-than-ideal mean absolute relative difference (18.8%). Calibrations relied on point-of-care glucometers rather than on laboratory-analysed values.

DISCLOSURES:

This study was supported by research grants from Umeå University and other sources. The CGM system was donated by Dexcom Inc., which had no role in the study design, data analysis, or publication. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.