CGM may help prevent blood sugar swings in preterm infants in ICU: Lancet

UK: The use of real-time Continuous glucose monitoring (CGM) in preterm infants requiring intensive care can aid earlier detection and prevention of exposures to the extremes of both hypoglycemia and hyperglycemia, show results from REACT trial.

The findings of the study were published in The Lancet Child & Adolescent Health.

Low (hypoglycemia) and high blood sugar levels (hyperglycemia) are common in preterm infants and are associated with an increased risk of morbidity and mortality. Owing to the infrequent measurement of blood sugar concentrations, interventions to reduce the risk associated with these exposures are particularly challenging with the potential of causing more harm than doing good. 

Continuous glucose monitoring (CGM) is widely used for improving blood sugar control in adults and children with diabetes but has not been approved for use in neonates. Considering this, Kathryn Beardsall, Department of Paediatrics, University of Cambridge, Cambridge, UK, and colleague aimed to evaluate the efficacy and safety of CGM in preterm infants requiring intensive care (REACT trial).

For this purpose, the researchers performed an international, open-label, randomized controlled trial across 13 neonatal intensive care units in the UK, Spain, and the Netherlands. It included infants who were within 24 h of birth, had a birthweight of 1200 g or less, had a gestational age up to 33 weeks plus 6 days, and had parental written informed consent. 180 of whom were randomly assigned in the ratio of 1:1 to real-time CGM (n=85) or standard care (n=95) (with masked CGM for comparison).