Continuous Glucose Monitoring among Infants Born Very Preterm: Evidence for Accuracy in Neonatal Intensive Care

Objective: To evaluate the accuracy of a device for continuous glucose monitoring (CGM) among infants born preterm admitted to Neonatal Intensive Care Unit. Study design: We analyzed paired CGM sensor glucose (SG) and point-of-care blood glucose (BG) measurements collected in infants born at <32 weeks of gestation or birthweight <1500 g. CGM was initiated within 48 hours from birth and maintained for 5 days. BG was performed every 12 hours and used to calibrate the sensor. Measures of CGM accuracy were computed from SG and BG pairs. Results: We included paired measurements from 501 SG-BG from 51 infants (age 30.5 weeks [interquartile range {IQR} 29.0 to 31.0 weeks], birthweight 1400 g [IQR 1100 to 1500 g] with at least 24 hours of CGM data. The mean absolute relative difference (MARD) between SG and point-of-care BG measures was 7.1% [IQR 5.6-9.3] corresponding to a difference of -5.6 mg/dL [95% CI -25 to +14 mg/dl]. The median sensor use was 96 hours [IQR 72-120] with 2.0 [IQR 1.7-2.4] calibrations per day. Conclusions: Accuracy of SG measurements compared with BG measurements appears to be acceptable in a clinical study setting, with a negligible difference between SG and BG. Our data suggest that SG use may be clinically acceptable when the sensor is regularly calibrated.