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dc.contributor.authorThomson, Lynn
dc.contributor.authorElleri, Daniela
dc.contributor.authorBond, Simon
dc.contributor.authorHowlett, James
dc.contributor.authorDunger, David
dc.contributor.authorBeardsall, Kathryn
dc.date.accessioned2018-11-24T00:30:57Z
dc.date.available2018-11-24T00:30:57Z
dc.date.issued2019-07
dc.identifier.issn1468-2052
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/285928
dc.description.abstractOBJECTIVE: Hyperglycaemia is common in very preterm infants and is associated with adverse outcomes. Preventing hyperglycaemia without increasing the risk of hypoglycaemia is difficult. Real time tracking with continuous glucose monitors (CGM) may improve glucose control. We assessed the feasibility and safety of CGM to target glucose control in preterm infants, to inform a randomised controlled trial (RCT). DESIGN: We performed a single centre study in very preterm infants during the first week of life. Accuracy was assessed by comparison of CGM with blood glucose levels (n=20 infants). In a separate pilot study of efficacy (n=20), real-time CGM combined with a paper guideline to target glucose control (2.6-10 mmol/L) was compared with standard neonatal care (masked CGM). Questionnaires were used to assess staff acceptability. RESULTS: No concerns were raised about infection or skin integrity at sensor site. The sensor performed well compared with point-of-care blood glucose measurements, mean bias of -0.27 (95% CI -0.35 to -0.19). Per cent time in target range (sensor glucose 2.6-10 mmol/L) was greater with CGM than POC (77% vs 59%, respectively) and per cent time sensor glucose >10 mmol/L was less with CGM than POC (24% vs 40%, respectively). The CGM also detected clinically unsuspected episodes of hypoglycaemia. Staff reported that the use of the CGM positively improved clinical care. CONCLUSIONS: This study suggests that CGM has sufficient accuracy and utility in preterm infants to warrant formal testing in a RCT.
dc.description.sponsorshipFunding was provided by the Efficacy and Mechanism Evaluation (EME) Programme, an MRC and NIHR partnership and the Evelyn Trust, Cambridge. Medtronic provided the CGM system and sensors, and support was received from the NIHR Cambridge Biomedical Research Centre. Medtronic had no role in design of the study, the gathering of data, access to data, preparation of the manuscript or decision to publish the results. The study was jointly sponsored by the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust.
dc.languageeng
dc.publisherBMJ Publishing Group
dc.subjectcontinuous glucose monitoring
dc.subjectglucose
dc.subjecthyperglycaemia
dc.subjecthypoglycaemia
dc.titleTargeting glucose control in preterm infants: pilot studies of continuous glucose monitoring.
dc.typeArticle
prism.publicationNameArchives of Disease in Childhood: Fetal and Neonatal Edition
dc.identifier.doi10.17863/CAM.33255
dcterms.dateAccepted2018-08-20
rioxxterms.versionofrecord10.1136/archdischild-2018-314814
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-08-20
dc.contributor.orcidBond, Simon [0000-0003-2528-1040]
dc.contributor.orcidHowlett, James [0000-0001-9274-5170]
dc.contributor.orcidDunger, David [0000-0002-2566-9304]
dc.contributor.orcidBeardsall, Kathryn [0000-0003-3582-183X]
dc.identifier.eissn1468-2052
rioxxterms.typeJournal Article/Review
pubs.funder-project-idMedical Research Council (MC_UU_12012/5)
pubs.funder-project-idNETSCC (None)
cam.issuedOnline2018-09-19
rioxxterms.freetoread.startdate2019-09-19


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