ADA: Use of a Continuous Glucose Monitoring System to Treat Hypoglycemia in Infants and Children

CGMS is a useful adjunct in the diagnosis and evaluation of hypoglycemia. 

The purpose of the study was to evaluate the use of a continuous glucose monitoring system (CGMS) in the evaluation and treatment of infants and children with hypoglycemic disorders. 

Patients with hypoglycemic disorders were admitted to the Pediatric Clinical Research Center and wore the CGMS device during their evaluation and treatment. Glucometer values were obtained at least 3 times each day and entered into the device for calibration purposes. The monitor was downloaded to a computer where the CGMS signal was converted to glucose values. We compared readings from CGMS to those obtained via glucometer. We evaluated the number of hypoglycemic episodes below 60 mg/dl detected by CGMS compared to glucometer and characterized episodes by their duration and severity.  

Five patients with hypoglycemic disorders were included in the study. There were a total of 13,369 sensor points, 343 paired sensor and glucometer data points, and 57 days included. A total of 180 episodes of hypoglycemia occurred in these 5 patients, with an average duration of 55 +/- 13 minutes. Forty-four percent of the episodes were 15-60 minutes and 25% were greater than 60 minutes in duration. Using a cut-off of 60 mg/dl for hypoglycemia, the sensor had a sensitivity of 65.4%, specificity of 90.6%, and false positive rate of 42.9%. The positive and negative predictive values were 57.1% and 93.2%, respectively. In a Clarke Error Grid analysis, 96.2% of paired values were in the clinically acceptable range. 

From the study it was concluded that CGMS is a useful adjunct in the diagnosis and evaluation of hypoglycemia, and for documentation of euglycemia in these patients following therapy. CGMS should be used in conjunction with frequent glucometer checks and careful clinical assessments.  American Diabetes Association's 62nd Annual Scientific Sessions

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