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Cited by 31Diabetes Management and ResearchPancreatic function and diabetesDiabetes and associated disorders

Continuous glucose monitoring systems: are they useful for evaluating glycemic control in children with hyperinsulinism

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Rayannavar, Arpana, Elci, Okan U., Mitteer, Lauren, De León, Diva D.·2019·Hormone Research in Paediatrics
DOI 10.1159/000506230PMC PMC7192768
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Abstract

Background: Effective treatment and close monitoring in children with congenital hyperinsulinism (HI) are important to prevent hypoglycemic-associated brain damage. The current monitoring approach involves measuring plasma glucose intermittently, but this does not provide a comprehensive assessment of glycemic control and may fail to detect episodes of hypoglycemia. Objective: To determine whether Dexcom G5®, a continuous glucose monitoring system (CGMS), is an accurate and effective method for monitoring glycemic control in children with HI. Methods: Cross-sectional, observational study in 15 children with HI. Participants wore a blinded Dexcom G5® device for 2 weeks. At the end of 2 weeks, data from the Dexcom G5® and home glucose meter were downloaded and analyzed. Results: Fourteen children (15–67 months) completed the study. Using Bland-Altman analysis, the mean (SD) difference between 1,155 paired CGM and glucose meter readings was –8.09 (53.76). The sensitivity and specificity of CGM to detect hypoglycemia (<70 mg/dL) were 86 and 81.4%, respectively. The positive predictive values for hypoglycemia and severe hypoglycemia (<54 mg/dL) detected by CGM were low (50.3 and 14.8%, respectively), while the negative predictive values were high (96.4% for glucose <70 mg/dL and 99.1% for glucose <54 mg/dL). Conclusion: Our study showed that CGM is not a reliable method to monitor for hypoglycemia, given the high number of false positive hypoglycemia readings. However, CGM can be useful in preventing unnecessary checks by glucose meter during times of normoglycemia. Therefore, the benefits of using CGM in patients with HI would be in guiding the need to check plasma glucose by glucose meter rather than point accuracy.

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  • The highest hypoglycaemia sensitivity of continuous glucose monitoring was reported at 86% with a hypoglycaemia threshold of 3.9 mmol/L.

    “The lowest hypoglycaemia sensitivity was reported at 17% with a hypoglycaemia threshold of 2.6mmol/L (62), as opposed to the highest hypoglycaemia sensitivity of only 86% with a hypoglycaemia threshold of 3.9mmol/L (63).”

    From Hypoglycaemia in adrenal insufficiency (2023) · cites this paper as [63]

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Authors
Rayannavar, A., Elci, O. U., Mitteer, L., & De León, D. D.
Affiliations
  • Children's Hospital of Philadelphia (US)
  • Westat (United States) (US)
ORCID
Venue
Hormone Research in Paediatrics
Publisher
S. Karger AG
Published
2019
Volume
92
Issue
5
Pages
319-327
ISSN
  • 1663-2818 (ISSN-L)
  • 1663-2826
DOI
10.1159/000506230
PMC
PMC7192768
OpenAlex
W3012856489
Cited by
31
References
13
Citations by year
2026: 2 · 2025: 1 · 2024: 6 · 2023: 8 · 2022: 8 · 2021: 4 · 2020: 2
FWCI
2.84
Type
journal article
Language
en
Open access
Licence
Locations
  • Hormone Research in Paediatrics (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (T32DK063688)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Keywords
continuous glucose monitoring, congenital hyperinsulinism, glycemic control, hypoglycemia detection, children, glucose meter accuracy, hypoglycemia prevention
MeSH terms
Blood Glucose, Brain Injuries, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Hyperinsulinism, Hypoglycemia, Infant, Male, Monitoring, Physiologic

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