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 pre- term admitted to the neonatal intensive care unit. Study design We analyzed paired CGM sensor glucose (SG) and point-of-care blood glucose (BG) measure- ments collected in infants born at <= 32 weeks of gestation or with a birth weight <= 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 501 SG-BG paired measurements from 51 infants (age 30.5 weeks [IQR 29.0-31.0 weeks], birth weight 1400 g [IQR 1100-1500 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 clin- ically acceptable when the sensor is regularly calibrated. (J Pediatr 2025;278:114416).